Body checking scores were significantly higher in APED users than in non-users with a medium effect size (Cohen, 1988
). Because body checking behaviors may maintain eating- and body-related psychopathology (Shafran et al., 2004
), addressing body checking behaviors in therapy may reduce body image dissatisfaction in men, and consequently reduce the desire to use APEDs. Body checking behaviors were significantly correlated with depression, desired BMI increase, negative affect, and symptoms of MD, as well as weight and shape concern, as has been reported in previous literature (Grilo et al., 2005
; Latner, 2008
; Reas et al., 2005
). As hypothesized, some body checking behaviors were normally distributed amongst participants, whereas others were less common in the non-clinical male sample. In addition, particular items appear to be significant predictors of MD, depression, and shape and weight concern.
Because MD is partly defined by extreme concern with shape and weight and is associated with a great deal of distress and impairment, these factors likely explain a significant proportion of the variance in MDDI scores. Even when partialing out variance accounted for by depression and concern with shape and weight, body checking uniquely explained the greatest proportion of variance in MD. When MDDI subscales were considered separately, body checking uniquely explained a significant proportion of the variance in drive for size and was the only significant predictor of functional impairment. However, body checking was not a significant predictor of appearance intolerance. Appearance intolerance was best predicted by concern with shape and weight, which accounted for a third of the total variance.
Although body checking and avoidance behaviors are included as targets of change in the leading evidence-supported treatments for eating disorders, BDD, and body image dissatisfaction, the relationship between these behaviors and psychopathology is largely unknown. While some work has investigated these behaviors in females, very little research on this topic has included males, and the males in these studies were obese binge eaters, behavioral weight loss participants, and bariatric surgery patients (Grilo et al., 2005
; Latner, 2008
; Reas et al., 2005
). The nature of checking and avoidance behaviors in normal-weight, non-clinical males had not been previously examined. This study found that, in a sample of undergraduate males, body checking behavior was the best predictor of APED use when depression, weight and shape concern, MD, positive affect, and negative affect were included in the logistic regression analysis.
It was not until recent years that male eating and body image concerns were adequately addressed in the eating disorders and body image literature (Cafri, van den Berg, & Thompson, 2006
). Although a great wealth of information has accumulated in a short period of time, many questions remain unanswered. The male body ideal has become increasingly lean and muscular, such that media-portrayed ideals are often almost impossible to attain without the use of steroids. Our appearance-obsessed culture supports the development of body image dissatisfaction, eating disorders, exercise addiction, and overconcern with shape and weight; yet, our culture also stigmatizes males for expressing emotions and seeking treatment for mental health-related concerns (Courtenay, 2003
; Golberstein, Eisenberg, & Gollust, 2008
). Weight satisfaction and muscle satisfaction appear to be distinct constructs associated with distinct body change strategies, such as decreasing calories consumed and increasing calories burned to decrease body fat, and increasing calories and/or protein consumed, taking APEDs, and lifting weights to increase muscle mass (Stanford & McCabe, 2005
). When taken to extremes, any of these body change strategies can be deleterious to an individual's physical and mental health.
This study provides important information about body checking in normal-weight, non-clinical young men that had not been assessed before, which adds important information to the field regarding male body image dissatisfaction and its emotional (e.g., depression, concern with shape and weight, negative affect) and behavioral (e.g., body checking, APED use) correlates. In addition, this study suggests that APED use may not be as rampant a problem in university populations as had previously been reported (Olivardia et al., 2004
). In contrast to Olivardia and colleagues' data suggesting that 27% of participants had used APEDs, the proportion of participants endorsing having ever used APEDs in the current study was approximately half as much as had previously been reported.
One limitation of the current study is the homogeneity of the sample. The sample consisted of undergraduate students in the Northeast, the majority of whom reported that they were Caucasian, limiting the ability to generalize findings to populations from different regions of the country, different countries, different levels of education, different age groups, and to minority populations. In addition, this study was exploratory in nature: all findings are correlational so no causality can be inferred. Responses were self-report, so participants may not have felt comfortable reporting their true feelings and behaviors on questions involving sensitive topics; however, participants completed the online questionnaire in the location of their choice and the anonymity of their responses was strongly emphasized to increase willingness to disclose sensitive information. Also, all participants whose data were included in the analyses gave reasonable responses for demographic information questions like height and weight and responded “No” to the screening questions included in the APED use section. Although the sample was homogeneous, young men may be particularly at risk for body image dissatisfaction and potentially dangerous body change strategies. Determining correlates of APED use and MD may inform prevention and treatment in this at-risk group.
This study is the first to report body checking behaviors in normal-weight males. It adds valuable information to the literature about the nature of body checking behavior and its correlates in undergraduate males, about which little has been reported thus far. In addition, the study had a large sample size, which improves the power of the statistical analyses, enabling tentative conclusions to be drawn regarding behaviors (e.g., steroid use) and psychopathology (e.g., MD) that have relatively low base rates. Future research should examine body checking and avoidance in more diverse populations. In addition, longitudinal and experimental studies of body checking and avoidance would help determine causality among variables of interest. Studies that assess the contingencies that maintain these behaviors may help determine their function. Finally, studies that manipulate whether or not body checking and avoidance behavior are addressed in treatment would answer questions regarding the clinical significance of these behaviors in the maintenance of eating- and body-related psychopathology and would elucidate the utility of addressing body checking and avoidance in treatment.