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Running head: BODY FUNCTIONALITY PROGRAMME 1
This is the author’s version of the accepted manuscript:
Alleva, J. M.,* Martijn, C., Van Breukelen, G. J. P., Jansen, A., & Karos, K. (2015). Expand
Your Horizon: A programme that improves body image and reduces self-objectification by
training women to focus on body functionality. Body Image, 15, 81-89.
http://dx.doi.org/10.1016/j.bodyim.2015.07.001
© 2015. This manuscript is made available under the CC-BY-NC-ND 4.0 license.
https://creativecommons.org/licenses/by-nc-nd/4.0/
* Corresponding author. E-mail address: jessica.alleva@maastrichtuniversity.nl
BODY FUNCTIONALITY PROGRAMME 2
Abstract
This study tested Expand Your Horizon, a programme designed to improve body image by
training women to focus on the functionality of their body using structured writing
assignments. Eighty-one women (Mage = 22.77) with a negative body image were randomised
to the Expand Your Horizon programme or to an active control programme. Appearance
satisfaction, functionality satisfaction, body appreciation, and self-objectification were
measured at pretest, posttest, and one-week follow-up. Following the intervention,
participants in the Expand Your Horizon programme experienced greater appearance
satisfaction, functionality satisfaction, and body appreciation, and lower levels of self-
objectification, compared to participants in the control programme. Partial eta-squared effect
sizes were of small to medium magnitude. This study is the first to show that focusing on
body functionality can improve body image and reduce self-objectification in women with a
negative body image. These findings provide support for addressing body functionality in
programmes designed to improve body image.
Keywords: body functionality, body image, body appreciation, self-objectification,
programme, intervention
BODY FUNCTIONALITY PROGRAMME 3
Expand Your Horizon: A programme that improves body image and reduces self-
objectification by training women to focus on body functionality
Approximately 60% of women have a negative body image (Tiggemann, 2004), which
is characterised by negative feelings, cognitions, behaviours, and perceptions regarding an
individuals’ own body (Garner & Garfinkel, 1981; Rosen, Saltzberg, & Srebnik, 1989;
Thompson, Heinberg, Altabe, & Tantleff-Dunn, 1999). Negative body image is a risk factor
for numerous unhealthy behaviours including fasting, self-induced vomiting, laxative misuse,
and excessive exercise (Cafri et al., 2005; Neumark-Sztainer, Paxton, Hannan, Haines, &
Story, 2006), and is associated with low self-esteem (Cash & Fleming, 2002a), depression
(Paxton, Neumark-Sztainer, Hannan, & Eisenberg, 2006), impaired sexual functioning
(Weaver & Byers, 2006), and a diminished quality of life (Cash & Fleming, 2002b). In
addition, negative body image is a main risk factor for the development and maintenance of
an eating disorder (Stice, 2002) and predicts treatment response and relapse in women who
have developed an eating disorder (Cash & Deagle, 1997; Rosen, 1996). For these reasons,
negative body image is an important target for intervention. The current study evaluates a
novel programme for improving body image, which centres on training women to focus on
the functionality of their body.
What is Body Functionality?
Body functionality is an aspect of body image that refers to everything that the body
can do (Abbott & Barber, 2010; Alleva, Martijn, Jansen, & Nederkoorn, 2014). It
encompasses body functions related to physical capacities (e.g., stamina; Abbott & Barber,
2010; Franzoi, 1995; Franzoi & Shields, 1984), health and internal processes (e.g., digestion;
Avalos & Tylka, 2006), as well as senses (e.g., sight), creative endeavours (e.g., dancing),
self-care (e.g., showering), and communication with others (e.g., via body language; Alleva et
al., 2014). Body functionality can also be seen as the “body as process” or “what is my body
BODY FUNCTIONALITY PROGRAMME 4
capable of?” component of body image, in contrast to physical appearance, which captures
the “body as object” or “how do I look?” component of body image (Franzoi, 1995;
Fredrickson & Roberts, 1997; see also Fox, 2003). In conceptualising body functionality, it is
important to keep in mind that it is not limited to physical capacities, which would position
body functionality as a construct that is restricted to able-bodied people (cf. Webb, Wood-
Barcalow, & Tylka, 2015), but also encompasses many functions that fall under the other
categories listed above.
How Might Focusing on Body Functionality Affect Women’s Body Image?
Body functionality and body satisfaction. Several studies have demonstrated that
focusing on body functionality is associated with higher levels of body satisfaction. For
example, interviews with women (Wood-Barcalow, Tylka, & Augustus-Horvath, 2010) and
adolescents (Frisén & Holmqvist, 2010) who score high on measures of body satisfaction
have shown that these individuals focus on the functionality of their body more than their
appearance and actively strive to take care of their body’s functions. In addition, across fitness
interventions designed to improve body image, objective changes in fitness (e.g., muscle tone)
explain less than 15% of variance in measures of body satisfaction (Martin Ginis & Bassett,
2011); it has been proposed that learning to focus on body functionality (more than
appearance) may play a larger role in explaining in fitness-related improvements in body
satisfaction (Boudette, 2006; Campbell & Hausenblas, 2009; Grogan, 2011; Martin &
Lichtenberger, 2002). Indeed, in contrast to exercising for appearance-related reasons (e.g.,
weight control), exercising for functionality-related reasons (e.g., health) has been associated
with higher levels of body satisfaction (e.g., DiBartolo, Lin, Montoya, Neal, & Shaffer 2007;
Gonçalves & Gomes, 2012; Hubbard, Gray, & Parker, 1998; Tiggemann & Williamson,
2000). Lastly, in an experimental study, Alleva, Martijn, Jansen, and Nederkoorn (2014)
demonstrated that focusing on body functionality leads to improvements in body satisfaction
BODY FUNCTIONALITY PROGRAMME 5
(specifically, satisfaction with body functionality) in undergraduate men and 30 to 50 year old
women.
Focusing on the functionality of the body may foster body satisfaction because it
encourages individuals to positively “reframe” (e.g., Lambert, Graham, Fincham, & Stillman,
2009) the way that they think about their body. Whereas an appearance-based focus on the
body often entails focusing on perceived imperfections (i.e., a negative orientation), which
may cause individuals to feel less satisfied with their body, a functionality-based focus on the
body entails focusing on what the body can do (i.e., a positive orientation), which may instead
generate positive feelings toward the body (Alleva, et al., 2014; Franzoi, 1995; Fredrickson &
Roberts, 1997; Tylka & Wood-Barcalow, 2015). Further, common conceptions of appearance
are often limited to few attributes (e.g., weight, measurements), whereas body functionality
encompasses a diverse range of attributes from which people can derive satisfaction. In
addition, in contrast to appearance, there is no overarching cultural ideal for body
functionality, so focusing on body functionality might be less likely to evoke body-related
social comparisons that can cause body dissatisfaction (Martin & Lichtenberger, 2002; Myers
& Crowther, 2007).
Body functionality and body appreciation. Focusing on body functionality has also
been related to body appreciation, which is an “unconditional approval and respect for the
body” (Avalos & Tylka, 2006; p. 486). For instance, Avalos and Tylka (2006) demonstrated
that a functionality-based focus on the body is related to greater body appreciation in samples
of undergraduate women. Similarly, interviews with women who score high on measures of
body satisfaction demonstrated that body appreciation was consistently linked with valuing
body functionality (e.g., “A big thing with my body is that it allows me to do physical activity
like hiking and biking;” Wood-Barcalow et al., 2010, p. 114). In addition, engaging in
physical activity that emphasises the functionality of the body has been related to higher
BODY FUNCTIONALITY PROGRAMME 6
levels of body appreciation (Langdon & Petracca, 2010; Swami & Tovée, 2009). Focusing on
body functionality may encourage individuals to realise how their body facilitates (e.g., via
physical movement), sustains (e.g., via digestion), and gives (e.g., via communicating with
others) regarding various aspects of their life, which should foster feelings of appreciation for
the body.
Body functionality and self-objectification. Objectification theory (Fredrickson &
Roberts, 1997) proposes that women in Western societies are routinely sexually objectified;
they are evaluated and valued predominantly based on their physical appearance, rather than
on their body functionality and internal qualities (e.g., personality). In other words, women
are seen as mere bodies, rather than as human beings (e.g., Haslam, Loughnan, & Holland,
2013; Heflick, Goldenberg, Cooper, & Puvia, 2011; Loughnan & Haslam, 2007; Vaes,
Paladino, & Puvia, 2011). Experiences of sexual objectification routinely occur in
interpersonal encounters (e.g., via the sexualised male gaze) and mass media (e.g., where
women are portrayed with an emphasis on their body or body parts, rather than on their face;
Archer, Iritani, Kimes, & Borrios, 1983; Fredrickson & Roberts, 1997; Halliwell, Malson, &
Tischner, 2011). According to objectification theory, living in a cultural milieu of sexual
objectification can socialise women to engage in self-objectification, meaning that they
evaluate and value their own body based on appearance, from a third-person “observer
perspective” instead of from a first-person perspective (Fredrickson & Roberts, 1997;
Huebner & Fredrickson, 1999). Self-objectification, in turn, can lead to serious consequences
such as negative body image, anxiety, depression, sexual dysfunction, and disordered eating
(see Moradi & Huang, 2008, for a review).
Focusing on body functionality has been related to lower levels of self-objectification.
For example, exercising for functionality-related reasons is associated with lower levels of
self-objectification (e.g., Prichard & Tiggemann, 2005; Strelan, Mehaffey, & Tiggemann,
BODY FUNCTIONALITY PROGRAMME 7
2003), as is engaging in physical activity that emphasises body functionality (Daubenmier,
2005; Impett, Daubenmier, & Hirschman, 2006; Prichard & Tiggemann, 2008; Tiggemann,
Coutts, & Clark, 2014). Conversely, the more that women engage in self-objectification, the
more they ‘disconnect’ from, and hold negative attitudes toward, their body functionality
(e.g., by concealing signs of their menstruation or decreased awareness of internal bodily
signals; Fredrickson & Roberts, 1997; Moradi & Huang, 2008; Roberts, 2000; Roberts &
Waters, 2004). Theoretically, a focus on body functionality is “antithetical” to self-
objectification, which entails emphasising appearance over body functionality (Roberts &
Waters, 2004; Webb et al., 2015). Focusing on body functionality may therefore decrease
self-objectification because it encourages women to think of their body as active, dynamic,
and instrumental, and consequently discourages them from thinking of their body as passive,
static, and aesthetic (Abbott & Barber, 2010; Fredrickson & Roberts, 1997; Moradi & Huang,
2008; Tiggemann, 2001; Tylka & Augustus-Horvath, 2011).
The Current Study
The aim of the current study is to investigate whether a programme designed to teach
women to focus on the functionality of their body can increase levels of body satisfaction and
body appreciation, and reduce levels of self-objectification. To do so, we created the Expand
Your Horizon programme, which trains women to focus on the functionality of their body
using three structured writing assignments (see Supplementary Materials). Although a handful
of body image interventions include aspects related to body functionality, such as encouraging
participants to engage in nonappearance-related experiences that induce a feeling of mastery
or pleasure (e.g., Cash, 2008; Fisher & Thompson, 1994; McLean, Paxton, & Wertheim,
2011), these aspects are small parts of broader intervention programmes. Expand Your
Horizon is unique in the extent of its focus on body functionality, and thus provides insight
BODY FUNCTIONALITY PROGRAMME 8
into the specific (causal) effects of focusing on body functionality on changes in women’s
body image.
We administered the Expand Your Horizon programme to a sample of 18 to 30-year-
old women with a negative body image, and employed a randomised controlled design with
an active control group and pretest, posttest, and one-week follow-up measurements. Based
on the foregoing discussion of the relation between focusing on body functionality and higher
levels of body satisfaction (e.g., Wood-Barcalow et al., 2010) and body appreciation (e.g.,
Avalos & Tylka, 2006), and lower levels of self-objectification (e.g., Roberts & Waters,
2004), we hypothesised that participants who receive the Expand Your Horizon programme
will experience: (1) improvements in body satisfaction, (2) an increase in body appreciation,
and (3) a decrease in self-objectification, at both posttest and follow-up, compared to
participants who receive the control programme.
Method
Participants
Women had to be between 18 and 30 years and have a sum score of ≥ 90 on the Body
Shape Questionnaire (BSQ; Cooper, Taylor, Cooper, & Fairburn, 1987) to be included in the
study (cf. McLean et al., 2011). A total of 167 women expressed interest in the study, of
which 145 filled in the BSQ. Eighty-seven women were eligible but six no longer responded
to our e-mails. Therefore, 81 women participated in the study; 41 were randomised to the
functionality group (i.e., the Expand Your Horizon programme) and 40 were randomised to
the control group. Participants were between 18 and 30 years (M = 22.77, SD = 3.19) with a
body mass index (BMI; BMI = weight in kilograms / height in metres squared) between 18.56
and 37.09 (M = 23.26, SD = 2.94). Note that BMI could not be calculated for 14 participants
because they did not provide information about their height and/or weight (height and weight
were self-reported). Participants’ BSQ scores ranged between 90 and 160 (M = 117.65, SD =
BODY FUNCTIONALITY PROGRAMME 9
19.69). Most participants identified as heterosexual (n = 74); two participants identified as
lesbian, two identified as bisexual, and three did not provide information about their sexual
orientation. The majority of participants (n = 55) were university students.
Measures
Screening measure. As aforementioned, the BSQ (Cooper et al., 1987) was used to
assess women’s eligibility to participate in the study. The BSQ contains 34 items (e.g., “Have
you felt so bad about your shape that you have cried?”), rated on a 6-point scale (1 = never to
6 = always), that assess individuals’ concerns about their body shape. Scores on the items of
the BSQ are summed, with higher scores reflecting higher levels of body concern. The BSQ
was chosen as a screening measure because it measures trait levels of body concern, is
relatively quick and easy to complete, and has demonstrated good internal consistency and
construct validity (Cooper et al., 1987; McLean et al., 2011).
Body satisfaction. Body satisfaction was measured using items from two
questionnaires: Items from the Multidimensional Body-Self Relations Questionnaire-
Appearance Subscales (MBSRQ-AS; Brown, Cash, & Mikulka, 1990; Cash, 2000) were used
to measure satisfaction with physical appearance, and items from the Body Esteem Scale
(BES; Franzoi & Shields, 1984) were used to measure satisfaction with body functionality.
The MBSRQ-AS consists of 34 items and comprises five subscales: Appearance
Evaluation, Appearance Orientation, Body Areas Satisfaction, Overweight Preoccupation, and
Self-Classified Weight. For the purpose of this study, only items of the Appearance
Evaluation Subscale (seven items; e.g., “I like my looks just the way they are”) and the Body
Areas Satisfaction Subscale (nine items; e.g., satisfaction with weight) were administered (cf.
Cash, 2000). The Appearance Evaluation Subscale is rated from 1 = definitely disagree to 5 =
definitely agree, and the Body Areas Satisfaction Subscale is rated from 1 = very dissatisfied
to 5 = very satisfied. We averaged scores on the items of these two subscales to create an
BODY FUNCTIONALITY PROGRAMME 10
index of appearance satisfaction; higher scores indicate greater appearance satisfaction. In
women, the Appearance Evaluation Subscale and the Body Areas Satisfaction Subscale
demonstrated good internal consistency and one month test-retest reliability (Cash, 2000). In
our sample, the internal consistency of the items of these two subscales (combined) at pretest,
posttest, and follow-up was, respectively, α = .83, .89, and .91.
The BES measures satisfaction with 35 body attributes that are rated on a 5-point scale
(1 = strongly dislike to 5 = strongly like), and consists of three subscales for women: Sexual
Attractiveness, Weight Concern, and Physical Condition. For the purpose of this study, only
the Physical Condition Subscale (nine items) was administered. Scores on the items of this
subscale (e.g., health, energy level) were averaged, with higher scores reflecting greater
functionality satisfaction. The BES evidenced adequate internal consistency and construct
validity in female undergraduates (Franzoi & Herzog, 1986; Franzoi & Shields, 1984). In this
study, the internal consistency of the Physical Condition Subscale at pretest, posttest, and
follow-up was, respectively, α = .83, .88, and .90.
Body appreciation. The Body Appreciation Scale (BAS; Avalos, Tylka, & Wood-
Barcalow, 2005) was used to measure body appreciation. The BAS consists of 13 items (e.g.,
“I respect my body”) that are rated on a 5-point scale (1 = never to 5 = always). Scores on the
13 items were averaged; higher scores indicate greater body appreciation. In female
undergraduates, the BAS demonstrated good internal consistency, three week test-retest
reliability, and construct validity (Avalos et al., 2005). In our sample, the internal consistency
of the BAS at pretest, posttest, and follow-up was, respectively, α = .86, .90, and .91.
Self-objectification. The Self-Objectification Questionnaire (SOQ; Noll &
Fredrickson, 1998) and the Objectified Body Consciousness Scale (OBC; McKinley & Hyde,
1996) were used to measure self-objectification. The SOQ instructs participants to rank 10
body attributes according to how important they are to their physical self-concept, ranging
BODY FUNCTIONALITY PROGRAMME 11
from least important to most important. Five of the attributes are related to appearance (e.g.,
weight) and five are related to functionality (e.g., health). In scoring the SOQ, participants’
most important attribute is given a score of 9, the second-most important attribute is given a
score of 8, the third-most important attribute is given a score of 7, and so on (with the lowest-
ranked attribute given a score of 0). Then, the sum of the scores for the functionality-related
attributes is subtracted from the sum of the scores for the appearance-related attributes. Final
SOQ scores range from -25 to 25, with higher scores reflecting higher levels of self-
objectification. The SOQ demonstrated satisfactory construct validity in female
undergraduates (Noll & Fredrickson, 1998).
The OBC consists of 24 items that are measured on an 8-point scale (1 = strongly
disagree to 7 = strongly agree, with a “does not apply” response option) and comprises three
subscales: Body Surveillance, Body Shame, and Control Beliefs. For the purpose of this
study, only the Body Surveillance Subscale (eight items) was used. Scores on the items of this
subscale (e.g., “During the day, I think about how I look many times”) were averaged, with
higher scores reflecting a stronger tendency to think of the body in terms of appearance. In
female undergraduates, the OBC evidenced good internal consistency and construct validity
(McKinley & Hyde, 1996). In our sample, the internal consistency of the Body Surveillance
Subscale at pretest, posttest, and follow-up was, respectively, α = .72, .82, and .81.
Procedure
Participants were recruited using advertisements on university and college campuses,
at supermarkets, gyms, and libraries, and two participant recruitment websites (i.e., websites
that individuals can use to search for studies that they can participate in), for a study about
“body image improvement programmes.” When women expressed interest in the study, they
filled in an electronic version of the BSQ and were invited to participate if they met the cut-
off score. Note that participants were aware that the study comprised two programmes and
BODY FUNCTIONALITY PROGRAMME 12
that they would be randomised to one of the two. However, participants were not given
information about the content of the programme until they were randomised to either the
functionality or control group (using Graph Pad Software, 2012). The entire study took place
online using Qualtrics Research Suite (Qualtrics, 2013), via which participants could
electronically fill in the measures as well as type and submit their writing assignment
responses. First, participants signed an electronic informed consent sheet and then completed
the pretest measures and first writing assignment. Two days later, participants completed the
second writing assignment. Two days afterward, they completed the third writing assignment
and then they immediately completed the posttest measures. One week later, participants
completed the follow-up measures. All measures were administered at all three time points.
Participants received reminder e-mails 24 hours before each test day and if they did not
complete the measures and writing assignments on time. Note that Qualtrics Research Suite
affords researchers direct insight into the completeness and content of participants’ writing
assignment responses and questionnaire data. In addition, for each writing assignment
participants reported the time that they started writing and the time that they finished writing.
At the end of the study, participants were debriefed and received a 10 Euro voucher. Ethical
approval was obtained by the ethics committee of Maastricht University.
The Programmes
The Expand Your Horizon programme consists of three structured writing
assignments. At the start of the programme, participants are given a brief introduction to body
functionality – including a list of examples of body functions – and why it is important. Each
of the three writing assignments focuses on two different areas of body functionality: The first
focuses on the body’s senses and physical capacities, the second focuses on health and
creative endeavours, and the third focuses on self-care and communication with others.
Participants may refer back to the list of body functions throughout the programme. For each
BODY FUNCTIONALITY PROGRAMME 13
writing assignment, participants describe the functions that their body performs (regarding the
respective areas of body functionality) and why they are personally important and meaningful
to them. The guidelines are that participants should: (1) try to write for at least 15 minutes, (2)
not stop writing once started, and (3) reread what they have written once finished writing
(note that they are not given instruction to edit their response). Participants are reminded not
to worry about spelling or grammar, and that their response will be unique because everyone’s
body is different (see Supplementary Materials to access the materials of the Expand Your
Horizon programme).
The active control programme was a “creativity training programme.” The first
writing assignment provided an introduction to the concept of creativity and why it is
important to develop creative skills (e.g., for fostering overall well-being). Participants were
told that the programme would help them to improve their creative skills by working on a
series of fictional short stories. The first writing assignment instructed participants to select a
main character (not themselves), setting, and plot for their story, and to write using as much
detail as possible. In the second and third writing assignments, participants were instructed to
choose a different main character, setting, and plot than they did in the previous writing
assignment(s). The three guidelines for the Expand Your Horizon programme (mentioned
above) were also used for this active control programme.
Statistical Analyses
The data were analysed in a series of 2 (Group: functionality vs. control) x 2 (Time:
posttest vs. follow-up) mixed repeated measures ANCOVAs, with grand-mean centred pretest
scores on the respective outcome as covariate (that is, for each outcome, the sample mean was
subtracted from each individual’s score on that outcome). This method of analysis (i.e., using
grand-mean centred pretest scores as covariate) is superior to analysing the data with pretest
as a repeated measure because it increases the power and reduces the risk of Type I errors
BODY FUNCTIONALITY PROGRAMME 14
arising from multiple testing (Van Breukelen, 2013; see Van Breukelen & Van Dijk, 2007, for
details about this method of analysis).
As a first step for each analysis, we checked the presence of Group x Time x Pretest
and Group x Pretest interactions. These interactions were not significant for any of the
outcomes and were therefore excluded from the statistical models. The analyses were then
rerun in a second step with only the Group x Time and Time x Pretest interactions, as well as
the main effects of Group, Time, and Pretest. Additionally, each of these analyses was rerun
with BMI as a covariate; however, adding BMI as a covariate did not affect the results, and
there were no Group x BMI interactions. The reported results are therefore based on the
statistical models without BMI.
For the primary outcome (body satisfaction: appearance and functionality satisfaction)
an alpha of .05 was chosen; to control for multiple testing, a stricter alpha of .01 was chosen
for the secondary outcomes (body appreciation and self-objectification; Howell, 2009). To
control for attrition bias, we conducted intention-to-treat analyses where missing data were
imputed using participants’ corresponding data at the previous time point. Outliers were
defined as values that were more than 3 SD above or below the group mean; these values were
replaced with the boundary values identified (i.e., the group mean plus or minus 3 SD). We
calculated partial eta-squared as effect sizes for each main effect and interaction effect, where
η𝑝
2 = 0.01, 0.06, and 0.14 constitute small, medium, and large effect sizes, respectively. It can
be shown that for the Group main effect of interest these values correspond to values of
Cohen’s d effect size equal to 0.20, 0.50 and 0.80, respectively (Cohen, 1988). Partial eta-
squared was chosen instead of Cohen’s d because the latter is defined only for a between-
subject effect, not for within-subject effects or interaction effects.
Results
Missing Data, Outliers, and Pretest Scores
BODY FUNCTIONALITY PROGRAMME 15
Three participants (Nfunctionality = 2) dropped out after pretest, and one participant in the
functionality group dropped out halfway through the online follow-up measurement. The
resulting missing values were imputed as aforementioned to include all participants in the
analyses. Two outliers were identified and replaced: One outlier was in the functionality
group and concerned pretest data for functionality satisfaction; the second was in the control
group and concerned posttest data for self-objectification (OBC Body Surveillance Subscale).
Table 1 presents pretest, posttest, and follow-up scores on all outcomes for the functionality
and control groups. As expected given the randomisation of participants to condition, there
was no significant group difference on any outcome at pretest: appearance satisfaction, F(1,
79) = 2.43, p = .12, η𝑝
2 = 0.03; functionality satisfaction, F(1, 79) = 0.670, p = .42, η𝑝
2 = 0.01;
body appreciation, F(1, 79) = 3.01, p = .09, η𝑝
2 = 0.04; self-objectification (SOQ), F(1, 75) =
0.06, p = .81, η𝑝
2 = 0.001; and self-objectification (OBC Body Surveillance Subscale), F(1,
79) = 1.07, p = .30, η𝑝
2 = 0.01.
Adherence to Programme Instructions
The content of participants’ writing assignment responses was checked and the self-
reported time spent on each writing assignment was calculated. The content of all
participants’ writing assignment responses was in line with the instructions of their respective
programme. For all three writing assignments there was no group difference in the amount of
self-reported time spent writing, all ps > .05.
Body Satisfaction
With regard to appearance satisfaction, the analyses revealed a significant main effect
of Group, F(1, 78) = 4.44, p = .038, η𝑝
2 = 0.05, indicating that, overall, participants in the
functionality group felt more satisfied with their appearance than participants in the control
group. The difference in appearance satisfaction between groups was the same at posttest as at
follow-up, as demonstrated by the nonsignificant Group x Time interaction, F(1, 78) = 0.26, p
BODY FUNCTIONALITY PROGRAMME 16
= .61, η𝑝
2 = 0.003. That is, at both posttest and follow-up, participants in the functionality
group were more satisfied with their appearance than participants in the control group. There
was also a significant main effect of Time, F(1, 78) = 7.66, p = .007, η𝑝
2 = 0.09, indicating
that, overall, participants in both groups felt more satisfied with their appearance at follow-up
than at posttest. This effect neither depended on participants’ pretest scores, as demonstrated
by the nonsignificant Time x Pretest interaction, F(1, 78) = 0.04, p = .838, η𝑝
2 = 0.001, nor on
their Group, as demonstrated by the nonsignificant Time x Group interaction.
With regard to functionality satisfaction, the results showed a significant main effect
of Group, F(1, 78) = 9.48, p = .003, η𝑝
2 = 0.11, indicating that, overall, participants in the
functionality group felt more satisfied with their body functionality than participants in the
control group. Again, this difference was the same at both posttest and follow-up, as
demonstrated by the nonsignificant Group x Time interaction, F(1, 78) = 0.07, p = .283, η𝑝
2 =
0.02. The results also showed a significant main effect of Time, F(1, 78) = 4.82, p = .031, η𝑝
2
= 0.06, indicating that, overall, participants in both groups felt more satisfied with their body
functionality at follow-up than at posttest. This effect did not depend on participants’ pretest
scores, as demonstrated by the nonsignificant Time x Pretest interaction, F(1, 78) = 0.001, p =
.977, η𝑝
2 < 0.001, or on their Group, as demonstrated by the nonsignificant Time x Group
interaction.
Body Appreciation
The results showed that participants in the functionality group experienced greater
body appreciation than participants in the control group, Group, F(1, 78) = 6.46, p = .013, η𝑝
2
= 0.08, although this effect was only marginally significant at p < .01. As in the former
analyses, the group difference was the same at both time points, Group x Time, F(1, 78) =
0.004, p = .950, η𝑝
2 < 0.001. The main effect of Time, F(1, 78) = 2.33, p = .131, η𝑝
2 = 0.03,
was nonsignificant, showing that, overall, there were no changes in body appreciation from
BODY FUNCTIONALITY PROGRAMME 17
posttest to follow-up. The Time x Pretest interaction, F(1, 78) = 0.23, p = .634, η𝑝
2 = 0.003,
was also nonsignificant.
Self-Objectification
SOQ. These analyses were conducted with 62 participants (Nfunctionality = 35) because
data were excluded from participants who did not fill in the SOQ correctly at one or more
time points (cf. Noll & Fredrickson, 1998). The main effect of Group, F(1, 59) = 7.22, p =
.009, η𝑝
2 = 0.11, was significant, showing that, overall, participants in the functionality group
experienced lower levels of self-objectification than participants in the control group. At both
posttest and follow-up, participants in the functionality group experienced lower levels of
self-objectification than participants in the control group, Group x Time, F(1, 59) = 3.19, p =
.079, η𝑝
2 = 0.05. The main effect of Time, F(1, 59) = 0.14, p = .711, η𝑝
2 = 0.002, was
nonsignificant, demonstrating that, overall, there were no changes in self-objectification from
posttest to follow-up. The Time x Pretest interaction, F(1, 59) = 0.14, p = .714, η𝑝
2 = 0.002,
was also nonsignificant.
Given the large amount of missing data for this outcome, we mimicked these analyses
using mixed regression to check if the results could be replicated when all participants with at
least posttest or follow-up data for the SOQ (N = 77) could be included in the analyses (which
is possible with mixed regression but not with ANOVA; see Van Breukelen, 2013, for
details). These results confirmed those of the original analyses. Further, given the absence of
both a main effect of Time and a Group x Time effect, a reasonable alternative method was to
solve the problem of missing data by calculating, per participant, the average of posttest and
follow-up data. This allowed us to conduct an ANCOVA analysis with N = 77, where Group
was entered as a predictor variable and Pretest was entered as a covariate. This analysis also
confirmed the original analyses, demonstrating that participants in the functionality group
BODY FUNCTIONALITY PROGRAMME 18
experienced lower levels of self-objectification than participants in the control group, F(1, 74)
= 7.95, p = .006.
OBC (Body Surveillance Subscale). The main effect of Group, F(1, 77) = 0.45, p =
.503, η𝑝
2 = 0.01, was nonsignificant. The main effect of Time, F(1, 77) = 0.25, p = .622, η𝑝
2 =
0.002, as well as the interaction effects of Group x Time, F(1, 77) = 0.07, p = .787, η𝑝
2 =
0.001, and Time x Pretest, F(1, 77) = 2.58, p = .113, η𝑝
2 = 0.03, were also nonsignificant.
Discussion
This study evaluated the Expand Your Horizon programme: a novel programme
designed to improve body image by training women to focus on the functionality of their
body. Compared to participants in the control programme, participants who took part in the
Expand Your Horizon programme experienced higher levels of appearance satisfaction and
functionality satisfaction, and lower levels of self-objectification. In addition, they tended to
feel greater appreciation for their body. These findings are in line with the prior literature that
suggested that focusing on body functionality can have beneficial effects on women’s body
image.
First, the finding that the Expand Your Horizon programme led to increases in body
satisfaction provides experimental support for the correlational and interview-based studies
that demonstrated a relation between focusing on body functionality and higher levels of body
satisfaction (e.g., Frisén & Holmqvist, 2010; Tiggemann & Williamson, 2010; Wood-
Barcalow et al., 2010). Focusing on the functionality of the body may encourage individuals
to positively reframe the way that they think about their body, thus shifting their orientation
from negative (appearance-focused) to positive (functionality-focused; Alleva, et al., 2014;
Franzoi, 1995; Fredrickson & Roberts, 1997; Tylka & Wood-Barcalow, 2015). In this sense,
the Expand Your Horizon writing assignments may work in a similar fashion as fitness-based
interventions (Martin & Lichtenberger, 2002), although it is possible that the present writing
BODY FUNCTIONALITY PROGRAMME 19
assignments make this shift more explicit and consequently encourage participants to shift
their orientation with explicit cognitive effort. It must be mentioned, however, that focusing
on body functionality may not necessarily entail a positive orientation for every individual.
Some aspects of body functionality may be perceived less positively, for instance if someone
strives to become a professional athlete, suffers from chronic pain, or has a physical disability.
These individual differences should be investigated in future research. Nevertheless, given the
fact that body functionality encompasses several areas (i.e., it is not limited to physical
capacities; Webb et al., 2015), each with several different aspects, dissatisfaction with one
area or aspect may be less likely to ‘spread’ and affect an individual’s overarching evaluation
of his or her body functionality.
Second, the fact that the Expand Your Horizon programme led to improvements in
body appreciation supports the prior studies that demonstrated a relation between a
functionality-based focus on the body and greater levels of body appreciation (e.g., Avalos &
Tylka, 2006; Langdon & Petracca, 2010; Swami & Tovée, 2009). Focusing on body
functionality may foster body appreciation because many areas (e.g., health) and aspects (e.g.,
absorbing vitamins) of body functionality are important – and often central – to leading a
normal and fulfilling life; contemplating this fact should generate appreciation and gratitude
for one’s own body. This notion has also been expressed by participants in prior interview-
based studies (e.g., “Just be glad that you do have a body that’s healthy and working properly.
Just be glad that you’re able to do the things you are;” Wood-Barcalow et al., 2010, p. 114).
In-depth content-based analyses of individuals’ responses to the Expand Your Horizon writing
assignments may provide additional insight into this relationship.
Lastly, the present findings show that focusing on body functionality leads to lower
levels of self-objectification; this lends experimental support to the prior studies that
demonstrated this relationship using correlational research (e.g., Daubenmier, 2005; Prichard
BODY FUNCTIONALITY PROGRAMME 20
& Tiggemann, 2008). It is also noteworthy that the Expand Your Horizon programme had a
medium-sized effect on self-objectification (η𝑝
2 = 0.11). These findings are promising because
they demonstrate that self-objectification – which many women habitually engage in
(Fredrickson & Roberts, 1997) and which has been shown to have serious consequences for
well-being (Moradi & Huang, 2008) – can be effectively counteracted, at least on the short
term. Furthermore, sexual objectification of women is ubiquitous in Western culture, and will
likely take time and extensive effort to change (Tylka & Augustus-Horvath, 2011). Therefore,
it is also promising that this technique might provide women with an individual-level strategy
to buffer these persistent societal-level influences. Future studies could investigate,
experimentally, whether focusing on body functionality can prevent the negative effects of
exposure to sexual objectification (e.g., media images of sexually objectified women).
It is important to note that the reductions found in self-objectification in this study
were only found with regard to the SOQ – no changes in self-objectification were found with
regard to the Body Surveillance Subscale of the OBC. Findings from the SOQ and OBC Body
Surveillance Subscale have varied in previous research as well (Moradi & Huang, 2008). The
divergence found in this study might be caused by the different aspects captured by each
questionnaire. The SOQ asks individuals to rank functionality and appearance-based body
attributes according to how important they are for their physical self-concept. Thus,
individuals make reflective, controlled decisions when filling in the SOQ. In contrast, many
items of the Body Surveillance Subscale of the OBC capture thought tendencies that might
occur automatically and without conscious control, such as the tendency to make social
comparisons (Mussweiler, Rüter, & Epstude, 2004; e.g., “I rarely compare how I look with
how other people look”). It could be that the Expand Your Horizon programme helped
participants realise that appearance is less important than body functionality, but that this
BODY FUNCTIONALITY PROGRAMME 21
change did not yet translate to improvements in habitual thoughts about their body. Future
research may elucidate these differences by including longer-term follow-up measurements.
Another important direction for future research will be to investigate the potential
mechanisms and relationships that underlie the functionality-based approach to improving
body image. For example, given that a functionality-based focus on the body is “antithetical”
to self-objectification (Roberts & Waters, 2004; Webb et al., 2015), focusing on body
functionality may directly reduce self-objectification, which in turn could lead to
improvements in body satisfaction and body appreciation. In fact, Tiggemann, Coutts, and
Clark (2014) have shown that engaging in belly dancing (a form of dance that emphasises
body functionality; Tiggemann et al., 2014) is associated with greater body appreciation via
reductions in self-objectification. Another possibility is that focusing on body functionality
may directly increase body appreciation, which should foster positive feelings toward the
body and decrease levels of self-objectification; this is because body appreciation entails an
unconditional approval of the body – irrespective of perceived imperfections – and an
emphasis on body functionality over appearance (Avalos & Tylka, 2006; Tylka, 2011; Wood-
Barcalow et al., 2010).
More broadly, it is also possible that, for women with a negative body image, writing
about the functionality of their body could highlight a discrepancy between their beliefs (e.g.,
that their body is inadequate) and behaviour (e.g., writing about the many capabilities of their
body). According to cognitive dissonance theory (Festinger, 1957), this discrepancy should
create psychological discomfort, or cognitive dissonance. Consequently, women with a
negative body image might alter their cognitions in order to alleviate this cognitive
dissonance, which could lead to improvements in body image (e.g., Halliwell & Diedrichs,
2014, Stice, Trost, & Chase, 2002). This same situation could also be explained from the
perspective of self-perception theory (Bem, 1972): Women with a negative body image might
BODY FUNCTIONALITY PROGRAMME 22
infer their body-related attitudes based on their behaviour (e.g., “I was able to describe all of
these positive aspects about my body, so perhaps I do not feel so bad about my body after
all”). Future studies that investigate these and other potential relations and mechanisms will
contribute to an improved understanding of body functionality and how to foster a healthy
body image.
Strengths and Limitations
The main strengths of the current study are that it tests a novel approach to improving
body image and focuses on body functionality, an understudied aspect of body image (Smolak
& Cash, 2011). In addition, we tested a group of women with a negative body image,
employed an active control group, and only four participants dropped out of the study. The
Expand Your Horizon programme is also relatively inexpensive and easy to administer (via
the Internet), and requires less than one hour of participants’ time. Further, the Expand Your
Horizon programme encourages women to focus on what their body is capable of, rather than
on perceived imperfections or negative feelings and cognitions, and therefore contributes to a
growing literature on positive body image (Halliwell, 2015; Tylka, 2011; Tylka & Wood-
Barcalow, 2015; Webb et al., 2015).
This study also has its limitations, however. At pretest, we did not measure
participants’ expectations about the programme that they were randomised to. It could be that
participants in the Expand Your Horizon programme expected greater improvements in body
image than participants in the control programme, who may have been less convinced that a
creativity training programme could affect their body image. In addition, as with all studies
that investigate an intervention programme, it is possible that our findings resulted in part
from demand characteristics. The inclusion of an active control group should have reduced
the impact of demand characteristics on our results, but future research may benefit from an
active control programme with a theme that is more closely related to body image. Also,
BODY FUNCTIONALITY PROGRAMME 23
although we were able to check participants’ writing assignment responses (to ensure that
they complied with the instructions of their respective programme), the amount of time
participants spent on the writing assignments was self-reported, so participants might have
misreported this information. Future research should implement methods to register this
information objectively.
A further limitation of this study concerns the instrument that was used to measure
satisfaction with body functionality, the Physical Condition Subscale of the BES. The
Physical Condition Subscale only focuses on two areas of body functionality: physical
capacities and health. To our knowledge, an instrument measuring satisfaction with body
functionality in the broader sense (i.e., incorporating other areas of body functionality) does
not yet exist (Webb et al., 2015). To progress research on body functionality, it is important to
create and validate such a questionnaire. Further, it will be important to consider
improvements to the Expand Your Horizon programme that may increase the magnitude of its
effects on body image. One possibility is to administer ‘booster’ writing assignments after
completion of the initial programme. Lastly, we tested ‘high-risk’ women between the age of
18 and 30, so it is an unanswered question whether the programme will have similar effects in
‘low-risk’ samples, different age groups, or in men. It is also unclear whether the effects of
the Expand Your Horizon programme are long-lasting, as we included a one-week follow-up.
Future studies using longer-term follow-ups are necessary.
Conclusion
In sum, the current study provides support for a promising technique for improving
body image and decreasing self-objectification – namely, training women to focus on the
functionality of their body. This study also provides the first experimental evidence that
focusing on body functionality can increase body satisfaction and body appreciation and
reduce self-objectification in women with a negative body image. Future research should be
BODY FUNCTIONALITY PROGRAMME 24
directed at improving the Expand Your Horizon programme and investigating the mechanisms
that underpin this approach. This study underlines the statements of other scholars (e.g.,
Smolak & Cash, 2011; Tylka & Wood-Barcalow, 2015) that body functionality is an
important construct that merits further attention.
BODY FUNCTIONALITY PROGRAMME 25
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