Department of Psychology, Union College, Schenectady, New York.
Department of Psychiatry & Psychology, Neurological Institute, Cleveland Clinic, Cleveland, Ohio.
Int J Eat Disord. 2018 Aug;51(8):745-770. doi: 10.1002/eat.22867. Epub 2018 Apr 16.
Body checking (BC) and body image avoidance (BIA) have been proposed as etiological and maintaining mechanisms for eating disorder (ED) pathology. To date, no comprehensive review summarizes the relationships of BC and BIA with ED pathology, body image dissatisfaction, or mood/affect.
Meta-analyses examined the relationships of BC and BIA with ED pathology, body image dissatisfaction, and mood/affect. Gender, publication status, and presence or absence of ED diagnoses were examined as potential moderators.
Results showed strong relationships between BC and ED pathology (ρ = 0.588) and BC and body image dissatisfaction (ρ = 0.631) and a moderate relationship between BC and mood/affect (ρ = 0.385). Similarly, results showed strong relationships between BIA and ED pathology (ρ = 0.553) and BIA and body image dissatisfaction (ρ = 0.543) and a moderate relationship between BIA and mood/affect (ρ = 0.392). Overall, limited evidence supported publication bias; however, publication bias may exist in the relationship between BIA and body image dissatisfaction in the literature. Subgroup moderator analyses suggested that gender moderates the strength of the relationships between BC and ED pathology, body image dissatisfaction, and mood/affect and between BIA and body image dissatisfaction.
Results are consistent with cognitive-behavioral models of ED pathology that suggest BC and BIA are behavioral expressions of overvaluation of weight and shape. Notably, more published research has investigated BC than BIA. Future studies, incorporating methods such as meta-analytic structural equation modeling, should examine these variables to further test cognitive-behavioral models of ED development and maintenance.
身体检查（BC）和身体意象回避（BIA）已被提出作为饮食失调（ED）病理的病因和维持机制。迄今为止，尚无综合综述总结了 BC 和 BIA 与 ED 病理、身体意象不满或情绪/情感的关系。
元分析检查了 BC 和 BIA 与 ED 病理、身体意象不满和情绪/情感的关系。性别、出版状况以及是否存在 ED 诊断被视为潜在的调节因素。
结果表明，BC 与 ED 病理之间存在很强的关系（ρ=0.588），BC 与身体意象不满之间也存在很强的关系（ρ=0.631），BC 与情绪/情感之间存在中度关系（ρ=0.385）。同样，结果表明 BIA 与 ED 病理之间存在很强的关系（ρ=0.553），BIA 与身体意象不满之间也存在很强的关系（ρ=0.543），BIA 与情绪/情感之间存在中度关系（ρ=0.392）。总体而言，有限的证据支持发表偏倚；然而，在文献中，BIA 与身体意象不满之间的关系可能存在发表偏倚。亚组调节分析表明，性别调节了 BC 与 ED 病理、身体意象不满和情绪/情感之间以及 BIA 与身体意象不满之间关系的强度。
结果与 ED 病理的认知行为模型一致，表明 BC 和 BIA 是对体重和体型过度重视的行为表现。值得注意的是，更多的已发表研究调查了 BC 而不是 BIA。未来的研究应结合元分析结构方程建模等方法，进一步检验 ED 发展和维持的认知行为模型，以检验这些变量。
