Category: Eating Disorders
Body checking has been identified as a maintaining factor for those with eating disorders as it increases an over-evaluation of eating, shape, and weight (Fairburn, 2008). Body checking includes behaviors such as feeling the body for fat and repeated weighing (Shafran et al., 2006). While a number of experimental studies have demonstrated the role body checking has in maintaining body dissatisfaction (Shafran, Lee, Payne, & Fairburn, 2007; Smeets et al., 2010; Walker, 2014), few studies have focused on specific treatments for body checking. The current study utilized Ecological Momentary Assessment/ Intervention (EMA/EMI) to evaluate a digital intervention targeting body checking. EMI is an intervention delivered with mobile technology to individuals in their naturalistic environments and has been shown to positively impact health behaviors such as smoking cessation and weight control (Heron & Smyth, 2010; Patrick et al., 2009). The hypotheses for the study were that body checking would decrease across the five-day intervention and that these behaviors would decrease directly following intervention prompts on days four and five.
Forty-four undergraduate female participants (Mage = 18.39 years; SD = 0.58) completed the full study protocol (qualification criteria were high levels of body checking and not being overweight). For five days, participants received five daily messages via their smart phones asking them to report how many times they had performed each of eight body checking behaviors. On days four and five, participants also received a total of five interventions (e.g., psychoeducation and cognitive/behavioral strategies) delivered at every other time point.
Multilevel modeling was used to investigate the relationship between time (within day and across days), body dissatisfaction, and reported body checking. Analyses revealed that body checking behaviors increased within each day (bs = 11.51 – 27.28, ps < .001), but decreased across the five-day intervention period (b = -1.07, p < .001). Body checking behaviors directly following intervention prompts on days four and five were not significantly impacted (b = 0.28, p = .86).
These results indicate a decrease in body checking across the five-day intervention period; however, no significant decrease directly following intervention prompts. Additionally, body checking was unexpectedly found to increase throughout the course of each individual day. Active control groups and EMA only groups should be considered in future studies to better understand the impact of the intervention. These results suggest the feasibility of brief EMI as a useful clinical tool and reveal that evenings may be a particularly high-risk time for body checking behaviors.