Evaluating Body Acceptance Programs for Young Men

NCT05258409 | Completed

• 1 other identifier: 201229
• Study Type: interventional
• Target: 241
• Locations: 1 country
• Sites: 1

Brief Summary

While eating disorders in males are often overlooked, up to 7 million men in the United States will experience an eating disorder in their lifetime. Critically, men are less likely to seek treatment for an eating disorder compared to women. Therefore, prevention programs that target male-specific eating disorder risk factors prior to the development of an eating or appearance-related disorder are crucial in reducing eating disorders in this population. Preliminary work by our group established the initial efficacy of a novel program, the Body Project: More than Muscles (MTM) compared to assessment-only control. This study will replicate and extend this research by comparing MTM to a time and attention matched control used in previous eating disorder prevention work, media advocacy (MA).

Conditions

Body Image Disturbance; Eating Disorder Symptom; Eating Behavior; Dysmorphic Features; Dysmorphic Disorder, Body; Dysmorphia; Eating Disorders; Exercise, Compulsive

Keywords

Male; Muscularity Oriented Eating; Exercise; Eating Disorder; Body Image; Body Dissatisfaction

Outcome Measures

Primary Outcomes (5)

• Eating Pathology Symptom Inventory (EPSI)

  The EPSI is a 45-item measure scored on a 5-point rating scale with scores ranging from 0 to 4 on individual questions. The EPSI measures eating pathology across eight dimensions with higher scores indicating greater eating pathology.

  change from baseline to immediately post-intervention, change from baseline to 1-month follow-up, and change from baseline to 6-month follow-up

• Eating Disorder Examination Questionnaire (EDE-Q)

  The EDE-Q is a 28-item measure scored on a 7-point rating scale with scores ranging from 0 to 168 (scores higher than 4 on individual questions are indicative of clinical levels). The EDE-Q is a transdiagnostic measure of Eating Disorder symptoms with high scores indicating elevated eating pathology.

  change from baseline to immediately post-intervention, change from baseline to 1-month follow-up, and change from baseline to 6-month follow-up

• Muscularity Oriented Eating Test (MOET)

  The MOET is a 15-item measure scored on a 5-point rating scale with scores ranging from 0 to 60. Higher scores on the MOET indicate greater muscularity-related disordered eating.

  change from baseline to immediately post-intervention, change from baseline to 1-month follow-up, and change from baseline to 6-month follow-up

• Muscle Dysmorphic Disorder Inventory (MDDI)

  The MDDI is a 13-item measure for muscle dysmorphia symptoms, which is a common feature of Eating Disorders in men. Items are scored 0 (never) to 4 (always) with higher scores indicating greater muscle dysmorphic symptoms. Scores on this measure range 0 to 52.

  change from baseline to immediately post-intervention, change from baseline to 1-month follow-up, and change from baseline to 6-month follow-up

• Eating Pathology Symptom Inventory-Clinician Rated Version (EPSI-CRV

  The EPSI-CRV is a semi-structured interview that assesses dimensional constructs of psychopathology associated with Diagnostic and Statistical Manual-5 Eating Disorders. The interview will take approximately 40 minutes to complete.

  Change from baseline to 6-month follow-up related to dimensional changes in Eating Disorder-related psychopathology

Secondary Outcomes (10)

• Sociocultural Attitudes Towards Appearance Questionnaire (SATAQ)

  change from baseline to immediately post-intervention, change from baseline to 1-month follow-up, and change from baseline to 6-month follow-up

• Drive for Muscularity Scale (DMS)

  change from baseline to immediately post-intervention, change from baseline to 1-month follow-up, and change from baseline to 6-month follow-up

• Male Body Attitudes Scale (MBAS)

  change from baseline to immediately post-intervention, change from baseline to 1-month follow-up, and change from baseline to 6-month follow-up

• Self-Objectification Questionnaire (SOQ)

  change from baseline to immediately post-intervention, change from baseline to 1-month follow-up, and change from baseline to 6-month follow-up

• Obligatory Exercise Questionnaire (OEQ)

  change from baseline to immediately post-intervention, change from baseline to 1-month follow-up, and change from baseline to 6-month follow-up

Study Arms (2)

Media Advocacy (MA)

ACTIVE COMPARATOR

Participants assigned to this condition take place in a time and attention-matched active control where they discuss the role of media in promoting the body ideal.

Behavioral: Media Advocacy (MA)

Body Project: More than Muscles (MTM)

EXPERIMENTAL

Participants assigned to this condition take part in a two-session intervention based on dissonance theory which encourages them to challenge the body ideal.

Behavioral: More than Muscles (MTM)

Interventions

Media Advocacy (MA) BEHAVIORAL

MA content generally centers on acknowledging and discussing the role the media has on shaping body image ideals. Session 1: In session 1, similar to MTM, the primary activities will include: (1) describing the ideal body for men in our culture, (2) discussing how the media impacts this ideal, with a particular focus on advertising. Following this, participants will (3) watch a video on how the media influences body image among men, and the consequences of internalizing these messages. Session 2: In session 2, content will continue by further discussion of the video showed in session 1, with participants sharing their reactions. Next, the group discusses the attainability of the ideal as well as discusses other forms of media (e.g., social media) and how it impacts body image.

Media Advocacy (MA)

More than Muscles (MTM) BEHAVIORAL

In session 1, the primary activities are: 1) define the "ideal" body type for men in our culture, 2) discuss the origin and perpetration of the "ideal," 3) brainstorm the costs of pursuing the "ideal," 4) participate in a verbal challenge during which participants counter the "ideal" message, and (5) are asked to complete three "homework" assignments (i.e., a letter to an adolescent boy, a behavioral challenge, and a mirror exposure assignment). In session 2, the primary activities are: 1) reviewing homework, 2) engage in role-plays to counter/discourage pursuit of the "ideal," 3) discuss ways to challenge and avoid "negative body talk" statements, 4) list ways to resist the pressure to pursue this "ideal" both individually and as a group within the larger community (i.e., body activism), 5) discuss barriers to body activism and strategies to overcome those barriers, and 6) individually select an exit exercise to continue to actively challenge the appearance ideal.

Also known as: Body Project

Body Project: More than Muscles (MTM)

Eligibility Criteria

• Age: 18 Years - 30 Years
• Gender Eligibility Details: Person who self-identify as male
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• to 30 years old
• Identify as male
• Endorse body image concerns
• Speak English and able to provide informed consent

You may not qualify if:

• Diagnosis of a DSM-5 eating disorder determined by SCID-5
• Significant neuropsychiatric illness (e.g., dementia, untreated severe psychiatric illness determined by SCID-unmedicated bipolar disorder, psychosis, or active suicidal ideation)
• Older than 30 years old
• Younger than 18 years old
• Non-English speaking

Sponsors & Collaborators

• Auburn University: lead
• Arlene and Michael Rosen Foundation: collaborator

Study Sites (1)

Auburn University

Auburn, Alabama, 36849-9027, United States

Location

Related Publications (25)

• Strother E, Lemberg R, Stanford SC, Turberville D. Eating disorders in men: underdiagnosed, undertreated, and misunderstood. Eat Disord. 2012;20(5):346-55. doi: 10.1080/10640266.2012.715512.

  PMID: 22985232 BACKGROUND

• Hudson JI, Hiripi E, Pope HG Jr, Kessler RC. The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication. Biol Psychiatry. 2007 Feb 1;61(3):348-58. doi: 10.1016/j.biopsych.2006.03.040. Epub 2006 Jul 3.

  PMID: 16815322 BACKGROUND

• Keel PK. Eating Disorders. Upper Saddle River: Prentice Hall; 2005

  BACKGROUND

• Rodgers RF, Ganchou C, Franko DL, Chabrol H. Drive for muscularity and disordered eating among French adolescent boys: a sociocultural model. Body Image. 2012 Jun;9(3):318-23. doi: 10.1016/j.bodyim.2012.03.002. Epub 2012 Apr 10.

  PMID: 22494958 BACKGROUND

• Tylka TL. Refinement of the tripartite influence model for men: dual body image pathways to body change behaviors. Body Image. 2011 Jun;8(3):199-207. doi: 10.1016/j.bodyim.2011.04.008. Epub 2011 Jun 12.

  PMID: 21664886 BACKGROUND

• Litt D, Dodge T. A longitudinal investigation of the Drive for Muscularity Scale: predicting use of performance enhancing substances and weightlifting among males. Body Image. 2008 Dec;5(4):346-51. doi: 10.1016/j.bodyim.2008.04.002. Epub 2008 Jul 21.

  PMID: 18644753 BACKGROUND

• Leit RA, Gray JJ, Pope HG Jr. The media's representation of the ideal male body: a cause for muscle dysmorphia? Int J Eat Disord. 2002 Apr;31(3):334-8. doi: 10.1002/eat.10019.

  PMID: 11920996 BACKGROUND

• Cafri G, Thompson JK, Ricciardelli L, McCabe M, Smolak L, Yesalis C. Pursuit of the muscular ideal: Physical and psychological consequences and putative risk factors. Clin Psychol Rev. 2005 Feb;25(2):215-39. doi: 10.1016/j.cpr.2004.09.003. Epub 2004 Dec 30.

  PMID: 15642647 BACKGROUND

• Pope HG Jr, Gruber AJ, Choi P, Olivardia R, Phillips KA. Muscle dysmorphia. An underrecognized form of body dysmorphic disorder. Psychosomatics. 1997 Nov-Dec;38(6):548-57. doi: 10.1016/S0033-3182(97)71400-2.

  PMID: 9427852 BACKGROUND

• Olivardia R, Pope HG Jr, Hudson JI. Muscle dysmorphia in male weightlifters: a case-control study. Am J Psychiatry. 2000 Aug;157(8):1291-6. doi: 10.1176/appi.ajp.157.8.1291.

  PMID: 10910793 BACKGROUND

• Bramon-Bosch E, Troop NA, Treasure JL. Eating disorders in males: a comparison with female patients. European Eating Disorders Review. 2000;8(4):321-328.

  BACKGROUND

• Griffiths S, Hay P, Mitchison D, Mond JM, McLean SA, Rodgers B, Massey R, Paxton SJ. Sex differences in the relationships between body dissatisfaction, quality of life and psychological distress. Aust N Z J Public Health. 2016 Dec;40(6):518-522. doi: 10.1111/1753-6405.12538. Epub 2016 Jul 3.

  PMID: 27372301 BACKGROUND

• Griffiths S, Mond JM, Li Z, Gunatilake S, Murray SB, Sheffield J, Touyz S. Self-stigma of seeking treatment and being male predict an increased likelihood of having an undiagnosed eating disorder. Int J Eat Disord. 2015 Sep;48(6):775-8. doi: 10.1002/eat.22413. Epub 2015 Jun 6.

  PMID: 26052695 BACKGROUND

• Striegel-Moore RH, Leslie D, Petrill SA, Garvin V, Rosenheck RA. One-year use and cost of inpatient and outpatient services among female and male patients with an eating disorder: evidence from a national database of health insurance claims. Int J Eat Disord. 2000 May;27(4):381-9. doi: 10.1002/(sici)1098-108x(200005)27:43.0.co;2-u.

  PMID: 10744844 BACKGROUND

• Brown TA, Keel PK. Current and emerging directions in the treatment of eating disorders. Subst Abuse. 2012;6:33-61. doi: 10.4137/SART.S7864. Epub 2012 Mar 29.

  PMID: 22879753 BACKGROUND

• Keel PK, Brown TA. Update on course and outcome in eating disorders. Int J Eat Disord. 2010 Apr;43(3):195-204. doi: 10.1002/eat.20810.

  PMID: 20186717 BACKGROUND

• Pope HG Jr, Olivardia R, Gruber A, Borowiecki J. Evolving ideals of male body image as seen through action toys. Int J Eat Disord. 1999 Jul;26(1):65-72. doi: 10.1002/(sici)1098-108x(199907)26:13.0.co;2-d.

  PMID: 10349585 BACKGROUND

• Leit RA, Pope HG Jr, Gray JJ. Cultural expectations of muscularity in men: the evolution of playgirl centerfolds. Int J Eat Disord. 2001 Jan;29(1):90-3. doi: 10.1002/1098-108x(200101)29:13.0.co;2-f.

  PMID: 11135340 BACKGROUND

• Pope H, Phillips KA, Olivardia R. The Adonis complex: The secret crisis of male body obsession: Simon and Schuster; 2000.

  BACKGROUND

• Harrison K, Cantor J. The relationship between media consumption and eating disorders. Journal of communication. 1997;47(1):40-67

  BACKGROUND

• Brown TA, Forney KJ, Pinner D, Keel PK. A randomized controlled trial of The Body Project: More Than Muscles for men with body dissatisfaction. Int J Eat Disord. 2017 Aug;50(8):873-883. doi: 10.1002/eat.22724. Epub 2017 May 8.

  PMID: 28481431 BACKGROUND

• Becker CB, Smith LM, Ciao AC. Peer-facilitated eating disorder prevention: A randomized effectiveness trial of cognitive dissonance and media advocacy. Journal of Counseling Psychology. 2006;53(4):550.

  BACKGROUND

• Becker CB, Bull S, Schaumberg K, Cauble A, Franco A. Effectiveness of peer-led eating disorders prevention: a replication trial. J Consult Clin Psychol. 2008 Apr;76(2):347-54. doi: 10.1037/0022-006X.76.2.347.

  PMID: 18377130 BACKGROUND

• Forbush KT, Wildes JE, Pollack LO, Dunbar D, Luo J, Patterson K, Petruzzi L, Pollpeter M, Miller H, Stone A, Bright A, Watson D. Development and validation of the Eating Pathology Symptoms Inventory (EPSI). Psychol Assess. 2013 Sep;25(3):859-78. doi: 10.1037/a0032639. Epub 2013 Jul 1.

  PMID: 23815116 BACKGROUND

• Murray SB, Brown TA, Blashill AJ, Compte EJ, Lavender JM, Mitchison D, Mond JM, Keel PK, Nagata JM. The development and validation of the muscularity-oriented eating test: A novel measure of muscularity-oriented disordered eating. Int J Eat Disord. 2019 Dec;52(12):1389-1398. doi: 10.1002/eat.23144. Epub 2019 Jul 25.

  PMID: 31343090 BACKGROUND

Related Links

• Lab Website

MeSH Terms

Conditions

Feeding Behavior; Body Dysmorphic Disorders; Congenital Abnormalities; Feeding and Eating Disorders; Compulsive Exercise; Motor Activity

Condition Hierarchy (Ancestors)

Behavior, Animal; Behavior; Somatoform Disorders; Mental Disorders; Congenital, Hereditary, and Neonatal Diseases and Abnormalities; Signs and Symptoms, Digestive; Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Behavior, Addictive; Compulsive Behavior; Impulsive Behavior

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: INVESTIGATOR, OUTCOMES ASSESSOR
• Masking Details: Participants will remain unaware of what group they have been randomized to as both groups will be actively be participating in groups focused on male body image
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Professor

Model Details: Participants will briefly be screened for eligibility criteria by phone. Eligible participants will be assessed using two structured clinical interviews (SCID-5 \& EPSI-CRV) and complete a set of self-report measures at baseline. Following assessment participants will be randomized into one of two groups. One group will receive a dissonance-based intervention known as the More than Muscles (MTM), while other participants will engage in a Media Advocacy (MA) active control. Participants will complete the same set of self-report measures from baseline, after their final group, at 1-month follow-up and at 6-month follow-up. During the 6-month follow-up participants will also be reassessed using the same structured clinical interviews at baseline.

Study Record Dates

• First Submitted: February 17, 2022
• First Posted: February 28, 2022
• Study Start: August 16, 2022
• Primary Completion: January 27, 2025
• Study Completion: January 27, 2025
• Last Updated: May 18, 2025

Record last verified: 2025-05

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)