The Effectiveness of Body Image Flexibility Interventions in Youth: A Systematic Review with Meta-Analysis

Abstract

Prevention programs that focus on enhancing positive body image may improve health and well-being in young people. Body image flexibility is a promising prevention approach, although its application with youth has yet to be comprehensively investigated. This systematic review evaluated the effectiveness of body image flexibility interventions among adolescents and emerging adults. There were 23 eligible studies (N = 2764, 91.3% female) published between 2004 and 2024. Random effects meta-analyses indicated that body image flexibility interventions led to immediate, g = 0.52 (13 studies, n = 1,045), and sustained, g = 0.27 (8 studies, n = 608, 1-week to 24-month follow-up) improvements in health outcomes and protected against adverse effects of body image threats, g = 0.33 (7 studies, n = 480), relative to no/minimal intervention controls. Improvements were largely attributable to reductions in body image concerns. Comparison with other evidence-based interventions, including cognitive and dissonance-based programs, suggested comparable effects. Randomized trials and universal programs demonstrated smaller improvements, and there was evidence of potential publication bias. Conclusions are thus limited by the quantity and quality of existing studies, with most focusing on emerging adult females. Recommendations are provided to address these limitations in future research and strengthen the reliability and generalizability of results.