Adjusting one's inner monolog can reduce a young person's negative body image

In a new study conducted in Italy, Prof. Guy Doron of Reichman University's Baruch Ivcher School of Psychology and his colleagues from the University of Padova (Università degli Studi di Padova) in Italy showed that fine-tuning one's inner monolog on body image can reduce the distress caused by negative body perceptions in young women (between the ages of 20-30). The adjustment of this inner monolog is done using an app that was developed in Israel by Prof. Doron and the company "GGtude".

In today's world, the standard of beauty is almost impossible to attain. Because social networks like Instagram and internet influencers who have become models because of various commercial collaborations set unachievable standards for what is considered beautiful, we encounter more and more young men and women who tell themselves that they "hate their bodies" or that "nothing looks good on me."

On top of this are the natural physiological changes that occur at this age, such as weight gain and changes in body shape, which contribute to body image distress.

Prof. Doron and his colleagues decided to isolate the element of the inner dialogue, i.e., all those thoughts that arise in the minds of young people regarding body image and try to reduce body image distress through the adaptation and calibration of this monolog. Psychological interventions such as cognitive behavioral therapy (CBT) are known to be effective in these cases, but at the same time, the shortage of trained professionals, high cost, geographical limitations, stigma and lack of anonymity involved in CBT often prevent young people from seeking such treatments.

Mobile health apps, on the other hand, have a high degree of availability (24 hours a day), are accessible from anywhere and low cost, and allow for anonymity; they are therefore enticing for young people to use.

In the study, clinical interviews were used to select 95 young women between the ages of 20 and 30 at high risk of developing body image disorders such as Body Dysmorphic Disorder (BDD)—which involves an obsessive preoccupation with certain body parts such as skin, the size or shape of the nose, hair, and so on—or eating disorders; they were then randomly divided into two groups.

One group started using the app "OCD.app—Anxiety Mood & Sleep" immediately at baseline, while the other group waited 16 days and only then began using the app. At baseline, the two groups did not differ in demographic variables (such as age and years of education), Body Mass Index (BMI), BDD and eating disorder symptoms, symptoms of social anxiety, perfectionism, self-esteem, and general distress.

The app helps young people refine their inner monolog by presenting statements that support or contradict their negative perceptions of their bodies (for example, the perception that external appearance alone determines academic, professional, marital, and family success, the perception that self-worth depends solely on appearance, and comparisons to unrealistic beauty ideals).

The users are asked to pull sentences that challenge negative body attitudes (such as "an imperfect body is a real body" or "even internet celebrities have wrinkles" towards themselves (swiping downwards). They are also asked to reject (by swiping up) sentences that reinforce negative body perceptions (for example, "imperfection is a failure" or "people are always looking for my flaws").

Pulling negative statements towards themselves leads the app to provide users with feedback that draws their attention to the unhealthy thought; the embracing of statements that encourage healthy thoughts about the body draws positive feedback from the app. By doing this exercise for three to four minutes daily for about two weeks, the users learn to adopt a healthier mindset towards their bodies, and to reject thoughts that are harmful to their body image. In this way, they rewire their inner monolog to be constructive rather than destructive.

The study's findings show that women in the group that began using the app immediately reported fewer thoughts and behaviors associated with extreme body dissatisfaction and BDD (i.e., repetitive and avoidance behaviors and social comparisons) than the group that started using the app later.

The first group also reported less overall dissatisfaction with their body shape and body parts that are a focus of concern in people with eating disorders (such as the stomach, thighs, and buttocks). Moreover, once the women in the delayed-use group started using the app, they also reported a significant decrease in symptoms of extreme body dissatisfaction, BDD, and body dissatisfaction associated with eating disorders (ηp² = .50 and ηp² = .28, respectively).

Overall, 34.7 percent of the women who participated in the study reported reliable clinical change with less body dissatisfaction or BDD symptoms after using the app for 16 consecutive days. These results were maintained for at least two weeks without using the app.

The effects of using the app on other symptoms of eating disorders, such as the desire to lose weight, bulimia, and associated traits were more limited. Low to moderate rates of reliable change were found in eating disorder risk indices (13.68 percent of participants), social anxiety (9.47 percent of participants), perfectionism (4.21 percent of participants) and global self-esteem (2.10 percent).

Prof. Guy Doron of the Baruch Ivcher School of Psychology at Reichman University said, "Considering the effectiveness of the application in reducing negative body image, the time saved, and the potential widespread applicability of this type of intervention, the findings of this study are promising. Its results indicate that even brief, daily cognitive training by using this app may lead to a significant reduction in symptoms related to body image distress."

The study is published in the journal Body Image.