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Using an ethical lens, this review evaluates two methods of working within patient care and public health: the weight-normative approach (emphasis on weight and weight loss when defining health and well-being) and the weight-inclusive approach (emphasis on viewing health and well-being as multifaceted while directing efforts toward improving health access and reducing weight stigma). Data reveal that the weight-normative approach is not effective for most people because of high rates of weight regain and cycling from weight loss interventions, which are linked to adverse health and well-being. Its predominant focus on weight may also foster stigma in health care and society, and data show that weight stigma is also linked to adverse health and well-being. In contrast, data support a weight-inclusive approach, which is included in models such as Health at Every Size for improving physical (e.g., blood pressure), behavioral (e.g., binge eating), and psychological (e.g., depression) indices, as well as acceptability of public health messages. Therefore, the weight-inclusive approach upholds nonmaleficience and beneficience, whereas the weight-normative approach does not. We offer a theoretical framework that organizes the research included in this review and discuss how it can guide research efforts and help health professionals intervene with their patients and community.

Individuals with eating disorders (ED) experience prolonged malnutrition, binge episodes, and compensatory behaviours that affect every organ system. Psychological and physiological symptoms are worsened with comorbid dysfunctional exercise, seen in up to 80% of those with an ED. Although return to exercise is an important component of treatment and recovery, little is known about the contraindications and risks of exercise engagement specific to those with an ED. This paper provides a comprehensive narrative review of the medical and physiological complications of engaging in exercise during ED treatment and outlines when exercise may be contraindicated or used in modified or cautionary ways. We conducted a literature search on MEDLINE, PubMed, and PsychArticles to identify relevant articles, which yielded six categories of medical and physiological complications of ED that may be exacerbated by exercise: energy availability, cardiovascular health, electrolyte abnormalities, biomedical function markers, sex hormones, and body composition. We summarize the evidence for these complications for readers and offer an initial set of recommendations for incorporating exercise during ED treatment based on our findings. This review may serve as a resource for members of ED treatment teams to help evaluate more readily and confidently whether exercise is safe for individual patients and when modifications and caution may be warranted. Plain English summary Dysfunctional exercise (DEX) is a symptom of eating disorders (ED) that precedes, maintains and exacerbates ED pathology. Health professionals struggle to clinically address and manage DEX as little information is available about its assessment and safe management. The current review provides a comprehensive summary of the medical and physiological complications of ED that may be exacerbated by exercise and outlines when exercise may be contraindicated or used in a modified or cautionary way. The literature review yielded six categories of complications: energy availability, cardiovascular health, electrolyte abnormalities, biomedical function markers, sex hormones, and body composition. We summarize the evidence for these complications for readers and offer an initial set of recommendations for incorporating exercise during ED treatment based on our findings. This review may serve as a resource for members of ED treatment teams to help evaluate more readily and confidently whether exercise is safe for individual patients and when modifications and caution may be warranted.

Integrating system-justification and objectification theories, the research reported here broadens the scope of prior work on women's self-objectification to examine its system-justifying function. I investigated the relation of trait and state self-objectification to support for the gender status quo and engagement in gender-based social activism among U.S. college women. Study 1 established that greater trait self-objectification was related to more gender-specific system justification and less engagement in gender-based social activism. The data supported a mediational model in which gender-specific system justification mediated the link between trait self-objectification and social activism. Results from Study 2, in which self-objectification was situationally activated, confirmed the same mediational model. These findings suggest that trait and state self-objectification may be part of a wider pattern of system-justifying behavior that maintains gender inequality and thwarts women's pursuit of social justice.

The Relational and Bodily Experiences Theory (RBET) represents a step forward in illuminating psychological contributors to women’s sexual desire in the form of early parent–child attachments and sexual body self-representations. We join with Cherkasskaya and Rosario (2018) in calling for broader and more diverse conceptualizations of women’s sexual desire, and we agree that internalized working models of relationships and self-representations very likely do operate in ways that facilitate or depress sexual desire. Despite these strengths, RBET is limited in its integration of critical sociocultural forces operating on, and competing with, women’s sexual desire. In their Target Article, Cherkasskaya and Rosario acknowledge that women’s sexuality exists within a sociocultural context, but the thrust of their theoretical model is limited to individual-level processes and outcomes, which centers the “problem of sexual desire” within the individual, and (inadvertently) serves to extend rather than upend a pathologizing narrative of women’s sexual desire.

Objectives The present study examined self-compassion and fear of self-compassion in relation to body checking behavior, an understudied marker of eating disorder risk. Stigmatizing self-perceptions in the form of self-objectification, body shame, and weight bias internalization were also examined as a collective set of factors that may connect self-compassion to body checking behavior. Methods Undergraduate women ( N = 177) recruited from a university participation pool completed the Self-Compassion Scale, the Fear of Self-Compassion Scale, the Weight Bias Internalization Scale—Modified, the Self-Objectification Beliefs and Behaviors Scale, the Phenomenological Body Shame Scale, and the Body Checking Scale in counterbalanced order via an online survey hosted on Qualtrics for course credit. Results Parallel mediation analyses conducted via PROCESS Model 4 demonstrated a significant indirect effect of self-compassion on body checking through weight bias internalization ( ab = − .20; 95% percentile bootstrap confidence interval (PB CI): − .31 to − .11), self-objectification ( ab = − .15; 95% PB CI: − .25 to − .08), and body shame ( ab = − .16; 95% PB CI: − .28 to − .05). Significant indirect effects of fear of self-compassion on body checking were also demonstrated through weight bias internalization ( ab = .18; 95% PB CI: .10 to .26), self-objectification ( ab = .13; 95% PB CI: .07 to .21), and body shame ( ab = .12; 95% PB CI: .03 to .21). No direct effects of self-compassion were observed. Conclusions The findings support self-stigma as a psychological bridge that links being self-compassionate to body checking behavior. Low self-compassion and fear of self-compassion may allow stigmatizing self-perceptions to take root and drive more body checking behavior.

[...]we are pleased to present six papers dedicated to this topic, four empirical pieces and two review articles. [...]we have included a review piece by T. L. Tylka et al. that aims to critically evaluate two methods of working within patient care and public health: the weight-normative approach (emphasis on weight and weight loss when defining health and well-being) and the weight-inclusive approach (emphasis on viewing health and well-being as multifaceted while directing efforts toward improving health access and reducing weight stigma).

Appearance-based Rejection Sensitivity (Appearance-RS) is the dispositional tendency to anxiously expect, readily perceive, and overreact to rejection based on one's physical appearance. The present research examined associations among Appearance-RS, self-reported symptoms of Body Dysmorphic Disorder (BDD), and motivations underlying acceptance of cosmetic surgery among a sample of American college students. Appearance-RS predicted greater self-reported BDD symptoms and endorsement of cosmetic surgery for both intrapersonal and social reasons. Results remained significant even after controlling for appearance satisfaction, fear of negative evaluation, general rejection sensitivity, and depressive symptoms. This research therefore highlights the importance of considering individual differences in sensitivity to appearance rejection when examining body image disturbances, such as self-reported symptoms of BDD, and reasons for endorsing cosmetic surgery. [PUBLICATION ABSTRACT]

Appearance-based Rejection Sensitivity (Appearance-RS) is the dispositional tendency to anxiously expect, readily perceive, and overreact to rejection based on one's physical appearance. The present research examined associations among Appearance-RS, self-reported symptoms of Body Dysmorphic Disorder (BDD), and motivations underlying acceptance of cosmetic surgery among a sample of American college students. Appearance-RS predicted greater self-reported BDD symptoms and endorsement of cosmetic surgery for both intrapersonal and social reasons. Results remained significant even after controlling for appearance satisfaction, fear of negative evaluation, general rejection sensitivity, and depressive symptoms. This research therefore highlights the importance of considering individual differences in sensitivity to appearance rejection when examining body image disturbances, such as self-reported symptoms of BDD, and reasons for endorsing cosmetic surgery. Reprinted by permission of Guilford Press