Contextual factors of body dissatisfaction: A 10-week Ecological Momentary Assessment study

Trait body dissatisfaction (BD) represents a pivotal factor in the development and maintenance of eating disorders and is associated with a range of other mental health sequelae. While mostly studied as a trait, recent research indicates that BD fluctuates on a momentary basis, which is linked to alterations in other state factors. Since previous studies have solely focused on a single association with a specific factor, this pre-registered study evaluated state BD and a multitude of state factors simultaneously to examine both concurrent and prospective associations.Using Ecological Momentary Assessment (EMA), n = 92 female participants with high trait BD (m = 23.74 years, sd = 3.53) completed a short questionnaire on their own smartphones at three semi-random time points a day for 10 weeks. The query contained 51 items pertaining to state BD and hypothesized associated contextual factors. As hypothesized, we found significant concurrent associations of state BD with mood, rumination, acceptance, self-esteem, perceived stress, food intake, physical activity (duration), sleep quality and body checking. In exploratory analyses, concurrent associations with state BD were found for social media content, social comparisons (frequency and direction), craving, sexual motivation, body complaints and the mid-luteal phase. Mood, acceptance, self-esteem, perceived stress, social media (content), body checking, social comparisons (direction), craving and body complaints prospectively predicted state BD. When controlling for other time-lagged variables, social media content and sleep-quality predicted state BD within days.A variety of state-level factors are concurrently and prospectively associated with state BD in everyday life. This study is the first to enable direct comparisons between effects of different factors in an ecologically valid setting. Associated factors may contribute to the maintenance of BD as a state and, as a consequence, to the stabilization of trait BD in the long term. Implications for future research and development of interventions for state BD are discussed.