G Model

BODYIM-713; No. of Pages 12 ARTICLE IN PRESS

Body Image xxx (2015) xxx–xxx

Contents lists available at ScienceDirect

Body Image
journal homepage: www.elsevier.com/locate/bodyimage

What is and what is not positive body image? Conceptual foundations

and construct definition
Tracy L. Tylka a,∗ , Nichole L. Wood-Barcalow b
a
Department of Psychology, The Ohio State University, Columbus and Marion Campuses, Columbus, OH, United States
b
The Center for Balanced Living, Columbus, OH, United States

a r t i c l e i n f o a b s t r a c t

Article history: A decade ago, research on positive body image as a unique construct was relatively nonexistent, and
Received 20 January 2015 now this area is flourishing. How and why did positive body image scholarship emerge? What is known
Received in revised form 1 April 2015 about this contemporary construct? This article situates and contextualizes positive body image within
Accepted 1 April 2015
Cash’s scholarship, eating disorder prevention efforts, feminist influences, strength-based disciplines
within psychology, and Buddhism. Extracting insights from quantitative and qualitative research, this
Keywords:
article demonstrates that positive body image is (a) distinct from negative body image; (b) multifaceted
Positive body image
(including body appreciation, body acceptance/love, conceptualizing beauty broadly, adaptive invest-
Construct definition
Foundations
ment in appearance, inner positivity, interpreting information in a body-protective manner); (c) holistic;
Protective factors (d) stable and malleable; (e) protective; (f) linked to self-perceived body acceptance by others; and (g)
Embodiment shaped by social identities. Complementing what positive body image is, this article further details what
Body appreciation positive body image is not to provide a more nuanced understanding of this construct.
© 2015 Elsevier Ltd. All rights reserved.

Introduction positive body image may help them appreciate, respect, celebrate,
and honor their bodies, which may make treatment gains more
Research on positive, adaptive, or healthy body image is essen- effective and lasting.
tial to the future of the field (Smolak & Cash, 2011, p. 472). But what is positive body image? How did it emerge? What
are its characteristics and expressions? What helps generate posi-
Body image research has a rich history, spanning nearly a cen-
tive body image and maintain it? Without exploring this construct,
tury and revealing many insights into its correlates, predictors,
we do not know the vital answers to these significant questions.
consequences, and treatments (Cash, 2004). Upon closer exam-
Fortunately, two events helped propel the study of positive body
ination, however, much of this history is dominated by a focus
image forward. First, the original edition of Body Image: A Hand-
on pathology that aimed to understand negative body image in
book of Theory, Research, and Clinical Practice called for researchers
the absence of considering positive body image (Smolak & Cash,
to (a) conceptualize embodiment as complex and varied by mov-
2011; Tylka, 2011, 2012). Focusing on alleviating symptoms of neg-
ing beyond the study of appearance to body functionality, and (b)
ative body image without considering how to promote positive
study the development and experience of a positive body image by
body image has limited our field by proscribing a comprehensive
exploring its resilience and protective factors (Cash & Pruzinsky,
understanding of body image (Smolak & Cash, 2011), which could
2002). On a personal note, this handbook inspired us to begin
inadvertently result in clinicians being poorly equipped to promote
developing measures of positive body image to investigate its dis-
health and well-being and, ironically, prevent and treat body image
tinctiveness via quantitative and qualitative designs. Alas, where
disturbance. If body image therapies reduce symptoms of negative
could we publish our work, since many body- and eating-related
body image, but do not enhance aspects of positive body image,
journal outlets were focused on pathology? This dilemma was
they may promote a neutral body image at best (e.g., “I don’t hate
resolved with the inception of Body Image: An International Jour-
my body anymore. I merely tolerate it.”). Helping clients adopt a
nal of Research in 2004, spearheaded by Editor-in-Chief Thomas
Cash. In its Aims and Scope, the journal has encouraged submis-
sions on positive body image by calling for research on (a) factors
∗ Corresponding author at: Department of Psychology, Ohio State University, 225
that influence positive body image development, (b) adaptive body
Psychology Building, Columbus, OH 43210, United States. Tel.: +1 740 725 6384;
fax: +1 614 292 5817.
image processes and their clinically relevant consequences on psy-
E-mail address: tylka.2@osu.edu (T.L. Tylka). chological functioning and quality of life, and (c) interventions to

http://dx.doi.org/10.1016/j.bodyim.2015.04.001
1740-1445/© 2015 Elsevier Ltd. All rights reserved.

Please cite this article in press as: Tylka, T. L., & Wood-Barcalow, N.L. What is and what is not positive body image? Conceptual foundations
and construct definition. Body Image (2015), http://dx.doi.org/10.1016/j.bodyim.2015.04.001
G Model
BODYIM-713; No. of Pages 12 ARTICLE IN PRESS
2 T.L. Tylka, N.L. Wood-Barcalow / Body Image xxx (2015) xxx–xxx

promote positive body image. Scholars interested in positive body quality of life among college women and men. For both women
image could now be assured that a journal would appreciate their and men, body image quality of life was inversely associated with
rigorous and seminal contributions to the study of positive embod- body dissatisfaction, negative body image emotions in various
iment, thus making Body Image: An International Journal of Research situational contexts, and self-evaluative salience (a dysfunctional
the second event that helped propel positive body image research over-valuation of appearance that is inextricably connected to
forward. self-worth) and positively associated with self-esteem, optimism,
As Cash (2004) reflected in his editorial article introducing Body and social support. More favorable body image quality of life
Image: An International Journal of Research, the field of body image was reported by men (compared to women), by African American
is “evolving in intriguing directions” (p. 2). Given the influence of women (compared to White women), and by women with a lower
the two abovementioned events, positive body image now hap- (compared to higher) body mass index (BMI).
pens to be one of these directions. Cash and Smolak (2011), in the Cash, Santos, and Williams (2005) coined and studied positive
second edition of the handbook Body Image: A Handbook of Sci- rational acceptance, which entails engaging in adaptive mental
ence, Practice, and Prevention, devoted an entire chapter toward and behavioral activities, such as positive self-care and rational
synthesizing the “handful of published studies on positive body self-talk, that reflect the acceptance of body image-related threats.
image” using positive psychology as its conceptual foundation Examples of threats to body image include being teased about
(Tylka, 2011, p. 56). Four years later, we are happy to report that weight, seeing advertisements containing dieting messages and/or
there are several hundred studies on positive body image, making models who conform to media appearance ideals, being told to go
it an understatement to say that positive body image research is on a diet, conversing with someone who begins to engage in body
gaining momentum. These seminal works have provided clarity on talk, being weighed at the doctor’s office, and realizing an article of
the characteristics and correlates of positive body image (i.e., what clothing has become tighter in the waistband. During body image-
positive body image is and what it is not), which we review in related threats, individuals high in positive rational acceptance
this article. Prior to this review, however, we recognize the dis- may remind themselves of their good qualities and tell themselves
ciplines and leaders who set the stage for positive body image that the situation will pass or may not be that important. Indeed,
inquiry. positive rational acceptance was related to positive psychological
functioning, although more so for college women than men (Cash
et al., 2005).
The Rise of Positive Body Image Inquiry: Foundations and
In the second edition of his Body Image Workbook, Cash (2008)
Leaders
articulated an 8-step, cognitive-behavioral program that contains
interventions for readers to develop a more mindful, accepting, and
Given the long history of equating body image research with
satisfying relationship with their bodies. Among the interventions,
negative body image, how did the study of positive body image
self-care and maintaining a positive body image are emphasized.
both emerge and flourish? Which disciplines, and who within these
For example in Step 8: Positive Body-Self Relations, Cash designed
disciplines, prompted the exploration of positive body image? We
specific activities to enhance appreciation of the body’s health, fit-
emphasize that the confluence of several disciplines, and leaders
ness, and sensate experiences, which emphasize the importance of
within disciplines, positioned the study of positive body image to
body functionality to body image.
be imperative and ripe for discovery.
Prevention. Researchers of eating disorder prevention efforts,
such as Michael Levine, Lori Irving, Niva Piran, Linda Smolak,
Influences within the Body Image Field Catherine Steiner-Adair, Susan Paxton, and Catherine Cook-
Cottone, also helped develop positive body image scholarship and
Thomas Cash. As noted previously, Thomas Cash is the inno- clinical practice. One strategy to prevent the onset of an eating
vator and common denominator of the two events that propelled disorder is to foster positive body image as a way to circum-
positive body image research forward: the emphasis of positive vent the development of a negative body image (Smolak, 1999),
body image as a future direction for research within the first edition and these scholars have traditionally conceptualized positive body
of Body Image: A Handbook of Theory, Research, and Clinical Practice image to include self-worth and appreciation for the functional-
(Cash & Pruzinsky, 2002) and the inclusion of positive body image ity and diverse appearances of the body (Menzel & Levine, 2011;
inquiry within the Aims and Scope of Body Image: An International Paxton, 1999; Piran, Levine, & Steiner-Adair, 1999; Smolak, 1999).
Journal of Research. In addition to these foundational contributions, Prevention researchers have devised ways to build positive body
it is also important to acknowledge Cash’s (and his collaborators’) image. For example, many programs contain efforts to increase
additional contributions to understanding and assessing positive media literacy, which build skills to protect body image against
body image. For example, Cash and his colleagues conducted the unrealistic media appearance ideals (Cook-Cottone, Kane, Keddie,
first study documenting positive body image as a unique construct & Haugli, 2013; Steiner-Adair & Sjostrom, 2006; Wilksch & Wade,
(Williams, Cash, & Santos, 2004). Below, we acknowledge Cash’s 2009). Some programs help participants develop an appreciation
seminal contributions of body image quality of life, positive ratio- for their bodies via nurturing body awareness and responsiveness
nal acceptance coping, and clinical interventions to positive body via yoga (Cook-Cottone et al., 2013; Scime & Cook-Cottone, 2008).
image scholarship. Cognitive dissonance-based prevention programs include behav-
Cash and Fleming (2002) investigated the positive and nega- ioral activities whereby participants speak or write positively about
tive impacts of body image on college women’s quality of life. their bodies, including their bodies’ physical, emotional, intellec-
Without exception, college women reported more positive than tual, and social qualities (Becker & Stice, 2011; Stice & Presnell,
negative consequences of their body image for the 19 life domains 2007).
studied (e.g., feelings of personal adequacy, interactions with Feminist influences. Feminist scholars in the body image field
friends, acceptability as a sexual partner, happiness in everyday have also contributed to positive body image theory, research, and
life, grooming activities, ability to control weight) in this initial practice. They argue that it is acceptable and preferable for bod-
validation study. This finding was monumental, as it countered ies to differ from societal ideals and champion for a culture that
prevailing notions that most women dislike their bodies and body resists engaging in body hate or shame-based dialog and action.
image adversely impacts their well-being. In a second study, Cash, They uncover and challenge the various media motives to use bod-
Jakatdar, and Williams (2004) further investigated body image ies and appearances to sell products.

Please cite this article in press as: Tylka, T. L., & Wood-Barcalow, N.L. What is and what is not positive body image? Conceptual foundations
and construct definition. Body Image (2015), http://dx.doi.org/10.1016/j.bodyim.2015.04.001
G Model
BODYIM-713; No. of Pages 12 ARTICLE IN PRESS
T.L. Tylka, N.L. Wood-Barcalow / Body Image xxx (2015) xxx–xxx 3

Proponents of Health at Every Size® such as Linda Bacon, Sigrún Tylka, & Wood-Barcalow, 2005) to assess (a) favorable opinions of
Daníelsdóttir, Deb Burgard, and Rachel Calogero help individuals the body regardless of actual physical appearance, (b) acceptance
understand that it is empowering to resist internalizing media of the body despite incongruences with media appearance ideals,
appearance ideals and messages, and instead, appreciate and love (c) respect toward the body by tending to its needs and engaging
the body, including its differences from these ideals. These pro- in healthy behaviors, and (d) protection of the body by rejecting
ponents challenge weight stigma, which presents roadblocks to unrealistic appearance ideals. Recently, we updated the BAS (i.e.,
health, and promote all individuals’ accessibility to physical health BAS-2; Tylka & Wood-Barcalow, 2015). We use the BAS and BAS-
and psychological well-being. They disseminate these messages 2 to conduct quantitative research on positive body image (e.g.,
through research in academic journals (e.g., Bacon, Stern, Van Avalos et al., 2005; Homan & Tylka, 2014; Tylka & Wood-Barcalow,
Loan, & Keim, 2005), children’s literature (e.g., Daníelsdóttir, 2014), 2015).
and literature geared toward general readership (e.g., Bacon & Positive psychology. Positive psychology is a more recent
Aphramor, 2014). strength-based discipline that shares many similarities with
Niva Piran and her colleagues have conducted research on girls humanistic and counseling psychology. Although research on posi-
and women for over 20 years, which culminated in the recognition tive psychological constructs was occurring prior to its introduction
of positive experiences of connected embodiment (i.e., the expe- as a discipline, its emergence reinvigorated and expanded the study
rience of engaging the body with the world), such as embodied of human strengths in various areas of scholarship and clinical rel-
agency, self-care, joy, and functionality (Piran, Carter, Thompson, evance. Its proponents, including Martin Seligman, Shane Lopez,
& Pajouhandeh, 2002; Piran & Teall, 2012), and its three core dimen- Sonja Lyubomirsky, and Barbara Fredrickson, argue that removing
sions: physical freedom, mental freedom, and social power (Piran, negative or maladaptive characteristics in the absence of teach-
2001, see Piran, 2015, in this issue). Furthermore, Mimi Nichter, ing positive and adaptive characteristics creates “languishing,” or
Carolyn Becker, and Reneé Engeln have studied and/or developed intermediate mental health characterized by a lack of pathology
programs to help girls and women develop skills to resist the pres- but the absence of vitality (Fredrickson & Losada, 2005; Seligman
sure to engage in body-based dialog, or fat talk, which provides a & Csikszentmihalyi, 2000). Indeed, positive characteristics may
forum for women to bond with one another by talking badly about not simply represent the absence of negative characteristics—for
their bodies (Becker & Stice, 2011; Nichter, 2001; Salk & Engeln- instance, fostering positive affect is more beneficial therapeutically
Maddox, 2011). than simply lowering negative affect (Fredrickson & Losada, 2005).
Feminist scholars also have considered an intersectional per- Thus, it is imperative for our field to study positive body image
spective, or the influence of multiple social identities, on body and how to promote it, because working to understand and reduce
image. Marika Tiggemann, Linda Smolak, Viren Swami, and Ruth negative body image alone will be insufficient.
Striegel Weissman have explored how social identities (e.g., age,
developmental level, race/ethnicity, socioeconomic status, femi-
Eastern Influences Outside of Psychology: Buddhism
nist identity) may be protective for positive body image, negative
body image, and eating disorders (Smolak, 1999; Striegel-Moore
Buddhism, which conceptualizes psychological distress as
& Cachelin, 1999; Swami, Airs, Chouhan, Leon, & Towell, 2009;
rooted in the rigid and inflexible desire to avoid or control adverse
Tiggemann, 2001; Tiggemann & Stevens, 1999).
internal experiences (e.g., thoughts, emotions, perceptions, and
sensations), has also contributed to positive body image theory,
research, and practice. Buddhism emphasizes the value in being
Strength-Based Disciplines within Psychology
mindful of internal experiences, accepting these internal experi-
ences without trying to change them, choosing a meaningful and
Strength-based disciplines within the broader field of psychol-
valued direction, and proceeding in this direction (Hayes, Strosahl,
ogy are foundational to the study of positive body image (Tylka,
& Wilson, 1999). Approaching distress in this way promotes psy-
2011, 2012). These disciplines (i.e., humanistic psychology, coun-
chological flexibility (Hayes et al., 1999) and self-compassion (Neff,
seling psychology, and positive psychology) emphasize that human
2003). When this flexible mindset is activated in the context of
strengths, psychological well-being, and physical health are impor-
positive body image, threats to body image are understood to be
tant to consider within theory, research, and practice.
time-limited and not true in an absolute sense, and the choice
Humanistic psychology. Largely shaped by Carl Rogers and
is made to proceed in a direction that values the body instead
Abraham Maslow, humanistic psychology has emphasized the need
of engaging in body-related rumination or criticism (Pearson,
for unconditional acceptance to promote well-being (Rogers, 1961).
Heffner, & Follette, 2010; Webb, Butler-Ajibade, & Robinson, 2014).
Applied to the study of body image, unconditional acceptance
Self-compassion encourages not only mindfulness of internal expe-
entails individuals perceiving that their bodies are accepted and
riences, but also kindness to oneself during times of distress, and
loved “as is” by significant others and not treated in a negative way
understanding that distressing internal experiences are shared by
by society at large (Avalos & Tylka, 2006). Humanistic psychology
all (Neff, 2003). Self-compassion may promote body compassion by
has also proposed the motives of self-actualization and transcen-
buffering the distress prompted by body image-related threats.
dence (Maslow, 1943), which involve moving beyond appearance
and the physical form of the body to its spiritual significance and
meaning (Jacobson, Hall, & Anderson, 2013). Summary
Counseling psychology. Since its inception in the early 1900s,
counseling psychology has recognized the importance of consid- The aforementioned disciplines and leaders provided a fertile
ering strengths alongside weaknesses, appreciated cultural and grounding for the development of positive body image the-
body-related diversity, and worked to prevent illness by promot- ory, research, and practice. Their contributions include (a) the
ing health (Gelso & Fretz, 2001). We, the authors, are counseling operationalization of core constructs, (b) the development of inter-
psychologists who are interested in body image, and we used the ventions to promote a mindful and appreciative connection to the
strength-based fundamentals within our discipline to notice the body, (c) the integration of a body acceptance-based philosophy,
lack of positive body image theory and research and to see value in and (d) moving body image beyond appearance to encapsulate
contributing to this work. Together, we developed an assessment other body-related dimensions, such as body functionality. These
of positive body image, the Body Appreciation Scale (BAS; Avalos, contributions underscore that positive body image is a unique

Please cite this article in press as: Tylka, T. L., & Wood-Barcalow, N.L. What is and what is not positive body image? Conceptual foundations
and construct definition. Body Image (2015), http://dx.doi.org/10.1016/j.bodyim.2015.04.001
G Model
BODYIM-713; No. of Pages 12 ARTICLE IN PRESS
4 T.L. Tylka, N.L. Wood-Barcalow / Body Image xxx (2015) xxx–xxx

construct worthy of investigation. Next, we use these investigations this conceptualization is inaccurate and incomplete. Five examples
to define and describe this construct. are provided below.
First, Williams et al. (2004) conducted a cluster analysis on U.S.
college women based on their body image evaluation, their body
Positive Body Image: What It Is, and What It Is Not
image emotional experiences, and the impact of body image on
their quality of life. Cluster analysis identifies groups of individ-
We conducted a mixed methods study with both qualita-
uals who are similar to each other but different from individuals
tive and quantitative research components to gain insight into
in other groups. Three distinct multidimensionally defined groups
the construct of positive body image (Wood-Barcalow, Tylka, &
emerged: a positive body image group (54%), a negative body image
Augustus-Horvath, 2010). We first utilized the Multidimensional
group (24%), and a “normative body image discontent” group (23%).
Body-Self Relations Questionnaire (Brown, Cash, & Mikulka, 1990;
While the normative body image discontent group and the nega-
Cash, 2000) and a general question, “I feel that I have a positive
tive body image group had similar levels of body dissatisfaction, the
body image,” to identify college women who espouse a positive
negative body image group reported greater body image dysfunc-
body image. We then conducted in-depth individual interviews
tion (i.e., higher body image emotional distress and more adverse
with these women to explore fully what it means to endorse a
impact of body image on quality of life). Importantly, the posi-
positive body image. To further substantiate information, we inter-
tive body image group demonstrated a unique pattern of superior
viewed body image researchers and clinical experts to discern their
well-being in comparison to the other groups: they were relatively
definition and description of this construct which was then inter-
content with their appearance, seldom expressed body image emo-
woven with the women’s reports. As we looked across the themes
tional distress, and felt that their body image favorably influenced
that emerged, we rather boldly decided to propose the following
their quality of life.
definition of positive body image:
Second, positive body image, assessed via the BAS, was uniquely
An overarching love and respect for the body that allows indi- associated with U.S. college women’s well-being (self-esteem, opti-
viduals to (a) appreciate the unique beauty of their body and mism, and proactive coping) after extracting shared variance with
the functions that it performs for them; (b) accept and even negative body image (Avalos et al., 2005). Similar findings were
admire their body, including those aspects that are inconsistent noted using the BAS-2 as the measure of positive body image:
with idealized images; (c) feel beautiful, comfortable, confident, after extracting shared variance with body dissatisfaction, body
and happy with their body, which is often reflected as an outer appreciation accounted for unique variance in U.S. college women’s
radiance, or a “glow;” (d) emphasize their body’s assets rather well-being (self-esteem and proactive coping), intuitive eating
than dwell on their imperfections; and (f) interpret incoming (i.e., eating according to hunger and satiety cues), and eating
information in a body-protective manner whereby most posi- disorder symptomatology, and U.S. college men’s well-being and
tive information is internalized and most negative information intuitive eating (Tylka & Wood-Barcalow, 2015). Positive body
is rejected or reframed. (Wood-Barcalow et al., 2010, p. 112) image, assessed via the BAS, was related incrementally to Australian
women’s greater use of sun protection (e.g., SPF products), perform-
While the above provides a “working definition” for scholars
ing skin cancer screening, and lower engagement in weight-loss
and clinicians, a significant limitation is that it was derived from
behaviors after extracting shared variance with body dissatisfac-
15 traditional college-aged women and five body image experts
tion (Andrew, Tiggemann, & Clark, 2014). Therefore, positive body
from the United States without an understanding of its general-
image has unique associations with well-being, self-care, and eat-
izability to males, people from non-Western areas, older women,
ing behavior that are not accounted for solely by negative body
etc. Although many aspects of this definition have been observed
image.
independently in adolescent girls and boys from Sweden (Frisén
Third, body image flexibility also has been found to be distinct
& Holmqvist, 2010; Holmqvist & Frisén, 2012), African American
from negative body image. Recognized as an aspect of positive
girls from the United States (Pope, Corona, & Belgrave, 2014), and
body image derived from Buddhism, body image flexibility entails
Aboriginal girls from Canada (McHugh, Coppola, & Sabiston, 2014),
a willingness to accept and experience perceptions, sensations,
as well as numerous quantitative studies, additional research is
feelings, thoughts, and beliefs about one’s body in an intentional
paramount to more fully understand this construct—its common-
way without attempting to change their intensity, frequency, or
alities across samples and its nuances within specific samples. In
form, while pursuing effective action in other life domains (Webb
short, a fundamental path has been emblazoned, and yet the field
et al., 2014). For instance, a woman who experiences external crit-
is still ripe for discoveries. Assuming that this definition is repre-
icism directed toward her body would demonstrate body image
sentative of positive body image, at least for select groups, we now
flexibility by being mindfully aware of the negative emotions that
describe positive body image by what it is, as well as what it is not.
arise, purposefully evoke self-kindness, recognize that most people
would have a similar emotional reaction in this situation, and then
Distinct from Negative Body Image engage in self-care (e.g., journal about the experience, go for a walk,
treat herself to a massage, or call a friend). Body image flexibility
Positive body image is its own construct; in other words, it is dis- (assessed as low experiential body image avoidance) was uniquely
tinct from negative body image. Positive body image is not on the associated with U.S. college women and men’s disordered eating
same continuum as negative body image, nor should it be repre- after extracting shared variance with body dissatisfaction (Sandoz,
sented as low levels of negative body image. Perhaps one reason Wilson, Merwin, & Kellum, 2013).
why research on positive body image research began as a slow Fourth, Tiggemann and McCourt (2013) examined relationships
start was due to it being conceptualized as one endpoint along a between positive body image (assessed by the BAS), body dissatis-
body image continuum, with negative body image anchored at the faction, and Australian women’s age. The strength of the inverse
opposite endpoint (Tylka, 2011, 2012). As a result of this conceptu- correlation between positive body image and body dissatisfac-
alization, positive body image did not need to be defined or studied tion decreased as women’s age increased. Moreover, positive body
separately, because findings from negative body image measures image was positively related to age, whereas body dissatisfaction
would reveal the entire picture—if negative body image was low, was unrelated to age. Tiggemann and McCourt concluded that pos-
positive body image would be high and vice versa. However, several itive body image and body dissatisfaction are not mirror images
independent research teams around the world demonstrated that of one another, as it becomes increasingly possible for women to

Please cite this article in press as: Tylka, T. L., & Wood-Barcalow, N.L. What is and what is not positive body image? Conceptual foundations
and construct definition. Body Image (2015), http://dx.doi.org/10.1016/j.bodyim.2015.04.001
G Model
BODYIM-713; No. of Pages 12 ARTICLE IN PRESS
T.L. Tylka, N.L. Wood-Barcalow / Body Image xxx (2015) xxx–xxx 5

simultaneously experience some level of body dissatisfaction but functionality, and health of the body. Body appreciation is not solely
also to appreciate and respect the body in other ways, especially appreciating one’s appearance or the extent that one’s body aligns
with age. with cultural appearance ideals. Rather, it involves praising the
Fifth, there is a conceptual distinction between body dissatisfac- body for what it is able to do, what it represents, and its unique
tion and positive body image. Many African American adolescent features. College women from the U.S. reported that they now
girls identified self-perceived flaws with their bodies and features appreciate features of their body that they previously disliked or
they would like to change (suggesting some degree of body dis- ignored (Wood-Barcalow et al., 2010). They further acknowledged
satisfaction), and at the same time they demonstrated positive that focusing on and being grateful for their bodies’ functionality
feelings about their bodies (Pope et al., 2014). Indeed, for older- aided their positive body image. Swedish adolescent boys and girls
adolescent African American girls, there was only 19% conceptual viewed their bodies as important aspects of themselves that they
overlap (r2 ) between body appreciation and body dissatisfaction, need to appreciate and take well care of, for example, by exercis-
and 27% conceptual overlap between body image flexibility and ing to maintain or even improve what their bodies were able to do
body dissatisfaction (Webb et al., 2014). While the conceptual over- (Frisén & Holmqvist, 2010). Swedish and African American adoles-
lap between body appreciation and body dissatisfaction appears to cents with positive body image appreciated diverse appearances
be larger for a predominantly Caucasian sample of college women and shapes, which allowed them to appreciate their own unique
(i.e., 53%) and men (41%), there is still evidence of construct differ- appearances (Holmqvist & Frisén, 2012; Pope et al., 2014). Native
entiation within these estimates (Tylka & Wood-Barcalow, 2015). Canadian adolescent girls stated that honoring their Aboriginal her-
itage, via engaging in Native customs (e.g., powwow dance) and
Multifaceted participating in social change to challenge negative stereotypes
of Aboriginal people, helped foster their positive body image by
Positive body image is a multidimensional construct that being proud of their Native appearance-related features and proud
involves much more than body satisfaction or appearance evalua- of their bodies for allowing themselves to partake in the customs
tion. Positive body image is not a unidimensional construct that can of their culture (McHugh et al., 2014).
be comprehensively assessed via a measure of body satisfaction or Body acceptance and love. Body acceptance and love is
gauged by the extent individuals favorably view their appearance. expressing love for and comfort with the body, even if not com-
Three examples illustrate the multifaceted nature of positive body pletely satisfied with all aspects of the body. Body acceptance and
image. love is not narcissism or vanity. If the focus is on “aligning with
First, we investigated whether positive body image would pre- sociocultural ideals” (e.g., looking like models in the media), “being
dict unique variance in women’s well-being and eating behaviors more attractive than others” (e.g., appearance-related comparison
above and beyond individuals’ self-reported appearance evalua- and competition), and/or “doing whatever it takes” to achieve and
tion. In two studies using the BAS (Avalos et al., 2005) and the BAS-2 maintain an appearance inconsistent with one’s physical features,
(Tylka & Wood-Barcalow, 2015), we uncovered that positive body the result may represent narcissism and vanity. In contrast, lov-
image was uniquely associated with each measure of well-being ing the body for what it can do and its connection to others (e.g.,
and eating behaviors after extracting shared variance with appear- ethnic heritage) and accepting one’s unique physical features is
ance evaluation. We concluded that positive body image is a more representative of positive body image.
complex construct than appearance evaluation alone. College women from the U.S. with positive body image empha-
Second, evidence suggests that facets of positive body image, sized that they chose to focus on their body assets rather than
such as body appreciation, body image flexibility, functional body their perceived body flaws, and they admired how their bodies
orientation (focusing on how the body feels and functions more are unique rather than attempted to conform to unrealistic soci-
so than appearance), and functional body satisfaction (satisfac- etal appearance ideals (Wood-Barcalow et al., 2010). Two-thirds of
tion with what the body can do and experience) do not overlap the adolescent sample from Sweden mentioned one or more body
completely with one another. Among African American adolescent areas that they were not satisfied with; however, they were not
girls, the conceptual overlap (r2 ) between body appreciation and troubled by these areas and instead accepted these features (Frisén
body image flexibility was 49%, demonstrating some differentiation & Holmqvist, 2010). African American adolescent girls emphasized
between these constructs (Webb et al., 2014). Also, functional body their body assets, and about a third of the sample reported global
satisfaction and functional body orientation, which overlapped 15% body acceptance—or liking everything about their bodies (Pope
with one another, overlapped only 27% and 30% with body appre- et al., 2014). Adolescent Aboriginal girls from Canada articulated
ciation, respectively, in a sample of U.S. college women (Homan & that body acceptance is necessary for body pride and emphasized
Tylka, 2014). that they liked how they looked and did not want to change their
Third, qualitative research has revealed that positive body image appearance even if others wanted them to make changes—they
contains many facets, although we do not have measures on all were comfortable in their bodies (McHugh et al., 2014).
these facets yet to study them via quantitative inquiry. Specifically, Broadly conceptualizing beauty. Broadly conceptualizing
research teams interviewed college women (seven African Ameri- beauty is the perception that a wide range of appearances can
can, seven White, and one biracial) with a positive body image from be beautiful, whether these appearances are unchangeable (e.g.,
the U.S. (Wood-Barcalow et al., 2010), adolescent girls and boys weight, height) or modifiable (e.g., personal style). Those who hold
with a positive body image from Sweden (Frisén & Holmqvist, 2010; a broad conceptualization of beauty may draw from inner char-
Holmqvist & Frisén, 2012), African American adolescent girls and acteristics, such as confidence and personality, when determining
their maternal caregivers from the U.S. (note that these girls were beauty in themselves and others. For example, they may remark,
not chosen based on having a positive or negative body image; Pope “confidence enhances beauty,” and “one aspect of her beauty is
et al., 2014), and Aboriginal adolescent girls who espoused body her generosity.” They also find beauty in their own features that
pride from Canada (McHugh et al., 2014). Several common facets may not align with sociocultural appearance ideals. Thus, broadly
emerged across the themes generated from each study, which sup- conceptualizing beauty is not limited to finding beauty in others;
port the assertion that positive body image is multifaceted. These on positive body imageis also generalized to the self. Further-
facets include: more, broadly conceptualizing beauty is not the same as sexual
Body appreciation. Body appreciation, defined here more nar- attractiveness—a person may see beauty in someone and may or
rowly than in Avalos et al. (2005), is appreciating the features, may not be sexually attracted to him or her.

Please cite this article in press as: Tylka, T. L., & Wood-Barcalow, N.L. What is and what is not positive body image? Conceptual foundations
and construct definition. Body Image (2015), http://dx.doi.org/10.1016/j.bodyim.2015.04.001
G Model
BODYIM-713; No. of Pages 12 ARTICLE IN PRESS
6 T.L. Tylka, N.L. Wood-Barcalow / Body Image xxx (2015) xxx–xxx

Broadly conceptualizing beauty has been a theme throughout radiance” (Tylka, 2011, p. 59). Inner positivity is not vain or narcis-
the qualitative/mixed methods literature on positive body image. sistic attitudes toward one’s appearance, nor is it expressed in vain
Adolescent girls and boys from Sweden emphasized that being or narcissistic acts.
attractive or beautiful does not imply having looks that are consis- Indeed, college women from the U.S. described positive body
tent with societal definitions of beauty, and they emphasized that image as being happy on the inside, which then reflects on the out-
people should “try to be themselves” rather than strive to attain side as a confident glow or “sparkle in the eye” (Wood-Barcalow
external ideals (Holmqvist & Frisén, 2012, p. 391). College women et al., 2010, p. 111). These women reported that inner positivity
from the U.S. indicated that they appreciated different “looks” and directed engagement toward self-care behaviors such as partici-
emphasized that beauty should not be compared between individ- pating in pleasurable exercise on a regular basis, adaptive stress
uals, as people can be beautiful in an indefinite number of ways relief (e.g., yoga), preventative care (e.g., doctor visits), flexible
(Wood-Barcalow et al., 2010). African American adolescent girls (i.e., intuitive) and nutritious eating, and pampering their bodies
tended to have a flexible definition of beauty and beauty ideals, (e.g., massage). Adolescent girls and boys from Sweden believed
placing more emphasis on creating a style “which works” to make that individuals’ dispositions can alter their perceived attractive-
a personal statement and project a unique presence (Parker et al., ness (Holmqvist & Frisén, 2012). Moreover, their inner positivity
1995). Adolescent Aboriginal girls from Canada conceptualized was tied to their physical activity, as many were involved in
positive body image as experienced on the “inside” yet expressed sports for years and had achieved “meaningful continuity in their
outwardly in their choice of style, grooming, and behaviors—these exercise”—that is, they exercised for enjoyment and challenge
girls were clear that positive body image did not result from looking rather than to control the size and shape of their bodies (Frisén &
a certain way (McHugh et al., 2014). Holmqvist, 2010, p. 210). Aboriginal adolescent girls from Canada
Adaptive appearance investment. Adaptive appearance reported that body pride was experienced internally (e.g., being
investment is regularly engaging in appearance-related self-care, comfortable in and loving the body) and expressed externally (e.g.,
such as grooming behaviors that project an individual’s sense of via confidence, self-respect, and participation in cultural practices
style and personality—it is enhancing one’s natural features via such as powwow dance) and that exercise and eating healthy foods
benign methods. Adaptive appearance investment is not engaging both stemmed from and maintained their positive body image
in potentially destructive appearance-altering methods to fit (McHugh et al., 2014).
external standards of beauty, basing self-worth on appearance, Filtering information in a body-protective manner. Filtering
or being preoccupied with appearance fixing behaviors. As Cook- information in a body protective manner is accepting information
Cottone (2015, in this issue) argues, individuals with positive body that is consistent with positive body image while rejecting mes-
image neither judge nor ignore their bodies. Instead, they engage sages that could endanger it. Individuals who regularly engage in
in self-care that involves adaptive appearance investment. this filtering process have been referred to as having “a protective
Mixed methods research has uncovered that those with positive filter” (Wood-Barcalow et al., 2010, p. 109). Filtering information in
body image are invested in their appearance, and they view this a body protective manner is not foolproof, as individuals with posi-
investment an adaptive representation of themselves to the world. tive body image can be susceptible to body image-related threats at
In our study, U.S. college women with positive body image revealed particularly vulnerable times (e.g., when tired, stressed, when the
that they maintain and enhance their appearance via self-care, such threat comes from someone particularly meaningful to the individ-
as getting manicures and engaging in healthy eating and exercise ual, etc.).
(Wood-Barcalow et al., 2010). Although they acknowledged the College women from the U.S. who had a protective filter
appearance-related benefits of these behaviors, they also viewed were aware of the unrealistic and fabricated nature of media
these behaviors as acts of kindness toward their bodies. They did images, rejected and challenged these images, as well as inter-
not invest their self-worth in their appearance, which helped some preted and internalized messages that were compassionate toward
women cope with changes in their appearance brought on by ill- their bodies (Wood-Barcalow et al., 2010). However, these women
nesses (e.g., cancer, lupus). African American girls emphasized that sometimes absorbed negative information, such as weight-related
they valued being “well-kept” and “having it going on,” which they criticism from significant others. In this manner, protective filter-
described as being well-groomed and projecting their sense of style, ing may be tied to body image flexibility, as these women were
personality, and confidence within their appearance (Parker et al., aware of their negative affect resulting from this criticism but were
1995, p. 108). According to the authors, “this indexed making what able to accept their feelings and, in time, move toward behaviors
they had work for them: long nails, pretty eyes, big lips, nice thighs, reflecting self-care instead of body shame. Swedish adolescents
a big butt—whatever” (p. 108). with a positive body image reported not being particularly bothered
Cash, Melnyk, and Hrabosky (2004) divided appearance invest- by negative appearance-related comments (Frisén & Holmqvist,
ment into self-evaluative salience (i.e., a dysfunctional connection 2010), were aware of unnatural and unrealistic appearance ideals
of appearance to self-worth) and motivational salience (i.e., a and the media’s use of these ideals for profit, and actively criticized
benign and potentially adaptive engagement in efforts to feel these ideals (Holmqvist & Frisén, 2012). Many African American
attractive). Women with positive body image have lower levels of girls also were aware of and denounced media appearance stan-
self-evaluative salience but similar levels of motivational salience, dards, although roughly a similar number reported attitudes and
compared to women with negative body image or normative body behaviors consistent with internalizing such ideals (Pope et al.,
discontent (Williams et al., 2004). Motivational salience has been 2014). Aboriginal adolescent girls from Canada spoke about the
found to be protective when individuals undergo appearance- need to overcome body-related pressures from influential others
related changes, such as changes brought on by breast cancer and the media in order to maintain their body pride (McHugh et al.,
(Carver et al., 1998). Whether motivational salience is the best 2014).
representation of adaptive appearance investment as reflected in
positive body image, however, has yet to be investigated. Holistic
Inner positivity. Inner positivity is the connection between pos-
itive body image, positive feelings (e.g., body confidence, optimism, Positive body image is holistic in that the multiple facets of
happiness), and adaptive behaviors (e.g., self-care, helping oth- positive body image reviewed in the previous section are best
ers). Inner positivity can also manifest as smiling, asserting oneself, interpreted together rather than independently of each other.
holding the “head up high,” and emanating a “special glow or “outer Additionally, internal experiences (e.g., inner positivity, protective

Please cite this article in press as: Tylka, T. L., & Wood-Barcalow, N.L. What is and what is not positive body image? Conceptual foundations
and construct definition. Body Image (2015), http://dx.doi.org/10.1016/j.bodyim.2015.04.001
G Model
BODYIM-713; No. of Pages 12 ARTICLE IN PRESS
T.L. Tylka, N.L. Wood-Barcalow / Body Image xxx (2015) xxx–xxx 7

filtering) are intertwined with external behaviors, interpersonal mindfulness, resilience, social closeness, and physical health.
relationships, community, media, and culture (Wood-Barcalow Indeed, Fitzsimmons and Bardone-Cone (2011) studied a “down-
et al., 2010). Body-related thoughts, affect, perceptions, and behav- ward spiral,” whereby initial weight concern predicted subsequent
iors also are interconnected. Thus, positive body image is not weight concern through body surveillance. Researchers exploring
segregated to one dimension of a person (e.g., perceptions, affective positive body image could use this reciprocal-influence design
evaluation) or even within the person, as it is often assessed within (Burns et al., 2008) to study, for instance, whether initial levels of
research. Cook-Cottone (2015, in this issue) refers to the holistic body appreciation predict subsequent body appreciation through
nature of positive body image as attunement, which is a reciprocal physical activity (e.g., yoga participation, belly dance), intuitive
process of mutual influence and co-regulation within and between eating interventions, and self-compassion interventions.
the internal systems (i.e., thoughts, affect, physiology) and external
systems (i.e., family, community, culture). Stable and Malleable
In our interviews with U.S. college women, we labeled this
process reciprocity (Wood-Barcalow et al., 2010). Similar to attune- Although seemingly incompatible, positive body image is both
ment, reciprocity is the mutual interdependence of the individual stable and malleable, including both trait and state qualities.
and the environment. We found that various sources, both internal Because we only have measures of trait positive body image, it is
(e.g., illness) and external (e.g., medical treatment, body accep- easy to assume that fluctuations in positive body image are nei-
tance from others, spirituality, media literacy) influenced women ther evidenced nor impactful. Yet, mounting evidence suggests that
with positive body image. For example, one woman revealed that positive body image is not solely a stable trait.
she appreciated her once renounced hair upon receiving a cancer A study emphasizing positive body image’s state and trait quali-
diagnosis and the recognition that she may lose her locks due to ties was conducted by Albertson, Neff, and Dill-Shackleford (2014).
chemotherapy. Appreciation for her hair explicated her ability to These authors designed and delivered a 3-week self-compassion
respond to a body image-related threat (i.e., anticipated changes in meditation training to adult women with existing body image
appearance resulting from cancer treatment) with adaptive coping. concerns. Women completed body image measures, including the
Support from her friends further was instrumental in this woman BAS (Avalos et al., 2005), at baseline, post-intervention, and three
accepting the appearance-related changes brought on by the ill- months after completing the intervention. Women who received
ness and its treatment: “My friends helped me calm down and the self-compassion meditation training reported significantly
remember that no matter what I look like, I’m still going to be me” greater gains in body appreciation at post-intervention compared
(Wood-Barcalow et al., 2010, p. 110). The women we interviewed to a waitlist control group, and maintained these gains at the 3-
were not only the recipients of these sources, but the women also month follow-up. Thus, positive body image can be increased via
changed, shaped, and altered their behaviors and environments in interventions and maintained over time, demonstrating both pos-
growth-enhancing ways. For instance, they chose to seek out oth- itive body image’s malleability and stability.
ers who had a positive body image, avoid body-related talk, and Furthermore, Halliwell, Jarman, McNamara, Risdon, and
searched for partners and friends who accepted their bodies in Jankowski (2015) examined the impact of a 1-hour cognitive
order to maintain their positive body image. They engaged in self- dissonance-based intervention on body appreciation (as assessed
care practices (e.g., yoga, stress management) and avoided practices by the BAS-2) in secondary school girls from the United Kingdom.
that could potentially harm their health and/or well-being (e.g., Participants in the intervention group who voiced opposition to the
reading appearance-related magazines), in order to protect their thin-ideal body type through various activities reported increased
physical health (to prevent future illness and/or reduce the negative body appreciation from pre- to post-intervention, whereas the
effects of their current illnesses) and psychological well-being. They control group experienced no change in body appreciation. These
served as mentors and role models to others, especially younger findings highlight the malleability of positive body image (i.e.,
females, about the importance of having a positive body image and evidenced by the intervention group) as well as its stability (i.e.,
self-care (e.g., regular enjoyable exercise, eating nutritiously). evidenced by the control group).
Reciprocity has also been noted in other qualitative studies. For Additional support for trait components of positive body image
instance, adolescents from Canada discussed how their Aboriginal include the BAS (Avalos et al., 2005) and BAS-2 (Tylka & Wood-
identity provided outlets for them to show their body pride, such as Barcalow, 2015) demonstrating trait stability over a 3-week period,
powwow dance, and by engaging in these outlets, they further built with a correlation of .90 noted across administrations for both
their body pride and cultural pride (McHugh et al., 2014). Partici- U.S. college women (BAS and BAS-2) and U.S. college men (BAS-2),
pating in athletics helped adolescent girls and boys from Sweden and scores did not increase or decrease between administrations.
focus on and appreciate the functionality of their bodies, and their Qualitative evidence for the long- and short-term malleability of
positive views about their bodies facilitated their engagement in positive body image has also been offered. In terms of its long-
sports for reasons related to self-care, enjoyment, and challenge term malleability, 12 of the 15 U.S. college women with positive
(Frisén & Holmqvist, 2010). Indeed, Tiggemann, Coutts, and Clark body image from Wood-Barcalow et al.’s (2010) study revealed
(2014) found that women who belly dance, an embodying activity that they endorsed a negative body image during adolescence.
promoted on the basis of fun and fitness and geared for individ- Transitioning to a positive body image was facilitated by a recip-
uals of all shapes and sizes, reported higher body appreciation than rocal process involving their cognitions, affect, perceptions, and
college women who have never engaged in belly dance. behaviors. For instance, they reported shifting their thinking (e.g.,
Research needs to investigate reciprocity within a quanti- choosing to conceptualize their weight gain during adolescence as
tative, and preferably longitudinal, paradigm. Efforts could be part of gaining a womanly shape), having others’ support and body
directed toward exploring “upward spirals,” or combinations acceptance, associating with friends who were not focused on body
of adaptive variables that trigger self-perpetuating cycles and and weight issues, modeling women who were proud of their body,
trajectories of positive psychological growth (Garland et al., and embracing an inclusive definition of beauty. The short-term
2010). Upward spirals have been studied in the field of positive malleability of positive body image was also noted within women’s
affect, such as Fredrickson’s (2001) broaden-and-build theory, responses when they were unable to filter out negative external
whereby positive emotions broaden cognitions, positive coping, influences (e.g., pressures to lose weight), prompting their positive
and interpersonal trust (i.e., expanding people’s mindsets), which body evaluation to decrease and their body investment to increase,
then build behavioral flexibility and personal resources such as which they referred to as “bad body image days.” Yet, these women

Please cite this article in press as: Tylka, T. L., & Wood-Barcalow, N.L. What is and what is not positive body image? Conceptual foundations
and construct definition. Body Image (2015), http://dx.doi.org/10.1016/j.bodyim.2015.04.001
G Model
BODYIM-713; No. of Pages 12 ARTICLE IN PRESS
8 T.L. Tylka, N.L. Wood-Barcalow / Body Image xxx (2015) xxx–xxx

noted that these shifts were temporary and that they were able to (Tylka & Kroon Van Diest, 2013), Australian adolescent girls
rebound from body image-related threats to their baseline positive (Andrew, Tiggemann, & Clark, 2015), and U.S. female college ath-
functioning. letes (Hahn Oh, Wiseman, Hendrickson, Phillips, & Hayden, 2012).
Longitudinal research is needed to investigate positive body Body appreciation was associated positively with self-compassion
image over years to provide a clearer picture of its stability and tran- among U.S. and Canadian college women (Homan & Tylka, 2015;
sience. It is worthwhile to investigate what characteristics promote Wasylkiw, MacKinnon, & MacLellan, 2012), as well as life satisfac-
resilience, or the ability to bounce back to positive body image, dur- tion and positive affect among U.S. college women and men (Tylka
ing and after perceived threats to body image. Trait positive body & Kroon Van Diest, 2013). Additionally, body appreciation has been
image may be similar to the trait of happiness: although a large linked in a positive direction to sexual satisfaction among U.S. adult
portion of happiness is heritable (i.e., some people are naturally women (Satinsky, Reece, Dennis, Sanders, & Bardzell, 2012), use of
happier than others), happiness can be enhanced for those with skin protection and skin cancer screening behaviors among Aus-
lower inherited happiness via the regular practice of intentional tralian adult women (Andrew et al., 2014) and U.S. college women
activities, such as random acts of kindness (Lyubomirsky, Sheldon, and men (Gillen, 2015), as well as sleep, meditation practice, and
& Schkade, 2005). Similarly, trait positive body image could be eas- conducting breast self-exams among U.S. college women (Tylka,
ier to achieve and maintain for some individuals (those with high 2015). Body appreciation also was linked positively to participation
heritable trait positive body image), whereas it may be more effort- in rigorous and regular exercise among U.S. college women when
ful for others. If so, it would be useful to understand the effortful, exercise motives were not mainly for appearance and weight loss
intentional activities (e.g., practicing positive body image affirma- (Homan & Tylka, 2014). Furthermore, body appreciation is inversely
tions, surrounding the self with others who have a positive body related to maladaptive perfectionism among U.S. college women
image) that boost positive body image for these individuals. Fur- (Iannantuono & Tylka, 2012), diet- and weight-related talk among
thermore, experimental research needs to examine fluctuations in Canadian women (Wasylkiw & Butler, 2014), unhealthy dieting
state positive body image. Modifications to the BAS (Avalos et al., behaviors among U.S. college women and men (Gillen, 2015; Tylka
2005) and BAS-2 (Tylka & Wood-Barcalow, 2015) could be incor- & Kroon Van Diest, 2013), and depressive symptoms among U.S.
porated to assess state body appreciation. For example, the first college women and men (Gillen, 2015).
item on both the BAS and BAS-2, “I respect my body,” could be One study has directly examined body appreciation as a protec-
modified to, “In this moment, I feel respect for my body.” Exper- tive factor. Halliwell (2013) integrated body appreciation within
imental designs could expose participants to potential threats to an experiment investigating U.K. college women’s vulnerability to
body image, such as exposure to media appearance ideals (Buote, media exposure. Women high in body appreciation did not place
Wilson, Strahan, Gazzola, & Papps, 2011), and potential enhance- increased importance on their appearance discrepancies (i.e., dif-
ments to body image, such as self-compassion or positive rational ferences between how they would like to look and how they
acceptance interventions (Albertson et al., 2014), to determine actually look) after viewing thin female models, as their appear-
which variables have the ability to impact state body appreciation ance discrepancies were similar in size to a control group who did
levels. not view thin models. In contrast, women low in body appreciation
placed increased importance on their appearance discrepancies
Protective after viewing thin female models compared to the control group.
Halliwell further observed that the protective effect of high body
Preliminary evidence supports that positive body image is likely appreciation extended to women who had internalized the thin
to be protective of physical health and psychological well-being. ideal.1 Among women who endorsed the thin ideal, those who
We qualify this statement because most of the research that has also had high body appreciation downplayed the importance of
been done on positive body image has been correlational or qual- their appearance discrepancies after viewing thin female mod-
itative in design rather than longitudinal or experimental. Clearly, els, whereas those who had low body appreciation reported larger
additional research investigating positive body image as a protec- appearance discrepancies and placed more importance on these
tive factor is warranted. Yet, in the research to date, it is clear that discrepancies after viewing thin female models.
positive body image is associated with numerous well-being, self- Two additional studies illustrated that body image flexibility
care, and adaptive physical health indices in a positive direction may also be a protective factor. Among U.S. college women and men
as well as distress and disturbance in an inverse direction (Andrew (Sandoz et al., 2013) and Portuguese community adult women and
et al., 2014; Augustus-Horvath & Tylka, 2011; Avalos & Tylka, 2006; men (Ferreira, Pinto-Gouveia, & Duarte, 2011), body image flex-
Gillen, 2015; Tylka, 2015). ibility (assessed as low experiential body image avoidance) was
Positive body image is not linked to disengagement in healthy related in a positive direction to general psychological flexibility
activity, eating, and self-care. It has been asserted that if individ- and in an inverse direction to disordered eating and body dissatis-
uals have a holistically favorable perspective of their bodies, they faction. Even more compelling is that both studies found that body
may not be motivated to engage in healthy behaviors (Heinberg, image flexibility buffered the relationship between body dissatis-
Thompson, & Matzon, 2001). As an example, some individuals have faction and disordered eating. Therefore, body dissatisfaction was
speculated that because African American female samples have, on less likely to be associated with disordered eating when body image
average, higher positive body image and higher BMIs than White flexibility was high. This finding suggests that the ability to note and
female samples, positive body image may contribute to obesity by accept negative body-related experiences (e.g., feelings, thoughts,
inhibiting motivation for weight control (for a review, see Flynn perceptions, and beliefs) while proceeding in a valued and adaptive
& Fitzgibbon, 1998). To date, there is no empirical research to direction can possibly prevent those who are dissatisfied with their
substantiate the speculation that positive body image leads to dis- bodies from engaging in disordered eating behaviors.
engagement in adaptive self-care behaviors.
Much of the evidence supporting positive body image as pro-
tective has been already reviewed (e.g., Frisén & Holmqvist, 2010;
Wood-Barcalow et al., 2010); thus, we highlight additional findings 1
Halliwell (2013) reported a correlation of −.36 between body appreciation and
in this section. Body appreciation has been found to be positively thin-ideal internalization. Although they are negatively related, it is not a strong cor-
related to intuitive eating among U.S. adult women (Augustus- relation. Thus, these constructs are differentiable. It is theoretically possible, then,
Horvath & Tylka, 2011; Avalos & Tylka, 2006), U.S. college men that some women appreciate their bodies yet prefer to be thin simultaneously.

Please cite this article in press as: Tylka, T. L., & Wood-Barcalow, N.L. What is and what is not positive body image? Conceptual foundations
and construct definition. Body Image (2015), http://dx.doi.org/10.1016/j.bodyim.2015.04.001
G Model
BODYIM-713; No. of Pages 12 ARTICLE IN PRESS
T.L. Tylka, N.L. Wood-Barcalow / Body Image xxx (2015) xxx–xxx 9

Although we do not conceptualize average or low BMI as a body appreciation. That is, lower body appreciation is not nec-
marker for physical health (see Tylka et al., 2014), it is important essarily related to having higher weights with respect to societal
to note that body appreciation and body image flexibility were ideals and/or norms but rather related to the perception that
inversely related to BMI in a number of studies (e.g., Lobera & Ríos, others do not accept their bodies. The various forms of weight
2011; Satinsky et al., 2012; Tylka & Kroon Van Diest, 2013; Tylka stigma that individuals encounter likely lower their perceptions of
& Wood-Barcalow, 2015; Webb et al., 2014). Therefore, promot- body acceptance by others, which then may serve as substantial
ing body acceptance and other facets of positive body image are roadblocks and barriers to body appreciation (Augustus-Horvath &
not likely to result in weight gain and “giving up” on achieving or Tylka, 2011; Tylka et al., 2014). Therefore, it is important that social
maintaining a healthy lifestyle. On the contrary, promoting positive activists, researchers, and clinicians work toward social change to
body image may increase participation in health-related behaviors eradicate both direct and subtle messages of body disparagement
(Andrew et al., 2014; Frisén & Holmqvist, 2010; Homan & Tylka, or shaming. Clearly, efforts need to be undertaken to inform
2014; Wood-Barcalow et al., 2010). parents, peers, schools, and the public (a) that positive body image
is more likely to be fostered by body acceptance than via messages
Linked to Self-Perceived Body Acceptance by Others to alter appearance and (b) how to differentiate between messages
that promote body acceptance and those that reflect detrimental
Positive body image is linked to perceiving that one’s body is appearance-related compliments (Calogero et al., 2009).
accepted by others, including family, friends, romantic partners, a In addition to body acceptance from family, friends, and part-
higher power, and society. If individuals perceive that their bodies ners, several U.S. college women with positive body image reported
are acceptable, they may be less preoccupied with changing their unconditional body acceptance from a higher power or God (Wood-
outer appearance and pay more attention to how their bodies feel Barcalow et al., 2010). They believed that religion and spirituality
and function. Often, positive body image is implicitly and indirectly assisted in their formation and preservation of a positive body
transmitted via (a) subtle acceptance-based messages from family image due to their belief that a higher power created their bodies
members and friends about style or appearance (e.g., “That haircut as unique and special, and in return, the women wanted to respect
really suits you”), (b) infrequent appearance-related talk, and (c) their higher power by caring for their bodies. Similarly, Aboriginal
general messages about beauty and love for the body (e.g., “We all adolescent girls from Canada described how spirituality influenced
need to love and appreciate our bodies,” “Everyone has a unique their body pride, helping them feel more connected with their bod-
beauty.”). ies, themselves, and nature (McHugh et al., 2014). African American
Positive body image is not aided by frequent body-related “com- adolescent girls who expressed a belief in God were accepting of
pliments” from others. In fact, one study found that the frequency their bodies, including their perceived flaws, believed that their
of appearance-based compliments women received, such as “You bodies were “gifts from God,” and viewed their bodies as perma-
are pretty,” “You have a nice body,” “You have pretty eyes,” was nent aspects of who they are spiritually. As such, the adolescent
associated with higher dysfunctional appearance investment (i.e., females felt they needed to love and care for their “gift” (Pope et al.,
body surveillance) and body dissatisfaction (Calogero, Herbozo, & 2014, p. 311).
Thompson, 2009). Does this finding suggest that others should Quantitative studies explored the connection between positive
never offer appearance-based compliments? Given sociocultural body image and spirituality. Homan and Cavanaugh (2013) discov-
pressures for attractiveness, never receiving an appearance-based ered that a secure attachment with God was associated with higher
compliment could also prompt body image distress. We acknowl- levels of body appreciation, a functional (rather than appearance-
edge that receiving and filtering body-related compliments from based) body orientation, and intuitive eating in a sample of U.S.
others is likely a complex process that has the propensity to be college women. Body sanctification, or the ability to conceptual-
either detrimental or enhancing due to a host of interacting vari- ize the body as holy, worthy of respect, and integral to one’s being,
ables (e.g., frequency of compliments, personality of the recipient, focuses on people’s experiences of their body (Jacobson et al., 2013).
perceived impact of the compliment, whether or not the com- For instance, those high in body sanctification may agree with state-
pliment is attached to a caveat or clause that reinforces societal ments such as “My body is a gift from God” and “God lives through
appearance standards). For example, “You’ve lost weight; you look my body” and perceive the body as spiritual, miraculous, divine, and
great!” intertwines weight loss with enhanced appearance, and spirit-filled (Mahoney et al., 2005). Among students from a U.S. lib-
thus has the potential to reinforce thin-ideal internalization. eral arts college, body sanctification was associated with (a) higher
Qualitative studies have revealed that individuals with posi- appearance and weight satisfaction and (b) lower body surveillance
tive body image perceive acceptance of their bodies by significant and depersonalization, even after controlling for general religious
others. Among Swedish adolescents with a positive body image, commitment (Jacobson et al., 2013).
the appearance-related conversations adolescents had with moth- As with other key features of positive body image, research is
ers, fathers, and siblings centered on external and interchangeable needed to investigate whether body sanctification and spirituality
aspects such as clothing choices and hairstyle rather than about can protect against body image-related threats and thereby reduce
body weight or size (Frisén & Holmqvist, 2010). College women the likelihood of pursuing potentially maladaptive appearance-
from the U.S. perceived that unconditional acceptance from family, fixing behaviors, such as cosmetic surgery. Researchers could assess
friends, and partners was central in the formation and mainte- body sanctification and spirituality within children and explore
nance of their positive body image, and provided examples such their responses to body image-related threats as they age.
as others reminding them that beauty is more than appearance
(Wood-Barcalow et al., 2010). Shaped by Social Identities
Quantitative studies show a strong connection between per-
ceptions of body acceptance by others and positive body image Given that positive body image emerged from and within disci-
among U.S. adult women (Augustus-Horvath & Tylka, 2011), plines that recognize individual differences and celebrate diversity,
female college athletes (Hahn Oh et al., 2012), and undergrad- researchers have considered how positive body image may be
uate men and women (Avalos & Tylka, 2006; Kroon Van Diest impacted by various social identities (e.g., culture, race, gender, age,
& Tylka, 2010). Augustus-Horvath and Tylka (2011) found that size, ability, sexual orientation, religion/spirituality, and socioeco-
perceived body acceptance by others accounted for, or mediated, nomic status). Tiggemann (2015, in this issue) thoroughly reviews
the inverse relationship between women’s body mass index and the literature on positive body image and social identities, and

Please cite this article in press as: Tylka, T. L., & Wood-Barcalow, N.L. What is and what is not positive body image? Conceptual foundations
and construct definition. Body Image (2015), http://dx.doi.org/10.1016/j.bodyim.2015.04.001
G Model
BODYIM-713; No. of Pages 12 ARTICLE IN PRESS
10 T.L. Tylka, N.L. Wood-Barcalow / Body Image xxx (2015) xxx–xxx

we direct interested readers to her article. The point we wish women and men, African American U.S. women, Malaysian women,
to make here is that positive body image is best conceptualized Brazilian women and men, Indonesian women and men, Chinese
and understood by the intersection of various social identities—an women from Hong Kong, and Spanish adolescents (Lobera & Ríos,
intersection which inevitably alters the expression and importance 2011; Ng et al., 2015; Satinsky et al., 2012; Swami & Chamorro-
of positive body image for each individual. Yet, most research Premuzic, 2008; Swami & Jaafar, 2012; Tylka & Kroon Van Diest,
on positive body image decontextualizes, or does not recognize, 2013; Tylka & Wood-Barcalow, 2015; Webb et al., 2014). This
participants’ various social identities. Positive body image is not inverse link could reflect the external and internalized weight
universal—meaning that there is no unitary positive body image biases within many cultures (Tylka et al., 2014). Of particular
construct that applies to all groups within all social identities. We note, body appreciation was unrelated to BMI among women from
illustrate this point with research thus far on culture, age, gender, Zimbabwe, perhaps due to cultural acceptance of diverse body sizes
and BMI. and shapes within this nation (Swami, Mada, & Tovée, 2012).
Culture. Many studies on cultural variations in positive body Summary. Positive body image will be constructed differently
image using the BAS (Avalos et al., 2005) have been conducted by for each individual, given his or her unique constellation of social
Swami and colleagues (Ng, Barron, & Swami, 2015; see Tiggemann, identities. Research is needed to determine how positive body
2015, in this issue, for a review). This research has revealed that image is shaped by unexplored social identities, such as gen-
there are likely differences in the concept and experience of pos- der identity. For example, body functionality may be associated
itive body image across cultures. Feeling good about one’s body, more with a masculine view of the body, whereas the self-care
accepting one’s body and its unique qualities, and taking a positive dimensions of positive body image may be considered feminine.
attitude toward one’s body may be aspects of positive body image Gender identity, then, could interact with gender, with masculine
that are similar across cultures. However, aspects related to auton- men unwilling to engage in certain forms of self-care, and femi-
omy over, and investment in, the body (e.g., self-care via respecting nine women downplaying the overall importance of their body’s
the body, engaging in healthy behaviors to take care of the body, functionality. Because one or more social identities can alter the
rejecting media appearance ideals) may differ across cultures (Ng experience of positive body image, it is important that this is
et al., 2015; Swami & Jaafar, 2012). According to Ng et al. (2015), acknowledged and reflected in research and clinical practice. We
culture-specific experiences may lead to variations in embodiment therefore encourage researchers and clinicians to use an inter-
and how individuals relate to their bodies, which in turn can result sectional approach, whereby they explore how social identities
in various conceptualizations of positive body image. Furthermore, interact to shape individuals’ experiences of positive body image
some terms used to describe positive body image, such as “body (Cole & Sabik, 2009). This conceptualization inevitably makes pos-
respect,” may have different meanings across individualistic and itive body image research and practice complex, yet we need to
collectivistic cultures in particular. Ng et al. (2015) asserted that it rise to this challenge when attempting to understand the dynamic
is important to investigate the cultural expression of positive body nature of positive body image.
image within a given culture before conclusions are surmised from
an assessment normed in a different culture.
Age. Evidence suggests that older women report appreciat- Conclusion
ing their bodies more readily than younger women (Tiggemann
& McCourt, 2013). As women age, they may be more likely to Acknowledging the importance of positive body image inquiry
understand how their body functions, rather than focusing mostly arose, in part, within the body image field, as illustrated by con-
on its appearance. Interestingly, Tiggemann and McCourt (2013) tributions by Cash and colleagues, eating disorder prevention
noted that, for their sample of Australian women, body appre- efforts, and feminist discourse and activism related to embod-
ciation increased across age while body dissatisfaction remained iment. Moreover, strength-based disciplines within psychology,
stable. This disconnection between body dissatisfaction and body such as positive psychology and counseling psychology, provided
appreciation suggests that as women age, they may be more likely the backdrop and rationale for why positive body image scholarship
to experience body appreciation even when they are dissatisfied is imperative—to balance research and clinical efforts for a more
with aspects of their bodies. In their sample of U.S. adult women, complete understanding of body image. Outside psychology, Bud-
Augustus-Horvath and Tylka (2011) found that early adult (ages dhism’s offerings of experiential awareness and self-compassion
26–39) experienced a stronger connection between body appreci- further aided the development of novel methods to promote a
ation and having a functional body orientation than the emerging mindful, appreciative, and benevolent connection to the body.
(ages 18–25) and middle (ages 40–65) adults, perhaps due to such Our current understanding of positive body image demon-
factors as recognizing and appreciating their bodies’ functionality strates that it is: a distinct construct from negative body image,
during pregnancy and childbirth. multifaceted (with the facets including body appreciation, body
Gender. Similar themes and characteristics related to positive acceptance and love, adaptive appearance investment, broadly con-
body image were noted among Swedish adolescent females and ceptualizing beauty, inner positivity that radiates outward and
males (Frisén & Holmqvist, 2010). Furthermore, research has shown manifests as adaptive behavior, and filtering information in a body-
that U.S. women and men have a similar concept and experience protective manner), holistic (in which internal experiences such as
of positive body image, as assessed by the BAS (Tylka, 2013) and inner positivity and protective filtering are interwoven with exter-
the BAS-2 (Tylka & Wood-Barcalow, 2015). Indeed, body appre- nal behaviors, interpersonal relationships, community, media, and
ciation was connected to physical health-related behaviors and culture to create attunement), stable but adjustable via interven-
well-being equally for U.S. college women and men (Gillen, 2015). tion, likely protective, linked to unconditional body acceptance by
However, some differences emerged in women and men’s levels others, and molded by individuals’ multiple social identities. We
of body appreciation. Whereas an online sample of community also elucidate that positive body image is not: being highly satisfied
men reported similar levels of body appreciation as community with all aspects of appearance, limited to appearance at the exclu-
women, college men reported higher levels of body appreciation sion of other body dimensions (e.g., body functionality), expressed
than college women (Tylka & Wood-Barcalow, 2015). as narcissism or vanity, foolproof in its ability to protect against
Body mass index. Researchers have documented an inverse all body image-related threats, linked to disengagement from self-
relationship between body appreciation and BMI for many cultural care, or aided by frequent appearance-related compliments from
and ethnic groups, including samples of predominantly White U.S. others.

Please cite this article in press as: Tylka, T. L., & Wood-Barcalow, N.L. What is and what is not positive body image? Conceptual foundations
and construct definition. Body Image (2015), http://dx.doi.org/10.1016/j.bodyim.2015.04.001
G Model
BODYIM-713; No. of Pages 12 ARTICLE IN PRESS
T.L. Tylka, N.L. Wood-Barcalow / Body Image xxx (2015) xxx–xxx 11

The study of positive body image is rather young, yet it is flour- Cole, E. R., & Sabik, N. J. (2009). A fractured mirror: Intersectional approaches to
diverse women’s perceptions of beauty and bodies. In M. T. Berger & K. Guidroz
ishing. We are confident that this area of scholarship will continue
(Eds.), The intersectional approach: Transforming the academy through race, class,
along this “positive” trajectory, as much remains to be discovered. and gender (2nd ed., pp. 173–192). Chapel Hill: University of North Carolina
New insights will continue to add to and shape the nuances of our Press.
understanding of positive body image as a construct. We are excited Cook-Cottone, C. P. (2015). Incorporating positive body image into the treatment of
eating disorders: A model for attunement and mindful self-care. Body Image (in
to participate in and witness the unfolding of this line of inquiry. this issue).
Cook-Cottone, C., Kane, L. S., Keddie, E., & Haugli, S. (2013). Girls growing in well-
ness and balance: Yoga and life skills to empower. Stoddard, WI: Schoolhouse
Educational Services.
References Daníelsdóttir, S. (2014). Your body is awesome: Body respect for children. Philadelphia,
PA: Singing Dragon.
Albertson, E. R., Neff, K. D., & Dill-Shackleford, K. E. (2014). Self-compassion and body Ferreira, C., Pinto-Gouveia, J., & Duarte, C. (2011). The validation of the Body Image
dissatisfaction in women: A randomized controlled trial of a brief meditation Acceptance and Action Questionnaire: Exploring the moderator effect of accep-
intervention. Mindfulness, http://dx.doi.org/10.1007/s12671-014-0277-3 tance on disordered eating. International Journal of Psychology and Psychological
Andrew, R., Tiggemann, M., & Clark, L. (2014). Positive body image and young Therapy, 11, 327–345.
women’s health: Implications for sun protection, cancer screening, weight loss Fitzsimmons, E. G., & Bardone-Cone, A. M. (2011). Downward spirals of body surveil-
and alcohol consumption behaviours. Journal of Health Psychology, http://dx.doi. lance and weight/shape concern among African American and Caucasian college
org/10.1177/1359105314520814 women. Body Image, 8, 216–223. http://dx.doi.org/10.1016/j.bodyim.2011.04.
Andrew, R., Tiggemann, M., & Clark, L. (2015). Predictors of intuitive eating in adoles- 003
cent girls? Journal of Adolescent Health, 56, 209–214. http://dx.doi.org/10.1016/ Flynn, K. J., & Fitzgibbon, M. (1998). Body images and obesity risk among Black
j.jadohealth.2014.09.005 females: A review of the literature. Annals of Behavioral Medicine, 20, 13–24.
Augustus-Horvath, C. L., & Tylka, T. L. (2011). The acceptance model of intuitive http://dx.doi.org/10.1007/bf02893804
eating: A comparison of women in emerging adulthood, early adulthood, and Fredrickson, B. L. (2001). The role of positive emotions in positive psychology:
middle adulthood. Journal of Counseling Psychology, 58, 110–125. http://dx.doi. The broaden-and-build theory of positive emotions. American Psychologist, 56,
org/10.1037/a0022129 218–226. http://dx.doi.org/10.1037/0003-066x.56.3.218
Avalos, L. C., & Tylka, T. L. (2006). Exploring a model of intuitive eating with col- Fredrickson, B. L., & Losada, M. F. (2005). Positive affect and the complex dynamics
lege women. Journal of Counseling Psychology, 53, 486–497. http://dx.doi.org/10. of human flourishing. American Psychologist, 60, 678–686. http://dx.doi.org/10.
1037/0022-1067.53.4.486 1037/0003-066X.60.7.678
Avalos, L. C., Tylka, T. L., & Wood-Barcalow, N. (2005). The Body Appreciation Scale: Frisén, A., & Holmqvist, K. (2010). What characterizes early adolescents with a pos-
Development and psychometric evaluation. Body Image, 2, 285–297. http://dx. itive body image? A qualitative investigation of Swedish girls and boys. Body
doi.org/10.1016/j.bodyim.2005.06.002 Image, 7, 205–212. http://dx.doi.org/10.1016/j.bodyim.2010.04.001
Bacon, L., & Aphramor, L. (2014). Body respect: What conventional health books get Garland, E. L., Fredrickson, B., Kring, A. M., Johnson, D. P., Meyer, P. S., & Penn, D. L.
wrong, leave out, and just plain fail to understand about weight. Dallas, TX: BenBella (2010). Upward spirals of positive emotions counter downward spirals of neg-
Books. ativity: Insights from the broaden-and-build theory and affective neuroscience
Bacon, L., Stern, J. S., Van Loan, M. D., & Keim, N. L. (2005). Size acceptance and on the treatment of emotional dysfunctions and deficits in psychopathology.
intuitive eating improve health for obese, female chronic dieters. Journal of Clinical Psychology Review, 30, 849–864. http://dx.doi.org/10.1016/j.cpr.2010.03.
the American Dietetic Association, 105, 929–936. http://dx.doi.org/10.1016/j.jada. 002
2005.03.011 Gelso, C., & Fretz, B. (2001). Counseling psychology (2nd ed). Fort Worth, TX: Harcourt.
Becker, C. B., & Stice, E. (2011). Succeed body image programme manual. New York: Gillen, M. M. (2015). Associations between positive body image and indicators of
Oxford University Press. men’s and women’s mental and physical health. Body Image, 13, 67–74. http://
Brown, T. A., Cash, T. F., & Mikulka, P. J. (1990). Attitudinal body image assessment: dx.doi.org/10.1016/j.bodyim.2015.01.002
Factor analysis of the Body-Self Relations Questionnaire. Journal of Personality Hahn Oh, K., Wiseman, M. C., Hendrickson, J., Phillips, J. C., & Hayden, E. W.
Assessment, 54, 213–230. http://dx.doi.org/10.1207/s15327752jpa5501&2 13 (2012). Testing the acceptance model of intuitive eating with college women
Buote, V. M., Wilson, A. E., Strahan, E. J., Gazzola, S. B., & Papps, F. (2011). Setting athletes. Psychology of Women Quarterly, 36, 88–98. http://dx.doi.org/10.1177/
the bar: Divergent sociocultural norms for women’s and men’s ideal appear- 0361684311433282
ance in real-world contexts. Body Image, 8, 322–334. http://dx.doi.org/10.1016/ Halliwell, E. (2013). The impact of thin idealized media images on body satisfaction:
j.bodyim.2011.06.002 Does body appreciation protect women from negative effects? Body Image, 10,
Burns, A. B., Brown, J. S., Sachs-Ericsson, N., Plant, E. A., Curtis, J. T., Fredrickson, B. L., 509–514. http://dx.doi.org/10.1016/j.bodyim.2013.07.004
& Joiner, T. E. (2008). Upward spirals of positive emotion and coping: Replica- Halliwell, E., Jarman, H., McNamara, A., Risdon, H., & Jankowski, G. (2015). Dis-
tion, extension, and initial exploration of neurochemical substrates. Personality semination of evidence-based body image interventions: A pilot study into the
and Individual Differences, 44, 360–370. http://dx.doi.org/10.1016/j.paid.2007. effectiveness of using undergraduate students as interventionists in secondary
08.015 schools. Body Image, 14, 1–4. http://dx.doi.org/10.1016/j.bodyim.2015.02.002
Calogero, R. M., Herbozo, S., & Thompson, J. K. (2009). Complimentary weightism: Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (1999). Acceptance and commitment
The potential costs of appearance-related commentary for women’s self- therapy: An experiential approach to behavior change. New York, NY: Guilford
objectification. Psychology of Women Quarterly, 33, 120–132. http://dx.doi.org/ Press.
10.1111/j.1471-6402.2008.01479.x Heinberg, L. J., Thompson, J. K., & Matzon, J. L. (2001). Body image dissatisfaction
Carver, C. S., Pozo-Kaderman, C., Price, A. A., Noriega, V., Harris, S. D., Derhagopian, R. as a motivator for healthy lifestyle change: Is some distress beneficial? In R.
P.,. . .& Moffatt, F. L. (1998). Concern about aspects of body image and adjustment H. Striegel-Moore & L. Smolak (Eds.), Eating disorders: Innovative directions in
to early stage breast cancer. Psychosomatic Medicine, 60, 168–174. http://dx.doi. research and practice (pp. 215–232). Washington, DC: American Psychological
org/10.1097/00006842-199803000-00010 Association.
Cash, T. F. (2000). Users’ manual for the Multidimensional Body Self-Relations Ques- Holmqvist, K., & Frisén, A. (2012). “I bet they aren’t that perfect in reality”: Appear-
tionnaire. Available from the author at www.body-images.com ance ideals viewed from the perspective of adolescents with a positive body
Cash, T. F. (2004). Body image: Past, present, and future. Body Image, 1, 1–5. http:// image. Body Image, 9, 388–395. http://dx.doi.org/10.1016/j.bodyim.2012.03.007
dx.doi.org/10.1016/S1740-1445(03)00011-1 Homan, K. J., & Cavanaugh, B. N. (2013). Perceived relationship with God fosters pos-
Cash, T. F. (2008). The body image workbook (2nd ed.). Oakland, CA: New Harbinger. itive body image in college women. Journal of Health Psychology, 18, 1529–1539.
Cash, T. F., & Fleming, E. C. (2002). The impact of body image experiences: Develop- http://dx.doi.org/10.1177/1359105312465911
ment of the Body Image Quality of Life Inventory. International Journal of Eating Homan, K. J., & Tylka, T. L. (2014). Appearance-based exercise motivation mode-
Disorders, 31, 455–460. http://dx.doi.org/10.1002/eat.10033 rates the relationship between exercise frequency and positive body image. Body
Cash, T. F., Jakatdar, T. A., & Williams, E. F. (2004). The Body Image Quality of Life Image, 11, 101–108. http://dx.doi.org/10.1016/j.bodyim.2014.01.003
Inventory: Further validation with college men and women. Body Image, 1, Homan, K. J., & Tylka, T. L. (2015). Self-compassion moderates body comparison and
279–287. http://dx.doi.org/10.1016/S1740-1455(03)00023-8 appearance self-worth’s relationships to body appreciation. Manuscript submitted
Cash, T. F., Melnyk, S. E., & Hrabosky, J. I. (2004). The assessment of body image for publication.
investment: An extensive revision of the Appearance Schemas Inventory. Inter- Iannantuono, A. C., & Tylka, T. L. (2012). Interpersonal and intrapersonal links to body
national Journal of Eating Disorders, 35, 305–316. http://dx.doi.org/10.1002/eat. appreciation in college women: An exploratory model. Body Image, 9, 227–235.
10264 http://dx.doi.org/10.1016/j.bodyim.2012.01.004
Cash, T. F., & Pruzinsky, T. (2002). Future challenges for body image theory, research, Jacobson, H. L., Hall, E. L., & Anderson, T. L. (2013). Theology and the body: Sancti-
and clinical practice. In T. F. Cash & T. Pruzinsky (Eds.), Body image: A handbook fication and bodily experiences. Psychology of Religion and Spirituality, 5, 41–50.
of theory, research, and clinical practice (pp. 509–516). New York: Guilford. http://dx.doi.org/10.1037/a0028042
Cash, T. L., Santos, M. T., & Williams, E. F. (2005). Coping with body-image threats and Kroon Van Diest, A. M., & Tylka, T. L. (2010). The caregiver eating messages scale:
challenges: Validation of the Body Image Coping Strategies Inventory. Journal Development and psychometric investigation. Body Image, 7, 317–326. http://
of Psychosomatic Research, 58, 190–199. http://dx.doi.org/10.1016/j.jpsychores. dx.doi.org/10.1016/j.bodyim.2010.06.002
2004.07.008 Lobera, I. J., & Ríos, P. B. (2011). Spanish version of the Body Appreciation Scale
Cash, T. F. & Smolak, L. (Eds.). (2011). Body image: A handbook of science, practice, and for adolescents. Spanish Journal of Psychology, 14, 411–420. http://dx.doi.org/10.
prevention. New York: Guilford. 5209/rev SJOP. 2011.v14.n1.37

Please cite this article in press as: Tylka, T. L., & Wood-Barcalow, N.L. What is and what is not positive body image? Conceptual foundations
and construct definition. Body Image (2015), http://dx.doi.org/10.1016/j.bodyim.2015.04.001
G Model
BODYIM-713; No. of Pages 12 ARTICLE IN PRESS
12 T.L. Tylka, N.L. Wood-Barcalow / Body Image xxx (2015) xxx–xxx

Lyubomirsky, S., Sheldon, K. M., & Schkade, D. (2005). Pursuing happiness: The archi- Stice, E., & Presnell, K. (2007). The Body Project: Promoting body acceptance and pre-
tecture of sustainable change. Review of General Psychology, 9, 111–131. http:// venting eating disorders: Facilitator’s guide. New York, NY: Oxford University
dx.doi.org/10.1037/1089-2680.9.2.111 Press.
Mahoney, A., Carels, R. A., Pargament, K. I., Wachholtz, A., Leeper, L. E., Kaplar, M., Striegel-Moore, R. H., & Cachelin, F. M. (1999). Body image concerns and disordered
& Frutchey, R. (2005). The sanctification of the body and behavioral health pat- eating in adolescent girls: Risk and protective factors. In R. H. Striegel-Moore
terns of college students. International Journal for the Psychology of Religion, 15, & F. M. Cachelin (Eds.), Beyond appearance: A new look at adolescent girls (pp.
221–238. http://dx.doi.org/10.1207/s15327582ijpr1503 3 85–108). Washington, DC: American Psychological Association.
Maslow, A. H. (1943). A theory of human motivation. Psychological Review, 50, Swami, V., Airs, N., Chouhan, B., Leon, M. A. P., & Towell, T. (2009). Are there eth-
370–396. nic differences in positive body image among female British undergraduates?
McHugh, T. L., Coppola, A. M., & Sabiston, C. M. (2014). “I’m thankful for being Native European Psychologist, 14, 288–296. http://dx.doi.org/10.1027/1016-9040.14.4.
and my body is part of that”: The body pride experiences of young Aboriginal 288
women in Canada. Body Image, 11, 318–327. http://dx.doi.org/10.1016/j.bodyim. Swami, V., & Chamorro-Premuzic, T. (2008). Factor structure of the Body Apprecia-
2014.05.004 tion Scale among Malaysian women. Body Image, 5, 409–413. http://dx.doi.org/
Menzel, J. E., & Levine, M. P. (2011). Embodying experiences and the promotion of 10.1016/j.bodyim.2008.04.005
positive body image: The example of competitive athletics. In R. M. Calogero, Swami, V., & Jaafar, J. L. (2012). Factor structure of the Body Appreciation Scale among
S. Tantleff-Dunn & J. K. Thompson (Eds.), Self-objectification in women: Causes, Indonesian women and men: Further evidence of a two-factor solution in a
consequences, and counteractions (pp. 163–186). Washington, DC: American Psy- non-Western population. Body Image, 9, 539–542. http://dx.doi.org/10.1016/j.
chological Association. bodyim.2012.06.002
Neff, K. D. (2003). Self-compassion: An alternative conceptualization of a healthy Swami, V., Mada, R., & Tovée, M. J. (2012). Weight discrepancy and body appreciation
attitude toward oneself. Self and Identity, 2, 85–101. http://dx.doi.org/10.1080/ of Zimbabwean women in Zimbabwe and Britain. Body Image, 9, 559–562. http://
15298860309032 dx.doi.org/10.1016/j.bodyim.2012.05.006
Ng, S.-K., Barron, D., & Swami, V. (2015). Factor structure and psychometric proper- Tiggemann, M. (2001). The impact of adolescent girls’ life concerns and leisure activi-
ties of the Body Appreciation Scale among adults in Hong Kong. Body Image, 13, ties on body dissatisfaction, disordered eating, and self-esteem. Journal of Genetic
1–8. http://dx.doi.org/10.1016/j.bodyim.2014.10.009 Psychology: Research and Theory on Human Development, 162, 133–142. http://
Nichter, M. (2001). Fat talk: What girls and their parents say about dieting. Cambridge, dx.doi.org/10.1080/00221320109597955
MA: Harvard University Press. Tiggemann, M. (2015). Considerations of positive body image across various social
Parker, S., Nichter, M., Nichter, M., Vuckovic, N., Sims, C., & Ritenbaugh, C. (1995). identities and special populations. Body Image (in this issue).
Body image and weight concerns among African American and White adolescent Tiggemann, M., Coutts, E., & Clark, L. (2014). Belly dance as an embodying activity?
females: Differences that make a difference. Human Organization, 54, 103–114. A test of the embodiment model of positive body image. Sex Roles, 71, 197–207.
Paxton, S. J. (1999). Peer relations, body image, and disordered eating in adolescent http://dx.doi.org/10.1007/s11199-014-0408-2
girls: Implications for prevention. In N. Piran, M. P. Levine & C. Steiner-Adair Tiggemann, M., & McCourt, A. (2013). Body appreciation in adult women: Relation-
(Eds.), Preventing eating disorders: A handbook of interventions and special chal- ships with age and body satisfaction. Body Image, 10, 624–627. http://dx.doi.org/
lenges (pp. 134–147). Philadelphia, PA: Brunner/Mazel. 10.1016/j.bodyim.2013.07.003
Pearson, A. N., Heffner, M., & Follette, V. M. (2010). Acceptance and commitment Tiggemann, M., & Stevens, C. (1999). Weight concern across the life-span:
therapy for body image dissatisfaction. Oakland, CA: New Harbinger Publications. Relationship to self-esteem and feminist identity. International Journal
Piran, N. (2001). Re-inhabiting the body from the inside out: Girls transform their of Eating Disorders, 26, 103–106. http://dx.doi.org/10.1002/(SICI)1098-
school environment. In D. L. Tolman & M. Brydon-Millers (Eds.), From subjects to 108X(199907)26:1<103::AID-EAT14>3.3.CO;2-S
subjectives: A handbook of interpretive and participatory methods (pp. 218–238). Tylka, T. L. (2011). Positive psychology perspectives on body image. In T. F. Cash &
New York: New York University Press. L. Smolak (Eds.), Body image: A handbook of science, practice, and prevention (2nd
Piran, N. (2015). New possibilities in the prevention of eating disorders: The intro- ed., pp. 56–64). New York: Guilford Press.
duction of positive body image measures. Body Image (in this issue). Tylka, T. L. (2012). Positive psychology perspective on body image. In T. F. Cash (Ed.),
Piran, N., Carter, W., Thompson, S., & Pajouhandeh, P. (2002). Powerful girls: A con- Encyclopedia of body image and human appearance (Vol. 2) (pp. 657–663). San
tradiction in terms? Young women speak about the experience of growing up in Diego, CA: Academic Press.
a girl’s body. In S. Abbey (Ed.), Ways of knowing in and through the body: Diverse Tylka, T. L. (2013). Evidence for the Body Appreciation Scale’s measurement equiv-
perspectives on embodiment (pp. 206–210). Welland, ON: Soleil Publishing. alence/invariance between U.S. college women and men. Body Image, 10,
Piran, N., Levine, M. P. & Steiner-Adair, C. (Eds.). (1999). Preventing eating dis- 415–418. http://dx.doi.org/10.1016/j.bodyim.2013.02.006
orders: A handbook of interventions and special challenges. Philadelphia, PA: Tylka, T. L. (2015). Positive body image’s relationships to physical health indices among
Brunner/Mazel. college women and men. Manuscript in preparation.
Piran, N., & Teall, T. (2012). The developmental theory of embodiment. In G. McVey, Tylka, T. L., Annunziato, R. A., Burgard, D., Daníelsdóttir, S., Shuman, E., Davis, C.,
M. P. Levine, N. Piran & H. B. Ferguson (Eds.), Preventing eating-related and & Calogero, R. M. (2014). The weight-inclusive vs. weight-normative approach
weight-related disorders (pp. 169–197). Ontario, Canada: Wilfrid Laurier Uni- to health: Evaluating the evidence for prioritizing well-being over weight loss.
versity Press. Journal of Obesity, 2014, 1–18. http://dx.doi.org/10.1155/2014/983495
Pope, M., Corona, R., & Belgrave, F. Z. (2014). Nobody’s perfect: A qualitative exam- Tylka, T. L., & Kroon Van Diest, A. M. (2013). The Intuitive Eating Scale-2: Item refine-
ination of African American maternal caregivers’ and their adolescent girls’ ment and psychometric evaluation with college women and men. Journal of
perceptions of body image. Body Image, 11, 307–317. http://dx.doi.org/10.1016/ Counseling Psychology, 60, 137–153. http://dx.doi.org/10.1037/a0030893
j.bodyim.2014.04.005 Tylka, T. L., & Wood-Barcalow, N. L. (2015). The Body Appreciation Scale-2: Item
Rogers, C. R. (1961). On becoming a person. Boston, MA: Houghton Mifflin. refinement and psychometric evaluation. Body Image, 12, 53–67. http://dx.doi.
Salk, R. H., & Engeln-Maddox, R. (2011). “If you’re fat, then I’m humongous!” Fre- org/10.1016/j.bodyim.2014.09.006
quency, content, and impact of fat talk among college women. Psychology of Wasylkiw, L., & Butler, N. A. (2014). Body talk among undergraduate women: Why
Women Quarterly, 35, 18–28. http://dx.doi.org/10.1177/0361684310384107 conversations about exercise and weight loss differentially predict body appre-
Sandoz, E. K., Wilson, K. G., Merwin, R. M., & Kellum, K. K. (2013). Assessment of ciation. Journal of Health Psychology, 19, 1013–1024. http://dx.doi.org/10.1177/
body image flexibility: The Body Image-Acceptance and Action Questionnaire. 1359105313483155
Journal of Contextual and Behavioral Science, 2, 39–48. http://dx.doi.org/10.1016/ Wasylkiw, L., MacKinnon, A. L., & MacLellan, A. M. (2012). Exploring the link between
j.jcbs.2013.03.002 self-compassion and body image in university women. Body Image, 9, 236–245.
Satinsky, S., Reece, M., Dennis, B., Sanders, S., & Bardzell, S. (2012). An assessment of http://dx.doi.org/10.1016/j.bodyim.2012.01.007
body appreciation and its relationship to sexual function in women. Body Image, Webb, J. B., Butler-Ajibade, P., & Robinson, S. A. (2014). Considering an affect regula-
9, 137–144. http://dx.doi.org/10.1016/j.bodyim.2011.09.007 tion framework for examining the association between body dissatisfaction and
Scime, M., & Cook-Cottone, C. (2008). Primary prevention of eating disorders: A positive body image in Black older adolescent females: Does body mass index
constructivist integration of mind and body strategies. International Journal of matter? Body Image, 11, 426–437. http://dx.doi.org/10.1016/j.bodyim.2014.07.
Eating Disorders, 41, 134–142. http://dx.doi.org/10.1002/eat.20480 002
Seligman, M. E. P., & Csikszentmihalyi, M. (2000). Positive psychology: An introduc- Wilksch, S. M., & Wade, T. D. (2009). School-based eating disorder prevention. In S. J.
tion. American Psychologist, 55, 5–14. http://dx.doi.org/10.1037/0003-066X.55. Paxton & P. J. Hay (Eds.), Treatment approaches for body dissatisfaction and eating
1.5 disorders: Evidence and practice (pp. 7–22). Melbourne, Australia: IP Communi-
Smolak, L. (1999). Elementary school curricula for the primary prevention of eating cations.
problems. In N. Piran, M. P. Levine & C. Steiner-Adair (Eds.), Preventing eat- Williams, E. F., Cash, T. F., & Santos, M. T. (2004, November). Positive and negative
ing disorders: A handbook of interventions and special challenges (pp. 85–104). body image: Precursors, correlates, and consequences. Paper presented at the 38th
Philadelphia, PA: Brunner/Mazel. Annual Meeting of the Association for Advancement of Behavior Therapy, New
Smolak, L., & Cash, T. F. (2011). Future challenges for body image science, practice, Orleans, LA.
and prevention. In T. F. Cash & L. Smolak (Eds.), Body image: A handbook of science, Wood-Barcalow, N. L., Tylka, T. L., & Augustus-Horvath, C. L. (2010). “But I like my
practice, and prevention (2nd ed., pp. 471–478). New York: Guilford Press. body”: Positive body image characteristics and a holistic model for young-adult
Steiner-Adair, C., & Sjostrom, L. (2006). Full of ourselves: A wellness program to advance women. Body Image, 7, 106–116. http://dx.doi.org/10.1016/j.bodyim.2010.01.
girl power, health, and leadership. New York, NY: Teachers College Press. 001

Please cite this article in press as: Tylka, T. L., & Wood-Barcalow, N.L. What is and what is not positive body image? Conceptual foundations
and construct definition. Body Image (2015), http://dx.doi.org/10.1016/j.bodyim.2015.04.001