Recent evidence shows that negative body image may be a potential risk factor for symptoms of orthorexia nervosa (ON). However, whether positive body image plays a protective role against symptoms of ON remains unclear. Although prior research has established associations between body appreciation (a core component of positive body image) and ON symptoms, this research is limited to cross-sectional designs, precluding inferences of temporal precedence. Thus, the present study overcomes this limitation by testing whether body appreciation prospectively predicts ON symptoms. Data were analysed from 1253 adult women (M age = 34 years (SD = 9.4), 81.3% Caucasian) who completed the Orthorexia Nervosa Inventory (ONI) and Body Appreciation Scale 2-Short Form (BAS2-SF) at baseline (T1) and at three-month follow-up (T2). Multiple linear regressions were used to test whether body appreciation scores at T1 predicted ONI subscale scores (behaviours, emotions, and impairments) at T2. Results revealed that higher body appreciation scores at T1 significantly predicted decreased scores on each ONI subscale at T2, though effect sizes were small. Findings provide preliminary evidence that body appreciation may protect against ON symptoms. If replicated, efforts to address ON symptoms may be enhanced by promoting body appreciation.

Body image concerns are a global issue among adolescents, including in India. These concerns can prevent adolescents from engaging in everyday life activities, impeding social and academic development. However, at present, there are no psychometrically valid measures to assess such impact in the Indian context. This study culturally adapted and validated the Body Image Life Disengagement Questionnaire (BILD-Q) for use in English among adolescents in urban India. A total of 1427 adolescents completed an adapted version of the BILD-Q along with additional measures pertaining to body image. Exploratory factor analysis identified one dimension of body image life disengagement, which provided the best fit. The 9-item one-factor model was further supported by confirmatory factor analysis. The scale demonstrated good internal consistency and test re-test reliability. Further analysis demonstrated that the scale can be used to compare scores between boys and girls without measurement bias. This study presents a culturally adapted version of the BILD-Q, which can be used as a valid and reliable measure to assess the impact of body image concerns on life disengagement among English-speaking adolescents in urban India.