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Background and Objectives It has been suggested that body comparison is a safety behavior in eating disorders. This experimental study investigates the causal impact of upward and downward body comparison on body image, eating pathology, self-esteem, anxiety and mood. It also considers whether trait body comparison and eating pathology are associated with responsiveness to upward and downward comparison. Methods Thirty-nine women participated. Each completed trait comparison and eating pathology measures. Following this, each participant spent an hour (on different days) making an upward, downward or neutral comparison in a naturalistic setting. After each condition, the participant completed measures of body satisfaction, self-esteem, anxiety, depression and eating pathology. Results Participants were significantly less satisfied with their bodies following upward comparison. Both upward and downward comparison were associated with particularly negative effects if an individual had greater trait eating concerns. The effects of downward comparison were correlated with increased anxiety. Limitations The sample was lacking in diversity. Compliance with the experimental tasks was not strictly monitored. Conclusions Upward comparison resulted in lower body satisfaction, but downward comparison did not result in positive effects. However, trait eating concerns and comparison influenced the impact of both forms of comparison. Body comparison should be a target for treatment in CBT for eating disorders, particularly where the individual has a strong tendency to make comparisons with other people. Level of evidence Level III: Evidence obtained from well-designed cohort or case–control analytic studies.

Does comparison of self with others influence body image among adult women? An experimental study in naturalistic settings