Table 3.
Characteristics of studies that met the inclusion criteria and assessed an aspect of negative body image.
| Author, (Year); Country | Sport(s) | N (% Female) | Age (SD) | Anthro/BC assessment method(s) | Anthro/BC indicator(s) | BI assessment tool(s) | BI outcome(s) | Main findings | Risk of bias |
|---|---|---|---|---|---|---|---|---|---|
| Aleksic-Veljkovic and Djurovic (2020); Serbia | Various sports | 54 (100%) | 19.0 (3.0) | Self-report questionnaire to inform height and weight | BMI | BSQ (Cooper et al., 1987); FRS (Stunkard et al., 1983) | BD; BD-S | BMI was positively correlated with BD and BD-S, in lean (BD: r = 0.342, p < 0.01; BD-S: r = 0.287, p < 0.05) and non-lean sport (BD: r = 0.371, p < 0.01; BD-S: r = 0.263, p < 0.05) athletes. BMI was positively correlated with BSQ in non-lean sport athletes (r = 0.267, p < 0.05), but not lean sport athletes (r = 0.106, p > 0.05). | Moderate |
| Cardoso et al. (2021); Brazil | Ballroom dancing | 320 (42%) | 31.5 (8.6) | Self-report questionnaire to inform height and weight | BMI | FRS (Stunkard et al., 1983), using Portuguese version (Scagliusi et al., 2006) | BD | The odds of being dissatisfied with the body due to excess weight were 51% greater in dancers with higher BMI compared to those with lower BMI (OR (95% CI): 1.518 (1.281–1.799), p < 0.001). | Low |
| Eufrásio de Medeiros et al. (2021); Brazil | Ballet | 25 (100%) | 24.0 (20.5–29.0)* |
Height; weight; Lunar DXA | BMI; %BF | BSQ (Cooper et al., 1987), using Portuguese version (Di Pietro and Silveira, 2009); FRS (Stunkard et al., 1983), using version for Brazilian adults and children (Kakeshita et al., 2009) | BD | BMI (r = 0.657, p = 0.002) and %BF (r = 0.574, p = 0.010) were positively correlated with body dissatisfaction. | Low |
| de Sousa Fortes et al. (2015a); Brazil | Various sports | 321 (0%) | 17.3 (5.5) | Skinfolds (triceps, subscapular (all athletes), chest (≥18 years old)) | %BF | BSQ (Cooper et al., 1987), using Portuguese version (Di Pietro and Silveira, 2009) | Body fat dissatisfaction | %BF and body fat dissatisfaction were positively correlated (r = 0.24, p < 0.01). | Low |
| de Sousa Fortes et al. (2015b); Brazil | Track & field | 83 (100%) | 15.1 (1.8) | Skinfolds (triceps. subscapular) | %BF | BSQ (Cooper et al., 1987), using version for Brazilian adolescents (Conti et al., 2009) | BD | %BF was significantly related to body dissatisfaction (F(1,82) = 28.50, p = 0.001). | Low |
| de Sousa Fortes et al. (2020); Brazil | Various sports | 484 (100%) | 17.1 (1.6) | Height; weight; skinfolds (triceps, subscapular) | BMI; %BF | BSQ (Cooper et al., 1987), using Portuguese version (Di Pietro and Silveira, 2009) | BD | BMI and %BF were positively correlated with body dissatisfaction (r = 0.20, p < 0.05). | Low |
| de Sousa Fortes et al. (2013); Brazil | Various sports | 580 (20%) | 10–19** | Height; weight; skinfolds (triceps, subscapular) | BMI; %BF | BSQ (Cooper et al., 1987), using version for Brazilian adolescents (Conti et al., 2009) | BD | %BF explained 18% of variance in BD in females and 13% in males. BMI explained 14% of variance, while BMI and %BF together explained 17% of variance in BD in males. All p < 0.01. The odds of BD among females with high %BF were 3.44 times the odds of BD if average %BF (95% CI: 1.29–9.17, p < 0.05). The odds of BD among males with obesity were 7.67 times odds of BD among males with normal weight (95% CI: 3.11–18.90, p < 0.05). The odds of BD among males with overweight was 5.85 times the odds of BD among males with normal weight (95% CI: 2.86–11.94; p < 0.05). |
Low |
| Francisco et al. (2013); Portugal | Gymnastics, dance | 131 (77%) | 15.3 (2.2) | Unclear | BMI | CDRS (Thompson and Gray, 1995), using Portuguese version (Francisco et al., 2012) | BD | BMI was negatively correlated with BD in elite athletes (r = −0.42, p < 0.01). | Moderate |
| Godoy-Izquierdo and Díaz (2021); Spain | Soccer | 45 (100%) | 20.9 (7.5) | Self-report questionnaire to inform height and weight | BMI | FRS (Stunkard et al., 1983), using Spanish version (Ramírez et al., 2015, 2018); BAQ (Ben-Tovim and Walker, 1991), using Spanish version | Negative attitudes towards the body and appearance | BMI was positively correlated with negative body attitudes (BAQ: r = 0.44, p < 0.01). | Low |
| Goltz et al. (2013); Brazil | Various sports | 156 (0%) | Weight class: 26.0 (7.1) Leanness: 31.7 (10.8) Aesthetic: 25.8 (8.9) |
Height; weight; skinfolds (triceps, chest, mid-axillary, subscapular, suprailiac abdominal, medial thigh) | BMI; %BF | BSQ (Cooper et al., 1987), using Portuguese version (Di Pietro and Silveira, 2009) | BD | Athletes dissatisfied with their bodies (12.5 ± 5.9%) have a higher %BF than athletes satisfied with their bodies (9.7 ± 3.9%), p = 0.0034. | Moderate |
| Gomes et al. (2011); Portugal | Various sports | 290 (48%) | 17.8 (3.5) | Self-report questionnaire to inform height and weight | BMI | EDE-Q shape concern and weight concern subscales (Fairburn, 2008), using Portuguese version (Machado et al., 2014) | Shape concern, weight concern | BMI was positively correlated with shape (r = 0.17, p < 0.01) and weight concern (r = 0.25, p < 0.001) | Moderate |
| Hernández-Martínez et al. (2017); Spain | Weightlifting | 32 (0%) | 23.2 (8.0) | Height; weight; skinfolds (triceps, chest, subscapular, supraspinal, abdominal, anterior thigh); limb circumference | BMI; %BF; FFMI | ESM (González-Martí et al., 2012) | Muscle (dis)satisfaction | FFMI was highest among those with the greatest level of dissatisfaction with muscle (22.80 kg/m2) compared to FFMI of those with the middle (22.38 kg/m2) and lowest (22.30 kg/m2) levels of muscle dissatisfaction. | Moderate |
| Jardim et al. (2022); Brazil | Rhythmic gymnastics | 18 (100%) | 16.4 (4.0) | Self-report questionnaire to inform height and weight | BMI | BSQ (Cooper et al., 1987), using Brazilian version (Cordás and Castilho, 1994) | BD | BMI was positively correlated with body dissatisfaction (r = 0.51, p = 0.025). | Moderate |
| Kagawa et al. (2023); Japan | Long-distance running | 31 (100%) | 19.0 (18.0–20.0)* | Height; weight; skinfolds (triceps, subscapular, biceps, iliac crest, supraspinal, abdominal, front thigh, medial calf); girths (circumferences); lengths; breadths; DF-BIA | BMI; %BF; FM; FFM; FMI; FFMI; % abdominal fat; sum of 8 skinfolds | BAQ (Ben-Tovim and Walker, 1991), using Japanese version (Kagawa et al., 2007); BSS (Slade et al., 1990), using Japanese version (Ishigaki et al., 2009) | Negative attitudes towards body; BD | Biceps (β = 0.653, p = 0.002) and triceps (β = 0.610, p = 0.008) skinfolds and calf maximum girth (β = −0.625, p = 0.002) were associated with BAQTotal. BMI or body composition measurements were not associated with negative body attitudes or body dissatisfaction. |
Low |
| Karr et al. (2013); USA | Various sports | 627 (100%) | 15.9 (1.2) | Self-report questionnaire to inform height and weight | BMI | EDI-3 BD subscale (Garner, 2004) | BD | BMI was positively associated with body dissatisfaction across all sport types (βs: 0.34–0.52, all p < 0.05) | Low |
| Mockdece Neves et al. (2016); Brazil | Artistic gymnastics | 40 (93%) | 13.3 (1.9) | Height; weight; skinfolds (triceps, subscapular) | BMI; %BF | BSQ (Cooper et al., 1987), using Spanish version (Conti et al., 2009) | BD | BMI and %BF were not significantly correlated with BSQ (BMI and BSQ: r = 0.262; %BF and BSQ: r = 0.159, all p > 0.05) and did not significantly explain body dissatisfaction among elite athletes. | Low |
| Pan et al. (2018); Taiwan and USA | Not defined | 139 (41%) | 19.4 (4.3) | Height; weight | BMI (categorical) | FRS (Stunkard et al., 1983) | BD | Athletes with overweight/obesity (M (SD): 2.53 (0.24)) had greater levels of BD compared to athletes without overweight/obesity (M (SD): 0.68 (0.19)). F (1, 128) = 36.86. | Low |
| Remmel et al. (2021); Estonia | Rhythmic gymnastics | 33 (100%) | 16.0 (12) | Height; weight; DXA | BMI; FM; LBM; %BF | BAT (Probst et al., 1995); subscale of factor 1: negative appreciation of body; subscale factor 3: general BD | Negative body attitudes | There were no significant relationships between BMI (r = 0.220), %BF (r = 0.040), FM (r = 0.065), nor LBM (r = 0.222) and BAT scores. All p < 0.05. | Moderate |
| Salas-Morillas et al. (2023); Spain | Acrobatic gymnastics | 130 (87%) | 14.1 (3.3) | Height; weight; skinfolds (triceps, biceps, subscapular, suprailiac, abdominal, medial calf) | BMI; Sum of six skinfolds; %BF | EDI-BD subscale (Garner, 2004) | BD | No anthropometric or body composition indicators were significantly correlated with BD (BMI: r = 0.162, p = 0.06; Sum of skinfolds: r = 0.094, p = 0.290; %BFS: 0.113, p = 0.202; %BFY: r = 0.144, p = 0.1010). | Moderate |
| Voelker et al. (2018); USA | Figure skating | 29 (0%) | 18.5 (4.2) | Self-report questionnaire to inform height and weight | BMI | CDRS (Thompson and Gray, 1995) | BD-S | BMI was positively correlated with sport-related body dissatisfaction (r = 0.64, p < 0.01) | Moderate |
| Voelker et al. (2014); USA | Figure skating | 272 (100%) | 15.6 (3.0) | Self-report questionnaire to inform height and weight | BMI | CDRS (Thompson and Gray, 1995) | BD; BD-S; body image distortion | BMI was positively correlated with general BD (r = 0.63, p < 0.01) and sport-related BD (r = 0.62, p < 0.01). | Moderate |
| Whitehead et al. (2020); Australia | Physique sports: Bikini, fitness, figure, bodybuilding | 348 (100%) | 31.4 (8.1) | Self-report questionnaire to inform height and weight | BMI | EDI-BD subscale (Garner, 2004) | BD | BMI was positively correlated with body dissatisfaction (r = 0.279, p < 0.01). | Moderate |
*Median (Q1-Q3); **Range. Anthro, Anthropometric; BC, Body Composition; BI, Body Image; BMI, Body Mass Index; %BF, Percent Body Fat; FFMI, Fat-Free Mass Index; FM, Fat Mass; FFM, Fat-Free Mass; LBM, Lean Body Mass; %FM, Percent Fat Mass; DF-BIA, dual-frequency-bioelectrical impedance analysis; BSQ, Body Shape Questionnaire; FRS, Figure Rating Scale; CDRS, Contour Drawing Rating Scale; BAQ, Body Attitudes Questionnaire; EDE-Q, Eating Disorder Examination-Questionnaire; ESM, Escala de Satisfacción Muscular; EDI-3, Eating Disorder Inventory-3; BAT, Body Attitude Test; BD, Body Dissatisfaction; BD-S, Sport-related Body Dissatisfaction; M, Mean; SD, Standard Deviation; OR, Odds Ratio; 95% CI, 95% Confidence Interval.