Evaluating the efficacy of two body image online writing interventions against a neutral writing control in targeting positive body image and distress in female cancer survivors: a randomised controlled trial

Objective This study evaluated the efficacy of two online writing interventions, Expand Your Horizon (EYH) and My Changed Body (MyCB), compared to control, in improving body image and distress in a cancer population, and investigated whether they target different mechanisms. Methods Adult female cancer survivors ( N = 132) were randomised to EYH, MyCB, or a neutral writing control. Body appreciation, body dissatisfaction, body functionality appreciation, self-compassion and distress were measured at baseline, immediately post-intervention, 1-week, and 2-week follow-up. Results EYH participants demonstrated significantly higher body appreciation ( p = .002, d = 0.31) and significantly lower body dissatisfaction ( p = .002, d = −0.22) immediately post-intervention compared to control. The same pattern existed for MyCB participants but was not significant. No significant differences in proposed mechanisms—self-compassion or functionality appreciation—emerged between groups. Main effects of time emerged on body dissatisfaction, distress, and self-compassion at the 1-week and 2-week follow-ups, with all participants improving over time. Conclusion The findings support the efficacy of EYH to improve state body appreciation and reduce body dissatisfaction in female cancer survivors. Further research is necessary to determine the optimal dose needed to produce sustained improvements in body image and distress.