Body checking in the eating disorders: Associations between cognitions and behaviors

OBJECTIVE: Body checking behaviors appear to be a manifestation of the cognitive distortions that are central to the maintenance of the eating disorders. However, there is little understanding of the cognitions that drive these behaviors. This study validates a novel measure of such cognitions (Body Checking Cognitions Scale [BCCS]) and examines the association between body checking cognitions, body checking behaviors, and general eating pathology. METHOD: Eighty-four eating-disordered women and 205 non-eating-disordered women each completed measures of body checking behaviors, body checking cognitions and eating pathology. A further 130 nonclinical women completed the measures to provide an independent cross-validation sample for the BCCS. RESULTS: The BCCS was reliable and valid, and cross-validation with an independent sample confirmed the four-factor structure. Eating-disordered women were significantly more likely to experience body checking cognitions than healthy women. Those cognitions were associated with a significant proportion of variance in eating pathology, over and above the variance explained by checking behaviors. CONCLUSION: This study provides evidence for a range of beliefs underlying body checking behavior in eating-disordered women, suggesting that interventions addressing those beliefs might be pertinent in some cases.