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Table 2 Relevant outcome measures and results of reviewed studies

From: Religiosity, spirituality in relation to disordered eating and body image concerns: A systematic review

Author (Year) (Country) Measures of Disordered Eating and Psychopathology Measures of Religiosity/Spirituality QIS* + Grade Results
Disordered Eating and Psychopathology
Boisvert et al. (2013) (Canada) [38] EDI- 1 item from each of DT, B, BD Religiosity- ‘I would describe myself as religious’ (King et al., 2001) 8 IV Correlation- Spirituality and eating disorder symptomatology (r = −.19, p < .001).
Spirituality- SWBS- 2 items from EWB subscale ANCOVA- Spirituality and eating disorder symptomatology (F(1, 497) = 13.74, p < .001).
Boisvert et al. (2012) (Canada) [37] EDI- 1 item from each of DT, B, BD Religiosity- ‘I would describe myself as religious’. (King et al., 2001) 8 IV Correlation- Eating disorder symptomatology not significantly related to spirituality (r = −.07) or religion (r = .08).
Spirituality- SWBS- 2 items from EWB subscale Path analysis- 10 % of the variance in EDI was explained by BMI (b = .28, p < .001) and body shame (b = .15, p < .001). 6 % of the variance in body shame was explained by age (older men had higher EDI) (b = .15, p < .001), being Asian (b = .11, p < .01) and lower spirituality (b = −.15, p < .001). Spirituality had a sig indirect effect on EDI mediated by body shame (b = −.02).
Boyatzis et al. (2006) (USA) [35] EDI – DT, B Quest Scale 10 IV Correlation- College freshmen + sophomores- Bulimia: Total Quest (r = .33, p < .01), Existential Questioning (r = .29, p < .05), Doubting as positive (r = .23, p < .10).
College juniors + seniors- Openness to Change: Bulimia (r = .28, p < .10), Drive for Thinness (r = .27, p < .10).
Buser (2013) (USA) [47] BULIT-R 5 RCOPE subscales 13 IV Correlation- Punishing God/Higher power reappraisal andbulimic symptoms (r = .25, p < .001). Other subscales not sig.
Punishing God/Higher power reappraisal, passive religious deferral, active religious surrender, benevolent religious reappraisal/spiritual support and religious focus. Hierarchical Regression- 1st step: BMI + religious affiliation 7.9 % (F(2, 589) = 25.23. p < .001), 2nd step: 5 coping scales 5.5 % (F(5, 584) = 7.469, p < .001) Cohen’s f2 = .06. Punishing God/Higher power reappraisal- (β = .242, p < .001).
Mediation Analysis- Punishing God/Higher power reappraisal partially mediated relationship between stress and bulimic symptoms. Sobel Test (z = 2.975, p < .01).
Feinson et al. (2012) (Israel) [41] DEB-SQ Self-reported religious observance category 9 IV ANOVA- No Sig Differences.
Forthun et al. (2003) (USA) [29] FAD- GFF subscale I/E-R 9 IV Correlation- Intrinsic religiousness: Bulimia (r = −.13, p < .01), Drive for Thinness (r = −.07, p < .05).
FARS- items selected Hierarchical regression + Simple Slope Analyses
EDI – DT, B Family dysfunction- B: Family x Intrinsic (B = −0.53, p < .01), Family x Extrinsic (B = 0.45, p < .10).
DT: Family x Extrinsic (B = 0.69, p < .10).
Intrinsic buffered association between family and B. Extrinsic made people more vulnerable to B/DT.
Parental History- B: History x Extrinsic (B = 2.29, p < .01).
DT: History x Intrinsic (B = −2.45, p < .05), History x Extrinsic (B = 2.98, p < .05).
Intrinsic buffered association between history and DT. Extrinsic made people more vulnerable to B/DT.
Gates et al. (2009) (USA) [36] EDI- B, DT MQOS- Religious angst subscale 8 IV ANOVA- Religious Angst: Higher levels of Drive for Thinness (F =1.86, p < 0.01), Bulimia (F =1.89, p < 0.01).
Gluck et al. (2002) (USA) [39] EDE-Q Orthodox Traditions Scale 9 IV ANOVA- secular Jews had higher EDE-Q scores then Orthodox Jews (F[1,125] = 8.5; P = .004).
RIQ Chi-square- Secular women were more likely to use laxatives to control their shape and weight (χ 2 [1,123] = 5.8, p = .02).
  MLR- SES + religious grouping: 11 % total EDE-Q (R2 = .11, p = .001).
Jacobs-Pilipski et al. (2005) (USA) [33] EDE 13-item self-report measure of spiritual and religious beliefs and practices. 9 IV ANOVA- No significant relationships.
EDI-2- DT, B
Latzer et al. (2014) (USA) [43] EDI Brief R-COPE 9 IV Correlation- Negative religious coping: total EDI (r = .28, p < .01), Drive for Thinness (r = .23 p < .05), Ineffectiveness (r = .24, p < .05), Maturity (r = .25, p < .05), EAT bulimia (r = .22, p < .05).
EAT-26 Regression- Negative religious coping (control BMI): total EDI (R2 = .19, p < .01), Ineffectiveness (R2 = .07, p < .05), Maturity (R2 = .06, p < .05), EAT Bulimia (R2 = .07, p < .05).
Latzer et al. (2007) (Israel) [40] EDI-2 Level of Religiosity Questionnaire 10 IV ANOVA- Religious observance: (low > Intermediate = high) total EDI (p < 0.008), Interpersonal Distrust (p < 0.03), Interceptive Awareness (p < 0.003), Asceticism (p < 0.01), Impulse Regulation (p < 0.02) and Social Insecurity (p < 0.03)
Correlation- Religiosity Level: EDI-2 total (r = −0.15 p < 0.01), Body dissatisfaction (r = −0.14 p < 0.01), Ineffectiveness (r = −0.14 p < 0.01), Interpersonal distrust (r = −0.11 p < 0.01), Impulse regulation (r = −0.17 p < 0.01), Social insecurity (r = −0.16 p < 0.01)
Regression- Religiosity and total EDI (p = .043)
Mahoney et al. (2005) (USA) [31] Dieting Practices Inventory- Unhealthy Dieting Practices subscale Manifestation of God in the Body scale. 9 IV Partial Correlation (BMI + gender controlled): Unhealthy dieting practises: Manifestation of God (r = −.12,p < .05), Sacred Qualities (r = −.18, p < .001) and Global Religiousness (r = −.13, p < .05). Binge eating: Sacred Qualities (r = −.14, p < .01).
Binge Eating Scale Sacred Qualities of the Body scale.
  Global Religiousness Score
Pinhas et al. (2008) (Canada) [42] EAT 26 Self Reported level of observance 9 IV No sig differences.
Watkins et al. (2006) (USA) [32] QEWP-R SWBS- RWB + EWB 11 IV ANOVA- SWBS: None binge- 96.35, Objective binge- 91.78, Binge trait- 86.11 (p ≤ 0.000) (BT < NB, BT < OB) RWB: None binge- 46.34, Objective binge- 43.63, Binge trait- 40.93 (p ≤ 0.000) (BT < NB) EWB: None binge- 50.09, Objective binge- 48.15, Binge trait- 45.18 (p ≤ 0.000) (BT < NB, BT < OB).
Weinberger-Litman et al. (2008) (USA) [44] EAT-26 Self-reported level of religious observance 10 IV ANOVA- Religious orientation: EAT total (F = 5.48, p = .001), Dieting (F = 3.78, p = .01), Bulimia (F = 4.49, p = .004), Oral Control (F = 4.45, p = .004). Generally lowest symptom severity to highest: Intrinsic, Anti-Religious, Pro-Religious and Extrinsic.
ROS ANCOVA (control age, BMI, religious observance, anxiety and depression)- all remain sig except oral control.
SWB  
Body Image Concerns
Boisvert et al. (2013) (Canada) [38] OBC- 2 items from Body Shame subscale Religiosity- ‘I would describe myself as religious’ (King et al., 2001) 8 IV Correlation- Spirituality and Body Shame (r = −.21, p < .01).
Spirituality- SWB- 2 items from EWB subscale ANCOVA- Spirituality and Body Shame (F(1, 502) = 21.36, p < .001).
Boisvert et al. (2012) (Canada) [37] OBC- 2 items from Body Shame subscale Religiosity- ‘I would describe myself as religious’. (King et al., 2001) 8 IV Correlation- Spirituality and Body shame (r = −.16, p < .01).
Spirituality- SWB- 2 items from EWB subscale Path analysis- 10 % of the variance in EDI was explained by BMI (b = .28, p < .001) and Body Shame (b = .15, p < .001). 6 % of the variance in Body Shame was explained by age (older men had higher EDI) (b = .15, p < .001), being Asian (b = .11, p < .01) and lower spirituality (b = −.15, p < .001). Spirituality had a sig indirect effect on EDI mediated by Body Shame (b = −.02).
Boyatzis et al. (2007) (USA) [25] BE Scale Demographic Survey- Self reported importance of religion 10 IIb ANOVA- BE-Appearance: (F(2, 122) = 5.42, p = 0.006). Religious group (M = 1.26) increased more than Control group (M = −0.98) (p = 0.005).
BE- Appearance and BE- weight subscales BE- Weight: no sig differences.
ANCOVA- BMI and pre-test scores as covariates. BE- Appearance: F(2,114) = 4.20, p < 0.02 (pre-test scores), F(2, 114) = 5.53, p < 0.01 (BMI).
BE- weight: no sig differences.
Boyatzis et al. (2006) (USA) [35] EDI – BD Quest Scale 10 IV Correlation-College freshmen + sophomores- Body Dissatisfaction: Total Quest scores (r = .34, p < .01.), Existential Questioning (r = .31, p < .05), Doubting as Positive (r = .28, p < .05).
BE scale College juniors + seniors- Body Esteem and Openness to Change (r = −.31, p < .05)
  College graduates- Body dissatisfaction and Existential Questioning (r = −.25, p < .10).
Gates et al. (2009) (USA) [36] EDI- BD MQOS- Religious angst subscale 8 IV ANOVA- Religious Angst: Higher levels of body dissatisfaction (F (33, 234) = 1.38, p = 0.09).
Gluck et al. (2002) (USA) [39] BSQ Orthodox Traditions Scale 9 IV ANOVA- Secular women had higher body dissatisfaction then orthodox women (F[1, 125] = 8.0, p = .005).
FRS RIQ Logistic Regression- Secular students 2x likely to have a fear of becoming fat (odds ratio [Exp (B)] = 2.3, p = .05) + 4x likely to be greatly influenced by their shape and weight (odds ratio [Exp (B)] = 3.8, p = .001).
MLR- Religious grouping: 6 % total BSQ (R2 = .06; p < .03).
Hayman et al. (2007) (USA) [46] OBC FMS- 20 items 10 IV Correlation- Whole sample: No sig. Women: No sig, Men: spirituality and body surveillance (r = −.41, p = .001).
VAS
CDRS
Homan et al. (2013) (USA) [45] BAOS AGI 10 IV Correlation- AG- Anxiety: Body Appreciation (r = −.28, p < .01), Body Acceptance by others (r = −.22, p < .05), Body Surveillance (r = −.33, p < .01).
BAS 1 item ‘How religious are you’ AG- Avoidance: Body Surveillance (r = −.21, p < .05).
OBC- Body Surveillance 1 item frequency of worship attendance Regression- AG- Anxiety: predicted Body Appreciation (B = −.22, p = .038) and Body Surveillance (B = −.29, p = .008).
   AG-Avoidance: no sig
Homan et al. (2010) (USA) [28] Perceived Sociocultural Pressure Scale (Stice, n.d.) AGI 9 IIb Correlation- AGI (Anxiety): Pressure to be thin (r = .22, p < .01), Thin-ideal Internalisation (r = .30, p < .001), Body Dissatisfaction (r = .25, p < .001), Dieting (r = .26, p < .001). AGI (Avoidance): Body Dissatisfaction (r = .18, p < .001).
SATAQ- Internalisation subscale Regression- Thin-ideal Internalisation predicted body dissatisfaction in secure and anxious relationship groups (t(222) = 2.31, p < .02, R2 = .08 vs. R2 = .27). Secure relationship buffers this relationship.
MBSRQ- Body Areas Satisfaction subscale Hierarchical regression- Anxious group- Body Dissatisfaction predicted by Pressure to be Thin (R2 = .03, p < .05), Thin Ideal Internalisation (R2 = .03, p < .05). Secure group- not sig.
DRES  
Inman et al. (2014) (USA) [26] BE Demographic Survey- Self reported importance of religion 10 IIb ANOVA- Feelings of love and acceptance between the four statement groups (F(3, 106) = 8.22, p < .001). Religious (Mnonbody = 7.59, Mbody = 7.41) greater then Non-Religious (Mcontrol = 5.22, Mpositive = 6.73) (t(106) = 4.08, p < .001).
EDI- DT, BD GCS 2 way ANCOVA- Appearance Esteem between the different statement groups not sig (F(3, 101) = .29, p = .83). Affirmation group x religious commitment interaction (F(3, 101) = 2.99, p < .04, η2 = .08).
RDS RCS Weight esteem between the different statement groups not sig (F(3, 101) = .52, p = .60), Affirmation group x religious commitment interaction (F(3, 101) = 3.42, p < .03, η2 = .09).
Emotions Correlation- Religious Commitment: Appearance Esteem (r = .20, p < .05), Weight Esteem (r = .19, p < .05), Body Dissatisfaction (r = −.21, p < .05).
Partial Correlation (control for general commitment)- Religious commitment: Body Dissatisfaction (r = −.20, p < .05).
Inman (2014) (USA) [27] BE RCS 10 IIb ANOVA- no sig differences between groups.
Emotions 2 way ANOVA- religiously committed men had higher Appearance Esteem at time 1 then less religious men (F(1, 48) = 17.76, p = .001, η2 = .27.). No sig interactions.
Correlation- Religious commitment: higher Appearance (r = .34, p < .05) and Weight Esteem (r = .35, p < .01).
Hierarchical regression and simple slope analysis: Religious commitment moderated the effect of harmful media on Weight Esteem in heavy men.
Jacobs-Pilipski et al. (2005) (USA) [33] EDI-2- BD Brief COPE 9 IV ANOVA- No significant relationships between S/R beliefs/practices and Body Dissatisfaction.
13-item self-report measure of spiritual and religious beliefs and practices. T- Test- Women with strong S/R beliefs/practices more likely to read religious works (T = 7.3, p = .000), pray (T = 9.3, p = .000) and meditate (T = 3.8 p = .007) than women without strong S/R beliefs/practices.
Women with strong S/R beliefs/practices less likely to use distraction to cope with body image distress (T = 2.7, p = .007) and reported prayer to be an effective strategy for dealing with dissatisfaction with weight and shape (T = 3.0, p = .004).
Kim (2006) (USA) [20] EDI- BD Compilation of measures- religious practice, application, commitment, identity, coping, social support 11 IV Regression (controlling BMI + demographics).
Men- Body satisfaction: positive spiritual coping (beta = 0.18, p < 0.05), negative spiritual coping (beta = −0.58, p < 0.01). Closer relationship with God (beta = 0.14, p < 0.05). All religious variables (R2 = 0.174, p < 0.05).
Women- Body satisfaction: positive spiritual coping (beta = 0.19, p < 0.01), negative spiritual coping (beta = −0.47, p < 0.01), spending more hours on religious and spiritual activities (beta = 0.01, p < 0.01), prayer (beta = 0.23, p < 0.05). All religious variables (R2 = 0.106, p < 0.01).
Mahoney et al. (2005) (USA) [31] MBSRQ- Body Areas Satisfaction and Appearance Orientation subscales Manifestation of God in the Body scale. 9 IV Partial Correlation (BMI + gender controlled)- Body area satisfaction: Manifestation of God (r = .13,p < .05), Sacred Qualities (r = .25, p < .001) and Global Religiousness (r = .13, p < .05).
Sacred Qualities of the Body scale. Hierarchical regression- Body area satisfaction- Step 1: Race, gender, global religiousness (R2 Change = .05, p < .01), Step 2: Manifestation of God, Sacred Qualities (R2 Change = .04, p < .01).
Global Religiousness Score
Weinberger-Litman et al. (2008) (USA) [44] BSQ Self-reported level of religious observance 10 IV ANOVA- Religious Orientation: Body Satisfaction (F = 6.15, p < .001). Intrinsic > extrinsic (p = .01), pro-religious (p < .001). ANCOVA- (control age, BMI, religious observance, anxiety and depression)- all remain sig
ROS ANOVA- Spiritual Well-Being: High > Moderate (F = 4.57, p = .03, d = .27) Body Satisfaction. Existential Well-Being: High > Moderate (F = 18.23, p < .001, d = .51) Body Satisfaction. ANCOVA- (control age, BMI, religious observance)- all remain sig, (control anxiety and depression)- loose sig.
SWB
  1. *QIS- Quality Index Score
  2. Abbreviations
  3. AGI- Attachment to God Inventory
  4. BAOS- Body Acceptance by Others Scale
  5. BAS- Body Appreciation Scale
  6. BE- Body Esteem Scale
  7. Binge Eating Scale
  8. Brief COPE
  9. BSQ- Body Shape Questionnaire
  10. BUILT-R- Bulimia Test Revised
  11. CDRS- Contour Drawing Rating Scale
  12. DEB-SQ- Disordered Eating Behaviors—Screening Questionnaire
  13. Dieting Practices Inventory
  14. DRES- Dutch Restrained Eating Scale
  15. EAT-26- Eating Attitude Test
  16. EDE- Eating Disorder Examination
  17. EDE-Q- Eating Disorders Examination- Questionnaire Version
  18. EDI- Eating Disorder Inventory, DT- Drive for Thinness, B- Bulimia, BD- Body Dissatisfaction
  19. EDI-2- Eating Disorder Inventory-2
  20. FAD- McMaster Family Assessment Device, GFF- General Family Functioning
  21. FARS- Family Addiction and Recovery Scale
  22. FMS- Faith Maturity Scale
  23. FRS- Figure Rating Scale
  24. GCS- General Commitment Scale
  25. Global Religiousness Score
  26. I/E-R- Intrinsic/Extrinsic-Revised scale
  27. Level of Religiosity Questionnaire
  28. Manifestation of God in the Body scale and Sacred Qualities of the Body scale
  29. MBSRQ- Multidimensional Body-Self Relations Questionnaire
  30. MQOS- Multidimensional Quest Orientation Scale
  31. OBC- Objectified Body Consciousness scale
  32. PACS- Physical Appearance Comparison Scale
  33. QEWP-R- The Questionnaire on Eating and Weight Patterns-Reviseds
  34. Quest Scale
  35. RCOPE- Religious Coping Questionnaire
  36. RCS- Religious Commitment Scale
  37. RDS- Restrictive dieting scale
  38. RIQ- Religious Identification Questionnaire
  39. ROS- Religious Orientation Scale
  40. SATAQ- Sociocultural Attitudes Towards Appearance Questionnaire
  41. SCSRFQ- Santa Clara Strength of Religious Faith Questionnaire
  42. SOQ- Self-Objectification Questionnaires
  43. SWBS- Spiritual Well-Being scale. EWB- Existential Wellbeing Subscale, RWB- Religious Well-Being
  44. VAS- Weight and Appearance Visual Analogue Scales
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