Skip to main content

Validation of a Latin-American Spanish version of the Body Esteem Scale for Adolescents and Adults (BESAA-LA) in Colombian and Nicaraguan adults



Body dissatisfaction (BD) is a growing concern in Latin America; reliable and culturally appropriate scales are necessary to support body image research in Spanish speaking Latin American countries. We sought to validate a Latin-American Spanish version of the Body Esteem Scale for Adolescents and Adults (BESAA; Mendelson et al. 2001).


The BESAA was translated, culturally adapted, and validated in a sample of adults in Colombia (N = 525, 65% women, Mage 24.4, SD = 9.28). We assessed factor structure (using confirmatory factor analysis (CFA), exploratory factor analysis (EFA) and exploratory structural equation model (ESEM)), internal reliability (using Cronbach’s alpha and omega), validity (using the Body Appreciation Scale BAS and Sociocultural Attitudes Towards Appearance Questionnaire SATAQ), test–retest stability in a small subsample (N = 84, using Intraclass correlations ICC) and measurement invariance across gender. To evaluate the generalizability of the scale, we assessed reliability, validity, and factor structure in a second sample from rural Nicaragua (N = 102, 73% women, Mage 22.2, SD = 4.72), and assessed measurement invariance across Nicaraguan and Colombian participants.


The scale showed good internal reliability and validity in both samples, and there was evidence of adequate test–retest stability in the Colombian sample. EFA showed a three-factor structure with subscales we labelled ‘appearance-positive’, ‘appearance-negative’ and ‘weight’, that was confirmed using CFA and ESEM in the Colombian sample. Measurement invariance was confirmed across the Colombian and Nicaraguan samples, and across gender within the Colombian sample.


The Latin-American Spanish version of the BESAA (BESAA-LA) appears to be a psychometrically sound measure with good reliability, validity and invariance across gender and countries. These results support the use of this scale to measure body satisfaction/dissatisfaction in Latin American adult populations.



La insatisfacción corporal (BD) es una preocupación creciente en Latinoamérica; cuestionarios confiables y culturalmente apropiados son importantes para fomentar la investigación de la imagen corporal en los países latinoamericanos. Tratamos de validar una versión en español latinoamericano de la Escala de Estima Corporal para Adolescentes y Adultos (Mendelson et al., 2001).


La escala fue traducida, adaptada culturalmente y validada en una muestra de adultos en Colombia (N = 525, 65% mujeres, Medad 24,4, SD = 9,28). Se evaluó la estructura factorial (mediante análisis factorial confirmatorio (AFC), análisis factorial exploratorio (AFE) y modelo exploratorio de ecuaciones estructurales (ESEM)), confiabilidad interna (utilizando alfa de Cronbach y omega), validez (utilizando la Body Appreciation Scale BAS y Sociocultural Attitudes Towards Appearance Questionnaire SATAQ), estabilidad test-retest en una pequeña submuestra (N = 84, usando correlaciones intraclase ICC) e invarianza de medición entre géneros. Para evaluar la generalización de la escala, se evaluó la confiabilidad, validez y estructura factorial en una segunda muestra de adultos Nicaragüenses (N = 102, 73% mujeres, Medad 22,2, SD = 4,72).


La escala evidenció una buena confiabilidad interna y validez en ambas muestras y mostró evidencia de una estabilidad temporal adecuada en la muestra colombiana. La EFA evidenció una estructura de tres factores con las subescalas que denominamos ‘apariencia-positiva’, ‘apariencia-negativa’ y ‘peso’ que se confirmó mediante AFC y ESEM en la muestra colombiana. Se confirmó la invarianza de medición en las muestras colombiana y nicaragüense, así como entre los géneros dentro de la muestra colombiana.


La versión en español latinoamericano BESAA-LA es una medida psicométricamente sólida con buena confiabilidad, validez e invarianza entre géneros y países. Estos resultados apoyan el uso de esta escala para medir la satisfacción/insatisfacción corporal en poblaciones adultas latinoamericanas.

Plain English summary

Body dissatisfaction is a risk factor for eating disorders, so it is important to have measures to reliably assess body satisfaction/dissatisfaction. As most research is conducted in English-speaking countries, relatively few questionnaires have been translated to other languages. Here, we assessed the usefulness of a Latin-American Spanish translation of the Body Esteem Scale for Adolescents and Adults (BESAA), used to assess body satisfaction/dissatisfaction, in adult samples from two Latin American countries, Colombia and Nicaragua. Our results indicate that the Latin-American Spanish version of the BESAA (BESAA-LA) is a reliable and valid measure of body satisfaction/dissatisfaction in Colombian and Nicaraguan adults.


Body dissatisfaction (BD), defined as the discrepancy between the ideal and actual body [11], has been reported to occur in many Latin American populations [9, 22, 47, 71, 75]. BD is associated with an increased risk of obesity [59], low self-esteem [16], depression, and eating disorders [53, 66, 76]. BD also increases the likelihood of considering plastic surgery [50, 63, 68]. Recent reports placed Brazil, Mexico, and Argentina among the top ten economies with the highest prevalence of plastic surgeries performed worldwide. Colombia was ranked as 13th (International Association for Aesthetic/Cosmetic surgery survey 2020). Recent meta-analyses show high prevalence of eating disorders in Latin America, especially binge-eating disorder [36, 37]. However, Latin American research is dominated by studies from Mexico and Brazil and less is known about body image in other Latin American countries [39]. Furthermore, body image studies in Latin American contexts tend to rely heavily on a few scales that measure a limited range of constructs and that have been developed and/or translated for European Spanish populations. For instance, amongst the most widely used scales are the Spanish Body Shape Questionnaire [18, 58] and Figure Rating scales (e.g., Stunkard's Silhouettes Scale, [67]. Both mostly focus on the perceptual aspect of BD, neglecting other aspects of the multidimensional construct of body image (e.g., cognitive, emotional, and behavioural aspects; [10].

Efforts are underway to address the lack of suitable instruments for Latin American contexts. For instance, Gongora et al. 26, demonstrated sound psychometric properties and invariance in male and female adolescents in three countries in their validation of a Latin Spanish version of the Body Appreciation scale (BAS-2; [72]). Similarly, Mebarak Chams [46] translated and validated the Body Image State Scale (BISS; [12]) in a Colombian sample and found similar factor structure and reliability to the original. Lacking, however, is a linguistically and culturally appropriate scale that includes positive and negative aspects of body image, validated for use in Latin American populations.

The Body Esteem Scale for Adolescents and Adults (BESAA)

The current study sought to address this gap by translating, culturally adapting, and validating the Body Esteem Scale for Adolescents and Adults (BESAA; [48] for use in Colombian and Nicaraguan participants. The BESAA measures body satisfaction/dissatisfaction and contains 23 items. It was originally developed and validated in adolescent and adult samples in Canada and has three subscales [48].

The subscale ‘appearance’ (e.g., “I like what I look like in pictures”) takes a holistic view of body image by including multiple aspects related to appearance, without specifying a particular appearance ideal. Therefore, this scale is well suited to use in different cultural contexts where focus lies more on body shape than body size (e.g., [1, 71]), or where other aspects of appearance (e.g., skin colour or hair texture, [21, 41]) may be salient aspects influencing body satisfaction.

The second subscale focuses on satisfaction with ‘weight’, with items such as “I am satisfied with my weight”. Higher BMI is a risk factor for body dissatisfaction, which has been confirmed in adults and adolescents around the world [78], including Colombian adults [25]. This subscale therefore assesses a relevant aspect influencing body satisfaction/dissatisfaction.

Items in the 'attribution subscale' (e.g., “My looks help me to get dates”) assess perceived judgments of others about appearance and weight. However, some scholars chose to exclude this subscale (e.g., [24, 45]), since evaluation from others is not a core aspect of body image and the subscale often showed lower reliability compared to the other two subscales of the BESAA (e.g., [17, 32, 48]).

The BESAA has been translated and validated in Icelandic [32], Italian [17], French [61, 74], Turkish [2], and Portuguese [65]. The English version has also been adapted to different cultural contexts in urban India [24] and Singapore [13]. The BESAA has been translated into Argentinian Spanish by Forbes et al. [22], but its psychometric validity was only assessed ten years later in adolescents in Spain [4]. None of the validation studies described were able to reproduce the original factor structure including all 23 items. Several studies reproduced the original three-factor structures, but excluded many items due to low loadings or high cross-loadings (Turkey: [2], Spain: [4],Italy: [17], Iceland: [32]. In India, France and Brazil, new structures emerged including two-, three-, and four-factor solutions (see [24, 61, 65, 74]).

Across these studies, researchers found good internal reliability for the whole scale and (varying) subscales, temporal stability, and validity (see [4] for a summary of validation studies). However, attempts to force an underlying factor structure have resulted in a varying number of items being retained across samples, which suggests that the BESAA factor structure might be unstable across samples and cultures.

Study aim

Given the points above, we evaluated a culturally adapted, Latin-American Spanish version of the BESAA (BESAA-LA) retaining as many items as possible, and focused on the assessment of the scale’s reliability, validity, and stability in two different samples within Latin America; university students from urban Colombia and adults from rural Nicaragua.

In Study 1, we present a full validation of the BESAA-LA following the guidelines for translation and validation of body image measures [69, 70]. Our psychometric evaluation of the scale included exploratory factor analysis (EFA), confirmatory factor analysis (CFA) and exploratory structural equation model (ESEM) to assess model fit and factor structure in Colombian participants. We also assessed reliability, validity, temporal stability and gender invariance in this sample.

In Study 2, we tested the generalisability of the scale by assessing internal reliability, validity and model fit of the BESAA-LA in a sample of adults from the Caribbean coast of Nicaragua. Additionally, we assessed measurement invariance across our Colombian and Nicaraguan samples.

Study 1—validation in Colombia



A total of 525 participants completed the questionnaire (Mage = 24.62, SD = 9.95), exceeding the recommended minimum 1:20 item participant ratio (see [29, 69]). Participants were asked about their gender identity, answer options included ‘female’, ‘male’, ‘other’ (with the option to specify) and ‘prefer not to say’. 65% of participants identified as female, 34% as male and 0.6% as other/preferred not to say).


This project complied with ethical guidelines for research with human participants and received ethical approval from Durham University (PSYCH-2020–08-20T11:47:35-dfls13) and Universidad del Norte (Nº 210). All data were collected using an online Questionnaire on Qualtrics™.

Undergraduate psychology students from Universidad del Norte and Corporación Universitaria Reformada in Barranquilla were invited to fill out the questionnaire. Additionally, they received a maximum of 0.5 percentage-point on their final exam when they recruited five people to participate. Out of 697 people who opened the questionnaire, 525 participants (64%) answered all questions. Two weeks later, all participants who completed the questionnaire received an email inviting them to complete the questionnaire again. Due to low participation rates for retest at the two-week interval, participants received another invitation four weeks later. Only 16% of participants (N = 84) filled out the questionnaire a second time.


Body Esteem Scale for Adolescents and Adults

The Body Esteem Scale for Adolescents and Adults [48] assesses body satisfaction/dissatisfaction and includes 23 items. It is answered on a Likert-scale from 1 = never to 5 = always, with higher average scores indicating higher body satisfaction.

Professor Beverley Mendelson granted permission to translate the Body Esteem Scale for Adolescents and Adults [48] in January 2022. The translation and cross-cultural adaptation followed the guidelines by Swami and Barron [69] and Kling et al. [35]. First, items were translated by two bilingual speakers into Spanish (FA, TT). The scale was then back translated into English by a Colombian bilingual speaker (AC). Any disagreements between translations were resolved through discussion.

In the next step, a committee consisting of two authors (JT, LF) and five students in Colombia confirmed that all wording was culturally appropriate (as suggested by [7]. Feedback on this final translation was then sought from a small group of Colombian students (N = 24). All items were judged to be comprehensible, and no further changes were made.

Body appreciation

The Latin Spanish version of the Body Appreciation Scale-2 (BAS-2; [26, 72]) was used to measure body appreciation. It includes 10 items on a Likert scale from 1 = never to 5 = always (e.g., “I respect my body”). Higher average scores indicate higher body appreciation. The scale showed good reliability in our sample (Cronbach’s α = 0.94). This scale has been used to test the nomological validity of the BESAA in other validation studies (see, e.g., [4, 28]) and we expected positive correlations between BAS-2 and BESAA-LA scores.

Media internalization and sociocultural pressures

The Spanish version of the Sociocultural Attitudes Towards Appearance Scale-4 (SATAQ-4; [40, 64]) was used to measure internalization and sociocultural pressures. The scale consists of five subscales, measuring internalization of the thin ideal, athletic ideal, and sociocultural pressures from family, friends, and the media. Participants respond on a Likert scale, where 1 = strongly disagree and 5 = strongly agree, to statements such as “It is important for me to look athletic”. Higher average scores indicate higher internalization and sociocultural pressures. Cronbach’s alpha confirmed good reliability in our sample with 0.92 (Cronbach’s α). The SATAQ has been used in another validation study to test discriminant validity [4]. We expected negative correlations between the SATAQ-4 subscales and the BESAA-LA.

Eating restraint

The restrained eating subscale of the Spanish version of the Eating Disorder Examination Questionnaire (EDE-Q; [42, 54]), was used to assess eating disorder symptoms. This subscale contains 5 items and measures the frequency of eating restraint over the last four weeks on a response scale from 0 = no days to 6 = every day. Higher average scores indicate higher eating disorder symptomatology. Good reliability was confirmed in our sample (Cronbach’s α = 0.86). The EDE-Q has been used in prior studies to test discriminant validity (e.g., [4, 24]). We expected a negative correlation between eating restraint and BESAA-LA.

Statistical analysis

Analyses were conducted in RStudio 4.0.3 (RStudio Team 2020). Packages Lavaan [60], and SEM [23] were used for confirmatory factor analysis (CFA) and Exploratory Factor Analysis (EFA). Exploratory structural Equation model (ESEM) was conducted in Mplus version 8.10 [52]. Analytic code and redacted-anonymized data are available on OFS (

The fit of previously validated factor structures (i.e., original, Spanish short, Brazilian, and French male and female versions) was first assessed using confirmatory factor analysis (CFA). As these factor structures did not satisfactorily fit our data, exploratory factor analysis (EFA) with a random half of the data was conducted. Parallel analysis [30], the Guttman-Kaiser criterion [27, 33], and the scree plot were considered to decide the number of factors to retain during EFA. Factors needed to fulfil the following criteria (as suggested by [69]): (a) each factor needed to contain at least 3 items, (b) the factor loading for each item needed to be at least 0.35, (c) each factor needed to explain at least 5% of the total variance, (d) items with cross-loadings of > 0.33 on more than one factor would be excluded. The newly found structure was confirmed using CFA on the second half of the data. We performed oblique rotation and used robust weighted least squares estimator (WLSMV), as recommended for categorical variables [51, 56]. Additionally, exploratory structural equation models (ESEM) were used to test model fit. Due to the presence of cross-loadings, ESEM has advantages over CFA since it does not force factor loadings on secondary factors to 0 [56]. A target rotation was specified based on the factor structure derived from EFA. This means we specified on which factor we expected items to load, while not restricting cross-loadings to 0. We followed the code provided by Prokofieva et al. [56].

The following fit indices were used to test adequate model fit, as recommended by Hu and Bentler [31]: Root Mean Square Error of Approximation (RMSEA, values less than 0.06 are considered good, and values between 0.07 and 0.10 are acceptable); Standardized Root Mean Square Residual (SRMR; values below 0.08 are good, values between 0.09 and 0.10 are acceptable); Tucker-Lewis Index and Comparative Fit Index (TLI and CFI; values higher than 0.95 suggest close fit for both, values between 0.90 and 0.94 are acceptable).

Internal consistency was assessed using Cronbach’s alpha coefficient (α; [20]) and McDonald’s Omega (ω; [44]). Alpha and omega values above 0.8 indicate good reliability (see [38]). Convergent and discriminant validity were evaluated using Pearson correlations. Test–retest reliability was assessed using the intraclass correlation coefficient (ICC; [3]), for which values above 0.75 are considered acceptable [55].

A series of multi-group CFA models was performed to assess configural, metric and scalar invariance across men and women—this is to say, whether the general factor structure is the same, whether the specific loadings are equal, and whether they have equal intercepts, respectively. This process involves sequentially creating three models, with every model adding more constraints compared to the previous one. The fit of the models is compared and if fit does not deteriorate in the more constrained model, invariance at the given level can be assumed. To confirm invariance, the chi-square difference test should be nonsignificant and differences in CFI, RMSEA and SRMR between the two models (configural vs. metric; metric vs. scalar) should remain small (ΔCFI < 0.01 and ΔRMSEA < 0.015 or ΔSRMR < 0.030 are considered sufficient, [14]. However, the chi-square difference test is sensitive to sample size (see [69]) and as long as the differences in CFI, RMSEA and SRMR remain small, invariance can still be assumed.


Confirmatory factor analysis with previously validated factor structures

The data did not show multivariate normality (skewness p < 0.001, kurtosis p = 0.39), as assessed by the Mardia test [43]. A table with descriptive statistics is provided in Additional file 1: S1. None of the previously validated factor structures (original, French female and male versions, Brazilian version, and Spanish short version) showed adequate fit for our data, with the Spanish short version showing closest fit compared to the other factor structures (see Table 1).

Table 1 Goodness of fit indices from confirmatory factor analysis using factor structures of other validation studies

Exploratory factor analysis

Exploratory factor analysis was performed with a random half of the sample (N = 275). Both parallel analysis and Kaiser-Guttmann criterion (3 eigenvalues were greater than 1; 9.46, 2.26, 1.42; fourth eigenvalue = 0.70) suggested a three-factor structure. In addition, the fit of the unidimensional model was assessed (see Table 3). The three-factor solution showed best fit for the data, according to relative and absolute fit indices. Item 5 (“I think my appearance would help me get a job”) showed poor factor loading and was subsequently removed. Four items (Item 4 “I am preoccupied with trying to change my body weight”; item 13 “My looks upset me”; item 17 “I feel ashamed of how I look.”; item 18 “Weighing myself depresses me”) showed loadings above 0.37 on more than one factor and were therefore excluded. The subscales of the 18-item version were named ‘appearance-positive’, ‘appearance-negative’ and ‘weight’. All factor loadings derived from EFA are shown in Table 2. CFA with the second random half of the sample showed acceptable fit of the 3-factor version with 18 items (see Table 3 for all results).

Table 2 Factor loadings of the 18-item version of the BESAA-LA derived from EFA, with item labels in Spanish and English
Table 3 Fit indices from EFA, CFA and ESEM for the 23- and 18-item versions of the BESAA-LA


To confirm factor structure, ESEM analysis was conducted using target rotation (based on EFA structure) in Mplus. Fit indices improved compared to CFA analysis and indicated good fit of the factor structure with the three subscales ‘appearance-positive’,appearance-negative’ and ‘weight’. See Table 3 for fit indices and Additional file 2: S2 for all factor loadings derived from ESEM.

Reliability and validity

The 18-item BESAA-LA and all subscales showed good internal reliability (total: α = 0.92, ω = 0.94; ‘appearance-positive’: α = 0.92, ω = 0.94; ‘appearance-negative’: α = 0.74, ω = 0.78 and ‘weight’: α = 0.89, ω = 0.90).

Convergent and discriminant validity were assessed using zero-order correlations. BAS, EDE, SATAQ thin-ideal internalization, athletic internalization and pressures all showed significant correlations with BESAA-LA total scale and subscales in the predicted directions. The BAS showed a strong significant positive correlation with BESAA-LA and all its subscales, confirming convergent validity. Strong significant negative correlations of the BESAA-LA with the thin internalization and pressure subscales of SATAQ, as well as small significant negative correlations with the subscale athletic internalization (except for the positive and weight subscales) confirmed discriminant validity. Eating restraint showed a moderate significant negative relationship with BESAA-LA. See Table 4 for all results.

Table 4 Zero-order correlations coefficients (Pearson’s r) between BESAA-LA, BAS, SATAQ and EDE

Temporal stability

Although only 84 participants (16% of our original Colombian sample) responded to the questionnaire a second time, intra-class correlation analysis suggested good test–retest reliability ICC = 0.754, p < 0.001, 95%CI 0.645 to 0.833, providing some support for the temporal stability of the BESAA-LA. ANOVAs indicated that those participants did not significantly differ from non-completers in terms of age (F(1, 523) = 2.908, p = 0.089), gender (F(1, 523) = 0.75, p = 0.387), or baseline BESAA-LA scores (F(1, 523) = 0.177, p = 0.674).

Measurement invariance across gender

A series of multi-group CFAs were conducted to check for invariance across gender. Table 5 shows the fit of the model for men and women followed by tests of configural, metric and scalar invariance. The configural invariance test confirmed that the factor structure does not differ between men and women. Metric invariance uses a more restricted model with equal factor loadings between groups. The chi-square difference test between the configural and metric model was nonsignificant (p = 0.195) and fit indices showed minimal changes, indicating metric invariance. To test scalar invariance, a model with equal intercepts imposed for men and women was created. Compared to the metric model, chi-square difference test was significant (p < 0.001), but changes in CFI, RMSEA and SRMR remained small, confirming scalar invariance of the BESAA-LA in men and women in Colombia (see Table 5).

Table 5 Configural, metric and scalar measurement invariance of the BESAA-LA across men and women in Colombian sample

Interim discussion

The aim of Study 1 was to translate and culturally adapt the Body Esteem Scale for Adolescents and Adults in a Colombian adult sample. The 18-item BESAA-LA showed good internal reliability, temporal stability and validity. As expected, the BESAA-LA showed a positive correlation with body appreciation, a construct that is related to body satisfaction, but that incorporates a broader range of factors, such as body functionality and self-love [73]. Significant moderate negative correlations were shown with the SATAQ subscales thin ideal internalization and sociocultural pressures, whereas the athletic internalization subscale showed significant, but small negative correlations with the BESAA-LA. This is in line with other studies that found lower correlations between the BESAA and athletic subscale, compared to other SATAQ subscales [4].

When assessing factorial validity, the original three-factor structure could not be reproduced. However, our three factor solution with subscales ‘appearance-positive’, ‘appearance-negative’ and ‘weight’ resembles the Brazilian structure [65]. This resemblance is not surprising, as these Latin American countries share geographical proximity, as well as a focus on appearance and beauty, which is reflected in high incidence of plastic surgery per capita in both Colombia and Brazil (International Association for Aesthetic/Cosmetic surgery survey 2020). Conceptually, the two subscales ‘appearance-positive’ and ‘appearance-negative’ support the proposition that positive and negative body image might be two separate constructs, rather than the ends of a continuum [65, 77]. The third subscale ‘weight’ has been found consistently across all validation studies conducted so far (Original validation [48], Iceland [32], Italy [17], Turkey [2], India [24], Spain [4] and Brazil [65]).

One item (item 5; “I think my appearance would help me get a job”) showed poor factor loading and was therefore excluded. This is in line with the French versions for men and women, where this item was excluded due to poor factor loading [61, 74]. Four items were excluded due to high cross-loadings. Items 4 and 18 ("I am preoccupied with trying to change my body weight” and “Weighing myself depresses me”) loaded on the ‘weight’ and ‘appearance-negative’ subscales, which makes conceptual sense, as both items are negative statements referring to weight. On the other hand, items 13 and 17 (“My looks upset me” and “I feel ashamed of how I look”) loaded both on ‘appearance-positive’ and ‘appearance-negative’ subscales. This could be due to the nature of these two items; whereas most items in the ‘appearance-negative’ subscale focus on wanting to look better or like someone else, these two items assess specific negative emotional reactions to one’s own physical appearance. During data collection, several participants commented that these questions had felt unusually emotionally intrusive compared to the rest of the questionnaire, which may explain the unusual loading pattern.

Study 2—evaluation in Nicaragua

In order to check the reliability, validity and factor structure of the BESAA-LA, we administered it in a second Spanish speaking adult population, to adults in rural Nicaragua.



102 participants (Mage = 22.16, SD = 4.72; 73% women, 27% men) completed the questionnaire. Among the participants, 49% identified as Mestizo, 38% as belonging to an afro-descended ethnic group (Creole or Garifuna), 8% to an indigenous ethnic group (Miskitu or Ulwa), and 5% identified as ‘other’ (but did not specify their ethnic identity). For a detailed description of ethnic groups in this region, see Boothroyd et al. [5] and Thornborrow et al. [71].


Ethical approval for data collection was given by Durham university (PSYCH-2020–08-20T11:47:35-dfls13). There is no formal ethics committee at URACCAN (Universidad de las regiones autónomas de la costa caribe Nicaragüense) where the data were gathered, however we received approval from the university’s vice rector to collect data. We sought feedback on the questionnaire items from WB and two local students, who confirmed congruency with local (Nicaraguan) terminology. The anonymous online questionnaire was distributed via Qualtrics™ to undergraduate psychology students and adults through personal contacts in the Pearl Lagoon region on the Caribbean Coast of Nicaragua.


As in Study 1, we used our translated version of the Body Esteem Scale for Adolescents and Adults (BESAA-LA) and the Latin Spanish version of the Body Appreciation Scale-2 (BAS-2; [26, 72]). The BAS-2 showed good reliability in our Nicaraguan sample (Cronbach’s α = 0.95).

Media internalization

To measure media internalization, we used the Spanish version of the Sociocultural Attitudes Towards Appearance Questionnaire-3 (SATAQ-3; [8, 62]). Participants respond to such items as “I would like my body to look like the people who are in movies”) on a 5-point Likert scale ranging from “strongly disagree” to “strongly agree”. Higher average scores indicate greater media internalization. Based on earlier work in this part of Nicaragua (see [71]), negatively worded items were removed. Items about magazines (which are not locally available) were adapted to refer to social media (e.g., “social media is an important source of information about fashion and ‘being attractive’”). The adapted scale showed good reliability in our sample (Cronbach’s α = 0.94).

Statistical analysis

As in Study 1, we used Cronbach’s alpha (α; [20]) and McDonald’s Omega (ω; [44]) to assess internal consistency, and Pearson correlations to assess validity. As described in Study 1, we performed confirmatory factor analysis to assess factor structure and multi-group CFA models to assess measurement invariance across Colombian and Nicaraguan participants.


Psychometric analysis using CFA

Goodness of fit indices from CFAs using the Latin-American Spanish version, the original factor structure, French male and female, Brazilian, and Spanish short versions revealed that the Latin-American Spanish version found in Colombia showed the best fit. See Table 6 for all fit indices.

Table 6 Goodness of fit indices from confirmatory factor analysis using factor structures of validation studies

Reliability and validity

Internal consistency was good for the BESAA-LA total scale (α = 0.93, ω = 0.95) and the subscales ‘appearance-positive’ (α = 0.88, ω = 0.93), ‘appearance-negative’ (α = 0.80, ω = 0.84) and ‘weight’ (α = 0.91, ω = 0.91). Validity of the BESAA-LA was confirmed through positive correlations of the total BESAA-LA and subscales with BAS, as well as negative correlations with SATAQ subscales. See Table 7 for all results.

Table 7 Zero-order correlations coefficients (Pearson’s r) between BESAA-LA, BAS and SATAQ

Measurement invariance across countries

Multi-group CFAs confirmed scalar invariance across Colombia and Nicaragua. Even though the chi-square difference test was significant when comparing the metric and scalar models ( χ2 p < 0.001), differences in CFI, RMSEA and SRMR remained small after the fixation of loadings and intercepts and scalar invariance can therefore be assumed (see Table 8).

Table 8 Configural, metric and scalar measurement invariance of the BESAA-LA across country


The present study aimed to assess the reliability, validity, stability, measurement invariance, and factor structure of a culturally and linguistically adapted version of the Body Esteem Scale for Adolescents and Adults in Latin America. The 18-item Latin-American Spanish version of the BESAA (BESAA-LA) showed good reliability (measured by Cronbach’s alpha and omega) and validity (using BAS and SATAQ) across two different Spanish speaking adult samples from urban Colombia and rural Nicaragua.

For both samples, none of the existing factor structures found in other validation studies (original structure, French male and female versions, Brazilian, and Spanish short versions) showed adequate fit. A three-factor structure established through EFA consisted of the three subscales ‘appearance-positive’, ‘appearance-negative’ and ‘weight’, and was confirmed through CFA in both Colombian and Nicaraguan samples. Importantly, the factor structure resembles the structure found with adolescents in Brazil and showed invariance across Colombia and Nicaragua, which suggests it may be suitable across Latin American populations.

However, we also note that there is a general difficulty in reproducing factor structures of the BESAA consistently in the broader literature, and that lower internal reliability was found for subscales than the full scale for our own samples and in other studies [2, 17, 48]. These points suggest that it might be better to use the BESAA as a holistic measure of body image, and that researchers should generally use total scale scores in their studies, rather than the individual subscales, unless there is a strong reason to isolate one aspect.

Strengths and limitations

This study benefits from a rigorous approach to scale adaptation, following the translation and cultural adaptation processes proposed by Swami and Barron, [69] and Kling et al. [35]. Our dataset in Colombia was large, and locally validated measures (SATAQ-4 and BAS) were used to confirm validity. Furthermore, this is the first formal validation study of a body image measure in a Nicaraguan population. Evidence of increasing body image risks in that country point to the potential utility of such a scale [71].

Additionally, multi-group CFA confirmed structural, metric, and scalar invariance of the scale across men and women (in Colombia) and across Colombian and Nicaraguan participants. This is the first study to assess measurement invariance of the BESAA-LA across different countries. Partial invariance across gender was established in Brazilian adolescents [65], whereas other studies did not assess measurement invariance of the scale at all. Evidence of measurement invariance is an important condition to conduct comparisons of scores between different groups and confirms that differences in scores are results of attitudinal, not psychometric differences of study populations [14, 15].

Data in Colombia were collected in two different universities (one private, one public) in Barranquilla. This allowed us to have a socioeconomically diverse sample of urban participants. Additionally, we tested the BESAA-LA in a sample from rural Nicaragua. Body dissatisfaction and body ideals often differ between urban and rural regions [6, 70], as well as higher and lower SES groups [25]. The BESAA-LA appears to be psychometrically sound in samples from both urban and rural contexts. This suggests that the scale may be suited to a variety of contexts.

Although a very small number of respondents limits the reliability of our estimates [55], the scale appears to have shown good temporal stability (as measured by ICC) in a subsample of our Colombian participants. Further supporting this point, at the initial assessment, test–retest ‘responders’ did not differ statistically from ‘non-responders’ in terms of gender, age or initial BESAA-LA scores. However, we aimed for an interval of two weeks between test and retest (as suggested by [55]), but were only able to reach a sufficient retest sample size within six weeks after initial assessment. Although this is not ideal, we deemed it better to have a retest interval of two to six weeks than not doing any retest analysis at all. Also, the considerably smaller size of the Nicaraguan sample, although sufficient to assess reliability, validity and conduct CFA (according to [34]), did not meet the ideal participant-to-item ratio of 20:1 (see [69]) and the CFA in the Nicaraguan sample should therefore be interpreted with caution.

Finally, the BESAA-LA proved to be a good tool for research with adults in these two regions, however future studies are needed to also assess the psychometric properties of the BESAA-LA in other age groups, for example adolescent populations, and in other Latin American samples.


The Latin-American Spanish Version of the Body Esteem Scale for Adolescents and Adults (BESAA-LA) showed good psychometric properties and appeared to be a valid tool to assess body satisfaction/dissatisfaction in two distinct adult populations in Spanish speaking Latin American countries.

Availability of data and materials

Anonymised data and R code are available at:


  1. Anderson-Fye EP. A “Coca-Cola” shape: Cultural change, body image, and eating disorders in San Andrés, Belize. Cult Med nd Psychiat. 2004;28(4):561–95.

    Article  Google Scholar 

  2. Arslan UE, Özcebe LH, Ünlü HK, Üner S, Yardim MS, Araz O, Huang TT. The validity and reliability of the Turkish version of the body esteem scale for adolescents and adults (BESAA) for children. Turk J Med Sci. 2020;50(2):471–7.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Bartko JJ. The intraclass correlation coefficient as a measure of reliability. Psychol Rep. 1966;19(1):3–11.

    Article  PubMed  Google Scholar 

  4. Beltrán-Garrayo L, Mercado-Garrido E, Román FJ, Rojo M, Sepúlveda AR. Assessing body esteem in adolescents: psychometric properties of the Spanish version of the Body Esteem Scale (BESAA-S). Child Youth Care Forum. 2023;52(3):683–701.

    Article  Google Scholar 

  5. Boothroyd LG, Jucker J-L, Thornborrow T, Barton RA, Burt DM, Evans EH, Jamieson MA, Tovée MJ. Television consumption drives perceptions of female body attractiveness in a population undergoing technological transition. J Personal Soc Psychol. 2020;119(4):839–60.

    Article  Google Scholar 

  6. Boothroyd LG, Jucker JL, Thornborrow T, Jamieson MA, Burt DM, Barton RA, Evans EH, Tovee MJ. Television exposure predicts body size ideals in rural Nicaragua. Br J Psychol Lond Engl. 2016;107(4):752–67.

    Article  Google Scholar 

  7. Brislin RW. Back-translation for cross-cultural research. J Cross-Cult Psychol. 1970;1(3):185–216.

    Article  Google Scholar 

  8. Calogero RM, Davis WN, Thompson JK. The sociocultural attitudes toward appearance questionnaire (SATAQ-3): reliability and normative comparisons of eating disordered patients. Body Image. 2004;1(2):193–8.

    Article  PubMed  Google Scholar 

  9. Carvalho PHB, d., & Ferreira, M. E. C. Disordered eating and body change behaviours: support for the Tripartite Influence Model among Brazilian male university students. Ciencia & Saude Coletiva. 2020;25:4485–95.

    Article  Google Scholar 

  10. Cash TF. Body image: past, present, and future. Body Image. 2004;1(1):1–5.

    Article  PubMed  Google Scholar 

  11. Cash TF, Fleming EC. The impact of body image experiences: development of the body image quality of life inventory. Int J Eat Disord. 2002;31(4):455–60.

    Article  PubMed  Google Scholar 

  12. Cash TF, Fleming EC, Alindogan J, Steadman L, Whitehead A. Beyond body image as a trait: the development and validation of the Body Image States Scale. Eat Disord. 2002;10(2):103–13.

    Article  PubMed  Google Scholar 

  13. Chang L, Li P, Loh RSM, Chua THH. A study of Singapore adolescent girls’ selfie practices, peer appearance comparisons, and body esteem on Instagram. Body Image. 2019;29:90–9.

    Article  PubMed  Google Scholar 

  14. Chen FF. Sensitivity of goodness of fit indexes to lack of measurement invariance. Struct Equ Model. 2007;14(3):464–504.

    Article  Google Scholar 

  15. Cheung GW, Rensvold RB. Evaluating goodness-of-fit indexes for testing measurement invariance. Struct Equ Model. 2002;9(2):233–55.

    Article  Google Scholar 

  16. Clay D, Vignoles VL, Dittmar H. Body image and self-esteem among adolescent girls- Testing the influence of sociocultural factors. J Res Adolesc. 2005;15(4):451–477.

    Article  Google Scholar 

  17. Confalonieri E, Gatti E, Ionio C, Traficante D. Body Esteem Scale: a validation on Italian adolescents. Psychometrics Methodol Appl Psychol. 2008;15(3):153–65.

    Google Scholar 

  18. Cooper PJ, Taylor MJ, Cooper Z, Fairbum CG. The development and validation of the body shape questionnaire. Int J Eat Disorders. 1987;6(4):485–94.;2-O.

    Article  Google Scholar 

  19. Cragun D, DeBate RD, Ata RN, Thompson JK. Psychometric properties of the Body Esteem Scale for Adolescents and adults in an early adolescent sample. Eat Weight Disorders Stud Anorexia, Bulimia Obes. 2013;18(3):275–82.

    Article  Google Scholar 

  20. Cronbach LJ. Coefficient alpha and the internal structure of tests. Psychometrika. 1951;16(3):297–334.

    Article  Google Scholar 

  21. De Casanova EM. No ugly women. Gender Soc. 2004;18(3):287–308.

    Article  Google Scholar 

  22. Forbes GB, Jung J, Vaamonde JD, Omar A, Paris L, Formiga NS. Body dissatisfaction and disordered eating in three cultures: Argentina, Brazil, and the US. Sex Roles. 2012;66(9):677–94.

    Article  Google Scholar 

  23. Fox J. Teacher’s corner: structural equation modeling with the sem package in R. Struct Equ Model. 2006;13(3):465–86.

    Article  Google Scholar 

  24. Garbett KM, Lewis-Smith H, Chaudhry A, Uglik-Marucha N, Vitoratou S, Shroff H, Dhillon M, Diedrichs PC. Cultural adaptation and validation of the body esteem scale for adults and adolescents for use in English among adolescents in urban India. Body Image. 2021;37:246–54.

    Article  PubMed  Google Scholar 

  25. Gilbert-Diamond D, Baylin A, Mora-Plazas M, Villamor E. Correlates of obesity and body image in Colombian women. J Women’s Health. 2009;18(8):1145–51.

    Article  Google Scholar 

  26. Góngora VC, Licea VC, Chams MRM, Thornborrow T. Assessing the measurement invariance of a Latin-American Spanish translation of the Body Appreciation Scale-2 in Mexican, Argentinean, and Colombian adolescents. Body Image. 2020;32:180–9.

    Article  PubMed  Google Scholar 

  27. Guttman L. Some necessary conditions for common-factor analysis. Psychometrika. 1954;19(2):149–61.

    Article  Google Scholar 

  28. Halliwell E, Jarman H, Tylka T, Slater A. Adapting the body appreciation scale-2 for children: a psychometric analysis of the BAS-2C. Body Image. 2017;21:97–102.

    Article  PubMed  Google Scholar 

  29. Hogarty KY, Hines CV, Kromrey JD, Ferron JM, Mumford KR. The quality of factor solutions in exploratory factor analysis: the influence of sample size, communality, and overdetermination. Educ Psychol Meas. 2005;65(2):202–26.

    Article  Google Scholar 

  30. Horn JL. A rationale and test for the number of factors in factor analysis. Psychometrika. 1965;30:179–85.

    Article  PubMed  Google Scholar 

  31. Hu LT, Bentler PM. Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Struct Equ Model Multi J. 1999;6(1):1–55.

    Article  Google Scholar 

  32. Jónsdóttir SR, Arnarson EÖ, Smári J. Body esteem, perceived competence and depression in Icelandic adolescents. Nordic Psychol. 2008;60(1):58–71.

    Article  Google Scholar 

  33. Kaiser HF. The application of electronic computers to factor analysis. Educ Psychol Meas. 1960;20(1):141–51.

    Article  Google Scholar 

  34. Kline TJ. Psychological testing: A practical approach to design and evaluation. New York: Sage publications; 2005.

    Book  Google Scholar 

  35. Kling J, Kwakkenbos L, Diedrichs PC, Rumsey N, Frisen A, Brandao MP, Silva AG, Dooley B, Rodgers RF, Fitzgerald A. Systematic review of body image measures. Body Image. 2019;30:170–211.

    Article  PubMed  Google Scholar 

  36. Kolar DR, Mebarak M. An update on the epidemiology of eating disorders in Latin America: current findings and future challenges. Curr Opin Psychiat. 2022;35(6):385–9.

    Article  Google Scholar 

  37. Kolar DR, Rodriguez DL, Chams MM, Hoek HW. Epidemiology of eating disorders in Latin America: a systematic review and meta-analysis. Curr Opin Psychiat. 2016;29(6):363–71.

    Article  Google Scholar 

  38. Lance CE, Butts MM, Michels LC. The sources of four commonly reported cutoff criteria: what did they really say? Organ Res Methods. 2006;9(2):202–20.

    Article  Google Scholar 

  39. Laus MF, Kakeshita IS, Costa TMB, Ferreira MEC, Fortes L, d. S., & Almeida, S. S. Body image in Brazil: recent advances in the state of knowledge and methodological issues [Imagem corporal no Brasil: avanços recentes no estado de conhecimento e em questões metodológicas]. Rev Saude Publica. 2014;48(2):331–46.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Llorente E, Gleaves DH, Warren CS, Perez-de-Eulate L, Rakhkovskaya L. Translation and validation of a Spanish version of the Sociocultural Attitudes Towards Appearance Questionnaire-4 (SATAQ-4). Int J Eat Disord. 2015;48(2):170–5.

    Article  PubMed  Google Scholar 

  41. Lowy AS, Rodgers RF, Franko DL, Pluhar E, Webb JB. Body image and internalization of appearance ideals in Black women: An update and call for culturally-sensitive research. Body Image. 2021;39:313–27.

    Article  PubMed  Google Scholar 

  42. Luce KH, Crowther JH. The reliability of the eating disorder examination—self-report questionnaire version (EDE-Q). Int J Eat Disorders. 1999;25(3):349–51.;2-M.

    Article  Google Scholar 

  43. Mardia KV. Measures of multivariate skewness and kurtosis with applications. Biometrika. 1970;57(3):519–30.

    Article  Google Scholar 

  44. McDonald RP. Test theory: A unified treatment. New York: Psychology Press; 2013.

    Book  Google Scholar 

  45. McLean SA, Wertheim EH, Masters J, Paxton SJ. A pilot evaluation of a social media literacy intervention to reduce risk factors for eating disorders. Int J Eat Disorders. 2017;50(7):847–51.

    Article  Google Scholar 

  46. Mebarak Chams M, Tinoco L, Mejia-Rodriguez D, Martinez-Banfi ML, Preuss H, Hammerle F, Vélez JI, Kolar DR. The spanish body image state scale: factor structure, reliability and validity in a colombian population. Front Psychol 2019;10:2553.

    Article  PubMed  PubMed Central  Google Scholar 

  47. Mellor D, McCabe M, Ricciardelli L, Merino ME. Body dissatisfaction and body change behaviors in Chile: the role of sociocultural factors. Body Image. 2008;5(2):205–15.

    Article  PubMed  Google Scholar 

  48. Mendelson BK, Mendelson MJ, White DR. Body-esteem scale for adolescents and adults. J Pers Assess. 2001;76(1):90–106.

    Article  PubMed  Google Scholar 

  49. Mendelson BK, White DR, Mendelson MJ. Self-esteem and body esteem: Effects of gender, age, and weight. J Appl Dev Psychol. 1996;17(3):321–46.

    Article  Google Scholar 

  50. Milothridis P, Pavlidis L, Haidich A-B, Panagopoulou E. A systematic review of the factors predicting the interest in cosmetic plastic surgery. Indian J Plast Surg. 2016;49(03):397–402.

    Article  PubMed  PubMed Central  Google Scholar 

  51. Moshagen M, Musch J. Sample size requirements of the robust weighted least squares estimator. Methodology. 2014.

    Article  Google Scholar 

  52. Muthén LK, Muthén B. Mplus user’s guide: statistical analysis with latent variables, user’s guide. Cambridge: Muthén & Muthén; 2017.

    Google Scholar 

  53. Ohring R, Graber JA, Brooks-Gunn J. Girls’ recurrent and concurrent body dissatisfaction: correlates and consequences over 8 years. Int J Eat Disorders. 2002;31(4):404–15.

    Article  Google Scholar 

  54. Peláez-Fernández MA, Labrador FJ, Raich RM. Validation of eating disorder examination questionnaire (EDE-Q)–Spanish version–for screening eating disorders. Spanish J Psychol. 2012;15(2):817–24.

    Article  Google Scholar 

  55. Polit DF. Getting serious about test–retest reliability: a critique of retest research and some recommendations. Qual Life Res. 2014;23(6):1713–20.

    Article  PubMed  Google Scholar 

  56. Prokofieva M, Zarate D, Parker A, Palikara O, Stavropoulos V. Exploratory structural equation modeling: a streamlined step by step approach using the R Project software. BMC Psychiat. 2023;23(1):546.

    Article  Google Scholar 

  57. RStudio Team. RStudio: Integrated Development for R. Boston, MA: RStudio, PBC. 2020. URL

  58. Raich R, Mora M, Soler A, Avila C, Clos I, Zapater L. Adaptation of a body dissatisfaction assessment instrument. Clínica y salud. 1996;7:51–66.

    Google Scholar 

  59. Rehkopf DH, Laraia BA, Segal M, Braithwaite D, Epel l. The relative importance of predictors of body mass index change, overweight and obesity in adolescent girls. Int J Pediatric Obesity. 2011;6(sup3):e233–42.

    Article  Google Scholar 

  60. Rosseel Y. lavaan: An R package for structural equation modeling. J Stat Softw 2012;48:1–36.

    Article  Google Scholar 

  61. Rousseau A, Valls M, Chabrol H. Étude de validation de la version française de l’Échelle d’Estime Corporelle (Body Esteem Scale) chez les adolescentes et les jeunes adultes. Eur Rev Appl Psychol. 2015;65(4):205–10.

    Article  Google Scholar 

  62. Sanchez-Carracedo D, Barrada JR, Lopez-Guimera G, Fauquet J, Almenara CA, Trepat E. Analysis of the factor structure of the sociocultural attitudes towards appearance questionnaire (SATAQ-3) in Spanish secondary-school students through exploratory structural equation modeling. Body Image. 2012;9(1):163–71.

    Article  PubMed  Google Scholar 

  63. Sarwer DB. Body image, cosmetic surgery, and minimally invasive treatments. Body Image. 2019;31:302–8.

    Article  PubMed  Google Scholar 

  64. Schaefer LM, Burke NL, Thompson JK, Dedrick RF, Heinberg LJ, Calogero RM, Bardone-Cone AM, Higgins MK, Frederick DA, Kelly M. Development and validation of the sociocultural attitudes towards appearance questionnaire-4 (SATAQ-4). Psychol Assess. 2015;27(1):54.

    Article  PubMed  Google Scholar 

  65. Smith HG, Garbett KM, Matheson EL, Amaral AC, Meireles JF, Almeida MC, Hayes C, Vitoratou S, Diedrichs PC. The body esteem scale for adults and adolescents: translation, adaptation and psychometric validation among Brazilian adolescents. Body Image. 2022;42:213–21.

    Article  PubMed  Google Scholar 

  66. Stice E. Risk and maintenance factors for eating pathology- a meta-analytic review. Psychol Bull. 2002;128(5):825–48.

    Article  PubMed  Google Scholar 

  67. Stunkard AJ. Use of the Danish adoption register for the study of obesity and thinness. Res Publ Assoc Res Nerv Ment Dis. 1983;60:115–20.

    PubMed  Google Scholar 

  68. Swami V. Body appreciation, media influence, and weight status predict consideration of cosmetic surgery among female undergraduates. Body Image. 2009;6(4):315–7.

    Article  PubMed  Google Scholar 

  69. Swami V, Barron D. Translation and validation of body image instruments: challenges, good practice guidelines, and reporting recommendations for test adaptation. Body Image. 2019;31:204–20.

    Article  PubMed  Google Scholar 

  70. Swami V, Frederick DA, Aavik T, Alcalay L, Allik J, Anderson D, Andrianto S, Arora A, Brännström A, Cunningham J, Danel D, Doroszewicz K, Forbes GB, Furnham A, Greven CU, Halberstadt J, Hao S, Haubner T, Hwang CS, Inman M, Jaafar JL, Johansson J, Jung J, Keser A, Kretzschmar U, Lachenicht L, Li NP, Locke K, Lönnqvist JE, Lopez C, Loutzenhiser L, Maisel NC, McCabe MP, McCreary DR, McKibbin WF, Mussap A, Neto F, Nowell C, Alampay LP, Pillai SK, Pokrajac-Bulian A, Proyer RT, Quintelier K, Ricciardelli LA, Rozmus-Wrzesinska M, Ruch W, Russo T, Schütz A, Shackelford TK, Shashidharan S, Simonetti F, Sinniah D, Swami M, Vandermassen G, van Duynslaeger M, Verkasalo M, Voracek M, Yee CK, Zhang EX, Zhang X, Zivcic-Becirevic I. The attractive female body weight and female body dissatisfaction in 26 countries across 10 world regions: results of the international body project I [Article]. Personal Soc Psychol Bull. 2010;36(3):309–25.

    Article  Google Scholar 

  71. Thornborrow T, Evans E, Tovee MJ, Boothroyd L. Sociocultural drivers of body image and eating disorder risk in rural Nicaraguan women. J Eat Disorders. 2022;10(1):1–16.

    Article  Google Scholar 

  72. Tylka TL, Wood-Barcalow NL. The Body Appreciation Scale-2: item refinement and psychometric evaluation. Body Image. 2015;12:53–67.

    Article  PubMed  Google Scholar 

  73. Tylka TL, Wood-Barcalow NL. What is and what is not positive body image? Conceptual foundations and construct definition. Body Image. 2015;14:118–29.

    Article  PubMed  Google Scholar 

  74. Valls M, Rousseau A, Chabrol H. Étude de validation de la version française du Body Esteem Scale (BES) dans la population masculine. Journal de thérapie comportementale et cognitive. 2011;21(2):58–64.

    Article  Google Scholar 

  75. Wal JSV, Gibbons JL, Grazioso M, d. P. The sociocultural model of eating disorder development: application to a Guatemalan sample. Eat Behav. 2008;9(3):277–84.

    Article  Google Scholar 

  76. Walker DC, White EK, Srinivasan VJ. A meta-analysis of the relationships between body checking, body image avoidance, body image dissatisfaction, mood, and disordered eating. Int J Eat Disorders. 2018;51(8):745–70.

    Article  Google Scholar 

  77. Webb JB, Wood-Barcalow NL, Tylka TL. Assessing positive body image: contemporary approaches and future directions. Body Image. 2015;14:130–45.

    Article  PubMed  Google Scholar 

  78. Weinberger N-A, Kersting A, Riedel-Heller SG, Luck-Sikorski C. Body dissatisfaction in individuals with obesity compared to normal-weight individuals: a systematic review and meta-analysis. Obes Facts. 2016;9(6):424–41.

    Article  PubMed  PubMed Central  Google Scholar 

Download references


We thank Elvis Calero for his facilitation at the university of URACCAN, as well as all our participants for their time. We also thank Beverley Mendelson for giving us permission to translate the Body Esteem Scale for Adolescents and Adults into Spanish. We also thank Ulrik Beierholm and Juan Camilo Mendoza Arango for their advice about ESEM.


This research was supported by a Wellcome Trust research grant awarded to LB (217399/Z/19/Z).

Author information

Authors and Affiliations



FA: Conceptualisation, data curation, investigation, methodology, project administration, formal analysis, writing- original draft, review & editing. TT: conceptualisation, data curation, investigation, methodology, writing- review & editing. WB: project administration, scale translation, investigation, writing- review & editing. LF: scale translation, investigation, abstract translation, writing—review & editing. JT: scale translation, investigation, abstract translation, writing—review & editing. GD: scale translation & adaptation, investigation, writing—review & editing. AC: conceptualisation, project administration, writing- review & editing. MM: conceptualisation, project administration, writing- review & editing. EE: conceptualisation, methodology, writing- review & editing. DK: conceptualisation, provided code for analysis, writing- review & editing. LB: conceptualisation, formal analysis, funding acquisition, methodology, project administration, supervision, writing- original draft, review & editing.

Corresponding author

Correspondence to Fabienne E. Andres.

Ethics declarations

Ethics approval and consent to participate

Ethical approval for this project was received from Durham University (reference PSYCH-2020–08-20T11:47:35-dfls13) and Universidad del Norte, Colombia (reference No 210). Data collection in Nicaragua was also approved by URACCAN. All participants gave informed consent via an electronic form at the start of the questionnaire on Qualtrics.

Consent for publication

All authors consent to the publication of this manuscript.

Competing interests

The authors declare that they have no competing interests.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Additional file 1:

 Descriptive statistics.

Additional file 2:

 ESEM results.

Rights and permissions

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Andres, F.E., Thornborrow, T., Bowie, W.N. et al. Validation of a Latin-American Spanish version of the Body Esteem Scale for Adolescents and Adults (BESAA-LA) in Colombian and Nicaraguan adults. J Eat Disord 11, 219 (2023).

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: