Beyond thinness: The contribution of muscularity-oriented disordered eating to clinical impairment across cultures

Muscularity-oriented disordered eating (MODE) has been linked to negative outcomes, even when controlling for thinness-oriented disordered eating; however, its contribution to clinical impairment across demographic groups remains understudied. This study examined whether MODE independently contributes to clinical impairment while accounting for cognitive restraint, restricting, and purging, and whether this relationship differs by gender and country. Female (n = 1575) and male (n = 906) students from Canada, the United States, and Iran completed self-report measures of MODE, thinness-oriented disordered eating, and clinical impairment. Hierarchical multiple regressions were conducted with gender and country as moderators. Analyses were pre-registered on Open Science Framework. The addition of MODE to the model significantly accounted for 11 % of unique variance in clinical impairment. No significant moderation effects of gender and country were found. Results suggest that across women and men from both Western and non-Western cultural contexts, the unique aspects of MODE are associated with disruptions in daily functioning in multiple domains. These findings challenge the belief that dieting for muscularity is inherently beneficial for well-being. More clinical attention on MODE is warranted, such as targeted prevention and treatment efforts that address MODE specifically, rather than conceptualizing it as an extension of thinness-oriented eating disorders.