Exploring Male Body Image: A Scoping Review of Measurement Approaches and Mental Health Implications

Body image (BI) concerns in men-spanning thinness, muscularity, and other related constructs-are increasingly being recognized for their links to depression, anxiety, and self-esteem, yet measurement approaches remain unevenly aligned.

Our objective was to map the landscape of BI instruments deployed with cisgender men and women and to examine whether thinness-, muscularity-, and non-specific self-image satisfaction measures differentially relate to key mental health outcomes.

Our eligibility criteria were peer-reviewed, quantitative studies published in English between January 2011 and December 2021. We only included studies with samples ≥30 cisgender men, psychometrically validated BI scales, results reported separately by gender, and U.S.-based investigations.

The source of evidence was a systematic search of PsycINFO.

Two reviewers double-screened titles/abstracts and full texts in EPPI-Reviewer. Data on measure orientation; validation sample characteristics; and effect sizes relating BI scores to depression, anxiety, and self-esteem were extracted. The effect sizes were transformed to r and averaged across the studies.

Of the 1178 records identified, 191 U.S. studies met the inclusion criteria. Fifty-five distinct BI instruments were used; twelve appeared in six or more studies and were classified as thinness-oriented, muscularity-oriented, or non-specific. The unweighted average correlations with depression ranged from r = 0.23 (muscularity) to 0.34 (non-specific), with anxiety at r = 0.16-0.25 and self-esteem at r = 0.20-0.57. The male samples showed greater heterogeneity of effect sizes, likely reflecting the sampling variability and the multifaceted nature of men's BI concerns.

This review confirms critical gaps in male BI measurement and interpretation. Although thinness- and muscularity-oriented scales each capture facets of men's BI, exclusive reliance on thinness measures risks overlooking leanness- and musculature-focused pathology. The greater variability of BI-mental health associations in men than women underscore the need for a diverse measurement toolkit that, at minimum, assesses thinness, muscularity, and other appearance-related constructs.