Who benefits from a digital intervention for appearance concerns? A randomized controlled trial of a large...

Individuals with excessive appearance concerns commonly engage in appearance-related safety behaviors (ARSBs), or behaviors aimed at managing or avoiding negative evaluation of one's physical appearance. Targeting these behaviors can lead to reductions in appearance concerns and related symptoms. However, prior studies have only examined these effects among women scoring above a specific cutoff, excluding men and individuals with lower levels of these concerns. The present study further evaluated the efficacy of this brief ARSB intervention and examined who benefits from this intervention.

Adults (N = 400) interested in treatment for appearance concerns were recruited across the United States and randomized to a 1-month smartphone-based intervention targeting ARSBs or a four-session relaxation video control.

Baseline appearance concerns moderated condition effects such that, among those with elevated concerns, ARSB fading led to lower appearance concerns than control at post, while conditions did not differ among those with low concerns. Probing the moderated effect using the Johnson-Neyman technique indicated ARSB fading led to significantly lower appearance concerns at post among those scoring in the upper two thirds in appearance concerns (SMD = 0.39). ARSB fading also led to lower body dissatisfaction (SMD = 0.15-0.19) at post and follow-up, and among those high in appearance concerns, ARSB fading led to lower bulimic symptoms at post (SMD = 0.34). No demographic factor moderated the effects of treatment, indicating comparable efficacy between men and women.

These findings further support the efficacy of ARSB fading and provide novel evidence for individuals who are likely to benefit from this intervention. (PsycInfo Database Record (c) 2026 APA, all rights reserved).