Abstract
BACKGROUND: 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. OBJECTIVES: 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. ELIGIBILITY CRITERIA: 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. SOURCES OF EVIDENCE: The source of evidence was a systematic search of PsycINFO. CHARTING METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.