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 * BIF is measured using the Body Image Acceptance and Action Questionnaire (BI-AAQ) (Sandoz et al., 2013). Participants rate a series of statements from 1 to 7 based on how true they are, with 1 being never true and 7 being always true. The statements are:

1. Worrying about my weight makes it difficult for me to live a life that I value. 2. I care too much about my weight and body shape. 3. I shut down when I feel bad about my body shape or weight. 4. My thoughts and feelings about my body weight and shape must change before I can take important steps in my life. 5. Worrying about my body takes up too much of my time. 6. If I start to feel fat, I try to think about something else. 7. Before I can make any serious plans, I have to feel better about my body. 8. I will have better control over my life if I can control my negative thoughts about my body. 9. To control my life, I need to control my weight. 10. Feeling fat causes problems in my life. 11. When I start thinking about the size and shape of my body, it's hard to do anything else. 12. My relationships would be better if my body weight and/or shape did not bother me.

=Measuring body image flexibility=
 * BIF is measured using the Body Image Acceptance and Action Questionnaire (BI-AAQ) (Sandoz et al., 2013). Participants rate a series of statements from 1 to 7 based on how true they are, with 1 being never true and 7 being always true. The statements are:

1. Worrying about my weight makes it difficult for me to live a life that I value. 2. I care too much about my weight and body shape. 3. I shut down when I feel bad about my body shape or weight. 4. My thoughts and feelings about my body weight and shape must change before I can take important steps in my life. 5. Worrying about my body takes up too much of my time. 6. If I start to feel fat, I try to think about something else. 7. Before I can make any serious plans, I have to feel better about my body. 8. I will have better control over my life if I can control my negative thoughts about my body. 9. To control my life, I need to control my weight. 10. Feeling fat causes problems in my life. 11. When I start thinking about the size and shape of my body, it's hard to do anything else. 12. My relationships would be better if my body weight and/or shape did not bother me.

 {Chloe tries on an outfit in a store and realises that she has gone up a size since last time she went shopping. She is upset and angry with herself that she didn’t notice she was gaining weight.}

{Which reaction is an example of Chloe using positive rational acceptance?}


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- Buying her previous size as motivation to lose weight, even though she wanted to wear the outfit now. + Telling herself “I still look good; this outfit suits me better with some curves anyway” and buying the correct size. - Thinking “it’s ok that I’m upset, but I’m going to buy the right size because I want to be able to wear it”.

{Which reaction is an example of body image inflexibility?}


 * type=""}

+ Buying her previous size as motivation to lose weight, even though she wanted to wear the outfit now. - Telling herself “I still look good; this outfit suits me better with some curves anyway” and buying the correct size. - Thinking “it’s ok that I’m upset, but I’m going to buy the right size because I want to be able to wear it”.

{Which reaction is an example of body image flexibility?}


 * type=""}

- Buying her previous size as motivation to lose weight, even though she wanted to wear the outfit now. - Telling herself “I still look good; this outfit suits me better with some curves anyway” and buying the correct size. + Thinking “it’s ok that I’m upset, but I’m going to buy the right size because I want to be able to wear it”.



ACT can be delivered in many different ways, including group therapy, brief interventions, or as a long-term therapy. It is also becoming increasingly accessible as a self-help tool. This website lists a number of resources that you can use to build your psychological flexibility. To increase your BIF, the Recovery Record app may be particularly helpful. It uses evidence-based cognitive behavioural and acceptance-based strategies, and can be used by anyone who struggles with disordered eating or body image issues.

This chapter will address:
 * What theoretical concepts are BIF based on and related to?
 * What does BIF have to do with eating disorders?
 * How does BIF benefit wellbeing?
 * How is BIF improved by therapy?