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Functionality appreciation was linked to having a positive body image among adolescents with eating disorders.

Adolescents with higher functionality appreciation also had lower eating disorder symptoms.

Adolescents’ self-esteem was not related to their functionality appreciation.

The following is a written by Spoorti Ramesh, a Bachelor of Psychology student under the supervision of Dr. Jessica M. Alleva.

Adolescence is a stage when identity and self-image are developing, and for many adolescents, this involves increased concern about one’s body weight, shape, and appearance. In turn, body concerns can make young people more vulnerable to eating disorders such as anorexia nervosa and bulimia nervosa. In fact, body concerns are a key risk factor for the development of eating disorders. Hence, a wealth of research has aimed to identify ways to address body concerns.

Previously, studies in this field have focused on reducing negative thoughts about one’s appearance as a way to improve body image in individuals with eating disorders. However, more recent research, primarily done with adults, suggests that shifting attention toward positive aspects of what the body can do may also play an important role. This raises a broader question: What if improving body image is not only about reducing negativity but also about actively building a more positive and appreciative view of the body?

Beyond Appearance: Functionality Appreciation

This is where functionality appreciation, a key aspect of positive body image, comes in. Functionality appreciation refers to focusing on and valuing the body for what it can do, rather than for how it looks. Think about the many ways your body allows you to experience the world, such as laughing with your friends, hugging someone you love, and feeling the warmth of the sun on your skin. These abilities are often taken for granted, although they play an important role in life. Functionality appreciation involves recognizing and valuing these abilities.

Previous research with adults has shown that people who appreciate their body functionality show a healthier relationship with their body overall. They often report feeling more accepting and respectful toward their bodies, which, in turn, may prevent harmful behaviours like disordered eating. However, this has not been investigated in adolescents, especially those who suffer from eating disorders.

Therefore, my colleagues and I aimed to better understand how functionality appreciation relates to other aspects of body image and eating disorder symptoms among adolescents with eating disorders. Specifically, we studied a group of 58 adolescent girls receiving treatment for eating disorders at a specialized clinic in the Netherlands. (Note: This study was conducted alongside a wider research project, described here.) The participants completed several questionnaires measuring:

functionality appreciation: how much they appreciate what their body can do

body appreciation: how much they appreciate and respect their bodies overall

eating disorder symptom severity: how severe their disordered eating behaviours and thoughts are, such as restrictive eating, binge eating, or concerns about weight and shape

We were interested to find out if adolescents with higher functionality appreciation also tended to report more positive feelings toward their body and themselves, as well as lower severity of eating disorder symptoms.

The results from this study revealed an interesting pattern. Adolescents who reported greater appreciation of what their body can do were also more accepting and respectful toward their bodies overall. They also tended to report less severe eating disorder symptoms, including fewer concerns about weight and shape, as well as less restrictive or disordered eating behaviours. In other words, young people who recognized and valued their body’s abilities tended to have healthier relationships with their bodies.

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However, not all findings were as expected. Namely, no relationship was observed between functionality appreciation and self-esteem. That is, while functionality appreciation was related to higher positive body image overall, and to lower eating disorder symptoms, it was unrelated to how participants felt about the “self” more broadly.

The present findings are largely in line with the prior research conducted among adults, showing a positive relationship between functionality appreciation and positive body image more broadly and lower eating disorder symptoms. However, prior research among adults has shown a relationship between functionality appreciation and higher self-esteem, which we did not find in this study among adolescents with an eating disorder. As this is the first study conducted among adolescents with an eating disorder, future research will be needed to further explore and explain the relationship between functionality appreciation and self-esteem.

Collectively, the present study is valuable because it is the first to have investigated functionality appreciation among adolescents with an eating disorder. For many adolescents who are struggling with eating disorders, the body becomes an aesthetic object to harshly evaluate and criticize, resulting in unhealthy habits aimed at achieving and maintaining a “perfect” body. Further, their attention becomes narrowly focused on appearance: weight, shape, or how the body compares to unrealistic cultural beauty standards.

Functionality appreciation could potentially help shift this attention to a more holistic perspective of all the ways our bodies support us in daily life. This shift does not mean ignoring concerns about appearance altogether. Instead, it means expanding how we perceive our own body, reminding us that the body is not merely something to be judged but is instrumental in allowing us to have meaningful experiences.

In recent years, psychologists and researchers in the body image field have been developing therapeutic approaches that incorporate this perspective. One such example encourages people to reflect on the many ways their bodies support them throughout the day and to write about activities their bodies allow them to enjoy. A growing body of research, particularly among adults, shows that focusing on body functionality can foster a healthier, more respectful relationship with the body.

At the same time, there is still much to learn about how this approach can best support adolescents with eating disorders. Future research will need to explore whether strengthening functionality appreciation can contribute to recovery over time and how it can be effectively integrated into existing treatments for young people of different genders, as body image concerns can take different forms across individuals.

Despite these open questions, the results from this study suggest that appreciating the body’s functionality is linked to a more positive relationship with the body among adolescents with eating disorders. Notably, related work from this project (linked above) has provided the first evidence that actively encouraging adolescents with eating disorders to focus on what their body can do improves aspects of positive body image, making it a promising approach in treatment.

Ramesh, S., Glashouwer, K. A., & Alleva, J. M. (2026). Functionality appreciation among adolescents and emerging adults with eating disorders: Associations with body appreciation, self-esteem, and eating disorder symptoms. Body Image, 56, 102056.

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