The Outfit Choice Task as a novel method for measuring body dissatisfaction in women with eating disorders and healthy controls

Background: Body dissatisfaction is a key feature of eating disorders. It is measured using questionnaires asking about satisfaction with body parts, or how feelings about weight and shape influence behaviour. Qualitative research finds that women most frequently use clothing to manage their appearance. Methods: We designed an Outfit Choice Task to assess clothing choice. We compared it with existing measures of body dissatisfaction in: Study 1, (online study of 244 women); Study 2 (face-to-face study of 93 women); and Study 3 (case-control study of 30 women with, and 30 without, a diagnosed eating disorder). Results: The Outfit Choice Task factor analysed into five factors comprising different types of outfit. Scores were strongly associated with existing measures of body dissatisfaction, after adjusting for Body Mass Index and age. Mean scores were lower (greater dissatisfaction) in those with an eating disorder (4.22 (95% 3.91, 4.52)) than controls (5.35 (95% CI 5.05, 5.64)). Discussion: The Outfit Choice Task provides a novel way of measuring body dissatisfaction. Since women are most likely to use clothing to manage concerns with their appearance, this scale is likely to be very relevant to women, and has potential use for measuring change in body dissatisfaction.