A comparative evaluation of cognitive-behavioral therapy (CBT) versus exercise therapy (ET) for the treatment of body image disturbance. Preliminary findings.
Six weeks of either CBT or coached exercise equally reduced body-image distress in college women.
01Research in Context
What this study did
Researchers compared two six-week programs for college women upset with their bodies. One group got standard cognitive-behavioral therapy. The other group lifted weights, ran, and biked three times a week.
A third group waited with no treatment. Staff measured body-image distress before and after.
What they found
Both CBT and exercise cut body-image distress the same amount. Each beat the no-treatment group.
The study ended at six weeks, so we do not know if the gains lasted.
How this fits with other research
Kaufman et al. (2010) looks like a contradiction at first. They pitted ACT against standard cognitive therapy for eating issues and saw ACT win big. The key difference: they measured eating pathology, not just body image, and used a newer third-wave protocol.
Plant et al. (2007) extends the story. They ran a true RCT comparing ACT to CBT for anxiety and depression and found equal, large gains. Together these studies show CBT and third-wave cousins often tie, but the outcome domain and client traits tip the scale.
Fradet et al. (2025) pushes the idea further. They added aerobic exercise to online cognitive training for early schizophrenia and got better psychotic-symptom control than training alone. Movement can boost cognitive interventions across diagnoses.
Why it matters
If a client hates the gym, CBT alone still works. If a client already exercises, formalize it: three structured sessions a week can match six weeks of CBT for body-image distress. Track mood and body talk each session to be sure the benefit holds.
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02At a glance
03Original abstract
Cognitive-behavioral therapy (CBT) was compared to a combination of aerobic/anaerobic exercise therapy (ET) for the treatment of elevated levels of body image disturbance in college females. CBT consisted of a modification of the 1987 Butters and Cash procedure that was tailored for group intervention; ET consisted of weightlifting and aerobic dancing. Using a counterbalancing procedure, the same therapists conducted both 6-week interventions, which were compared to a nontreated control group. Results revealed equivalent reductions for both treatment groups when compared to controls on measures of body image disturbance reflective of trait and state body weight anxiety, cognitive-behavioral aspects of appearance, and overall body dissatisfaction. Unfortunately, few subjects were available for follow-up analyses, preventing an evaluation of the stability of changes. The findings are discussed with regard to the potential role of fitness training as an adjunct to cognitive-behavioral interventions for body image disturbance.
Behavior modification, 1994 · doi:10.1177/01454455940182002