Body dissatisfaction and romantic relationship quality: A meta-analysis

Abstract

Research has shown that there is an association between body dissatisfaction (a person’s negative evaluation of their own physical body) and romantic relationship satisfaction. Some have suggested that individuals with higher levels of body dissatisfaction report less satisfaction with their romantic relationships. However, others have suggested that there is a positive relationship between these two variables. This meta-analysis sought to examine the relationship between body dissatisfaction and relationship satisfaction. Possible moderators of this relationship were also examined. Fifty-six studies were meta-analyzed to quantitatively summarize the relationship between body dissatisfaction and relationship satisfaction. Additionally, participant body mass index (BMI), relationship length, gender, sexual orientation, and age were considered as potential moderators of this relationship. Results confirmed previous findings, indicating that body dissatisfaction was negatively associated with relationship satisfaction (r_xy = −0.24). Furthermore, moderation analyses found that this negative relationship between body dissatisfaction and relationship satisfaction was attenuated as BMI increased. This relationship became stronger when the studies had higher female representation. Some sexual orientations also moderated the relationship. No moderating effects of age or relationship length were found.

Keywords

body image body dissatisfaction relationship quality relationship satisfaction meta-analysis

Introduction

Body dissatisfaction can be defined as an individual’s negative evaluation of their own physical body (Stice & Shaw, 2002). Relationship quality is defined as how positively or negatively individuals experience their romantic relationships (Morry et al., 2010). Research has yielded mixed results regarding the association between body dissatisfaction and relationship quality. Some findings suggest a negative association between body dissatisfaction and romantic relationship quality, such that as levels of body dissatisfaction increase, quality of romantic relationships decrease (e.g., Gagnon-Girouard et al., 2014). Others have suggested a positive association between those two constructs (e.g., Markey & Markey, 2006). For example, being in a romantic relationship may increase dissatisfaction with one’s body, such as when individuals receive criticism about their body from their partner (Pole et al., 2004). However, support and trust within a romantic relationship may also protect against body dissatisfaction (Juarez & Pritchard, 2012). Based on these findings, it is clear that body dissatisfaction may differ as a result of being in a relationship, however it is unclear how body dissatisfaction might be affected by relationship quality. The current research therefore sought to meta-analytically examine the association between body dissatisfaction and relationship quality to better understand the nature of this relationship.

Relationship quality

In relationship research, there has been much focus on what constitutes relationship quality. Many seem to agree that relationship quality serves as an umbrella term for overall relational functioning, with variables such as satisfaction used as indicators of one’s feelings towards their relationship (e.g., Farooqi, 2014; Postler, 2019). Relationship satisfaction is seen as a key measure of relationship quality and includes the subjective evaluation that one makes of their relationship and their overall desire to remain in the relationship (Hadden et al., 2014). Relationship satisfaction attempts to discern an answer to the overarching question: “What allows a romantic relationship to be successful and what determines satisfaction?” According to Hendrick and colleagues (1988), these questions are the basis of relationship research and lead researchers to explore possible predictors and outcomes, such as body image.

Relationship quality also includes other relationship factors beyond satisfaction. These include love, trust, support, and commitment (e.g., Fincham & Rogge, 2010; Fletcher et al., 2000; Li & Chan, 2012). Additionally, Hassebrauck and Fehr (2002) suggested four dimensions of romantic relationship quality: intimacy, agreement, independence, and sexuality. Within these four dimensions, intimacy is considered most central to relationship quality. However, satisfaction is the one most often associated with quality. Relationship satisfaction, often used interchangeably with relationship quality, is one’s subjective evaluation of their romantic relationships (Keizer, 2014). Relationship satisfaction serves as the main assessment of relationship quality, and relationship quality is often used to describe the overall feelings one has about their relationship. As such, it is not uncommon for researchers to use relationship quality to name the construct and use relationship satisfaction to measure it.

Objectification theory

Objectification theory, first introduced by Fredrickson and Roberts (1997), provides a framework to understand how body dissatisfaction and relationship quality are connected. This theory posits that individuals are treated and valued as objects and are socialized to internalize others’ evaluations of their own appearance. This process of internalization is known as self-objectification which manifests as body surveillance, and can lead to increased body shame, higher levels of anxiety, lower internal bodily awareness, and reduced flow experiences (in which a person feels joyful and uncontrolled by others; Fredrickson & Roberts, 1997). Self-objectification leads to detrimental consequences, such as poor body image and restricted eating behavior (Martins et al., 2007). Research has shown that there are positive correlations between self-objectification and body dissatisfaction, such that self-objectification is associated with an increase in body dissatisfaction (Martins, et al., 2007; Noll & Fredrickson, 1998).

As one’s dissatisfaction with their body has been shown to be influenced, in part, by objectification, this objectification can also directly influence one’s own relationship satisfaction. Some work has even indicated a negative association between objectification and relationship outcomes such as satisfaction and quality (e.g., Bloom, 2016; Zurbriggen et al., 2011). Particularly, due to the negative association with relationship quality and because objectification is positively correlated with body dissatisfaction (e.g., Grippo & Hill, 2008), it is possible that a negative correlation exists between an individual’s body dissatisfaction and aspects of their romantic relationship.

Research has consistently shown how objectification theory can be applied to romantic relationships, often with negative outcomes. For example, men who have objectifying beliefs towards women have a hard time forming close relationships with them (Brooks, 1995). Also, for men, romantic relationship satisfaction is negatively correlated with objectifying beliefs related to traditional masculinity (Burn & Ward, 2005). Zurbriggen and colleagues (2011) found that when a romantic partner’s objectification was higher, romantic relationship satisfaction was lower. In addition, those who consumed more objectification media experienced lower romantic relationship satisfaction. Both self-objectification and partner-objectification were negatively related to romantic relationship satisfaction (Zurbriggen et al., 2011). Furthermore, Bloom (2016) found a negative relationship between objectification of others and romantic relationship quality among emerging adults. Thus, studies on objectification theory have suggested that there is a negative association between objectification and romantic relationship quality.

Body dissatisfaction and relationship quality

Considering the connection provided via objectification theory, research concerning body dissatisfaction and relationship satisfaction has suggested that there is likely a relationship between these two constructs, yet results are still somewhat inconsistent, especially with regards to directionality. At least one study has suggested that as both men’s and women’s body dissatisfaction decreases, their relationship satisfaction decreases (Côté et al., 2021). Others have found that as body dissatisfaction increases, there is an increase in relationship quality, especially for college-aged women (Howard, 2014). However, others have found that as body dissatisfaction decreases for both men and women, relationship quality increases (Markey & Markey, 2006; Meltzer & McNulty, 2010). Some research also indicates that higher levels of body dissatisfaction is associated with lowered relationship quality (e.g., Friedman et al., 1998; Kidwai, 2013). Body dissatisfaction’s sociocultural influence no doubt influences one’s relationship satisfaction as well as their partner’s relationship satisfaction. Furthermore, research has shown that both women and men are valued for their bodies in relationships, with a seemingly universal importance of attractiveness for partner preferences among both genders (Laus, et al., 2018).

Body dissatisfaction is also related to aspects of romantic relationship quality other than relationship satisfaction. Juarez and Pritchard (2012) found that for both men and women, higher trust or higher support was associated with lower body dissatisfaction. In addition, trust and jealousy were also related to body esteem for women (Ambwani & Strauss, 2007). Lower jealousy was associated with higher body esteem while higher trust was associated with higher body esteem.

It is important to note that as body image has been linked to relationship satisfaction directly, one’s sexual satisfaction in their relationship has also been shown to mediate this association (Meltzer & McNulty, 2010; van den Brink et al., 2017). Specifically, work has shown that for both men and women there is a positive association between their body image and relationship satisfaction, with the couple’s sexual relationship and subsequently their sexual satisfaction mediating this relationship. Further, positive body image has been shown to be associated with greater sexual satisfactions (van den Brink et al., 2017). Taken in consideration with objectification theory, a negative body evaluation and feelings body self-consciousness, especially when a person experiences self-objectification as a sexual object for others, can lead to less pleasurable sexual experiences with a partner, due to the constant and distracting body monitoring (Fredrickson & Roberts, 1997). Subsequently, when one experiences lowered sexual satisfaction it can negatively impact one’s romantic evaluation of the relationship (Yeh et al., 2006).

Clearly, the relationship between body image and romantic relationship satisfaction does not occur in isolation, with one’s sexual relationship an important factor to consider. However, we believe that it is imperative that only the relationship between body dissatisfaction and relationship satisfaction be considered, as there is a need to meta-analytically establish both the strength and direction of such a relationship before considering additional variables such as sexual satisfaction. Doing so will provide a framework for future studies that may wish to expand the current research and consider sexual satisfaction as both an outcome and a mediator.

Potential moderators

It is possible that certain demographic features could moderate the relationship between body dissatisfaction and relationship quality. Of particular interest were the variables body mass index (BMI), relationship length, participants’ gender (i.e., operationalized as the percentage of the sample that was female), sexual orientation, and age. Some research supports the inclusion of these variables; most notably, the percentage of the sample that was female and sexual orientation (Ålgars et al., 2009; Ambwani & Strauss, 2007; Dahlenburg et al., 2020; Siever, 1994), while the inclusion of the others is primarily due to their consistent inclusion across articles.

In general, women tend to be less satisfied with their bodies than men (Ålgars et al., 2009). With regards to gender, Friedman and colleagues (1998) found that higher relationship quality is associated with lower body dissatisfaction for men and women. This finding was further supported by the work of Ambwani and Strauss (2007), which suggested that for both men and women, there was an association between body image and romantic relationships, with additional qualitative evidence suggesting that women in satisfying romantic relationships have better body self-esteem, more so than men. This study suggested that females may have been socialized to believe that their appearance determines their likelihood of receiving certain types of treatment or involvement in certain types of relationships, including romantic relationships. Additionally, Ambwani and Strauss (2007) found that body image was related to low self-esteem in women. Low self-esteem, in turn, is associated with women’s experience in romantic relationships. It seems that, regardless of gender, body image is an important variable when assessing relationship quality and thus, satisfaction.

Others have also suggested that there may be an influence of sexual orientation as well. Laus and colleagues (2018), have suggested the importance of considering body dissatisfaction in the context of sexual orientation. Dahlenburg and colleagues (2020) conducted a meta-analysis and found that although both men and women experienced body image disturbance regardless of their sexual orientation, lesbian women experienced less body image disturbance than heterosexual women. Gay men experienced more body image disturbance than heterosexual men (Dahlenburg et al., 2020). In addition, Frederick and Essayli (2016) also found that gay men experienced lower body dissatisfaction compared to heterosexual men across five studies.

Further, relationship length may also influence the association between body dissatisfaction and relationship quality. To this end, one study found that when the relationship length was longer, women’s perception towards partner’s satisfaction with their bodies was higher (Markey & Markey, 2006). Another study found that longer relationship length was a predictor of body dissatisfaction for both men and women (Laus, et al., 2018). In addition, research suggests that more time spent in a relationship might be associated with greater commitment (Laus et al., 2018) and that this commitment, as an indicator of satisfaction and quality, in turn has been determined to be associated with lower body dissatisfaction. Often, commitment may be seen as a form of acceptance by one’s partner, which could lead to greater satisfaction within the relationship. In addition, there was a non-linear relationship, indicating that body dissatisfaction fluctuated among individuals of different ages (Ålgars et al., 2009).

There is also some work that provides support for the moderating impact of BMI. For example, Ålgars and colleagues (2009) suggested that, for both men and women, when BMI increased, body dissatisfaction also increased. However, there is research suggesting that BMI may not affect body dissatisfaction in romantic relationships. For example, Bowsfield and Cobb (2021) found that although BMI negatively related to body satisfaction for both men and women, it did not change the relationship between body satisfaction and sexual quality. Additionally, a study by Erbil (2013) found that Turkish women whose BMI fell within the “overweight” or “obese” BMI categories had increased rates of body dissatisfaction (as measured by the Body Image Scale) compared to women with lower BMIs. Despite this association between BMI and body dissatisfaction, results from this study revealed that women’s BMI was not correlated with their sexual function (Erbil, 2013). Due to mixed results from existing studies involving BMI, body dissatisfaction, and relationship quality or sexual functioning, it is worth further exploring whether BMI moderates the relationship between body dissatisfaction and relationship satisfaction.

Current study

This meta-analysis aims to primarily examine the association between body dissatisfaction and relationship satisfaction, with a specific focus on the magnitude and directionality of this relationship. A meta-analysis concerning this unique relationship is warranted, as many researchers have considered this association and conclusive evidence is needed to strengthen the claims previously made. Results of this meta-analysis inform future implementation of couples’ and sex therapy. Additionally, the strength of the association between body dissatisfaction and romantic relationships may provide additional justification for interventions targeting reduction of body dissatisfaction. As suggested by the research and theory reviewed above, the following hypothesis was explored:

H1: There is a negative association between body dissatisfaction and relationship quality, such that when body dissatisfaction is lower, relationship quality will be higher.

Beyond this central hypothesis, we also consider the following research question, which pertains to the consideration of moderators of the relationship between body dissatisfaction and relationship quality.

RQ: Do any of the demographic variables provided across studies moderate the association between body dissatisfaction and relationship satisfaction? Specifically, do BMI, age, relationship length, sexual orientation, and gender (as measured by the percentage of the sample that was female) moderate this relationship?

Methods

Inclusion criteria

Multiple a priori criteria were used to determine the inclusion and exclusion status of the studies considered for our meta-analysis. First, the studies included in the meta-analysis must have examined the association between body dissatisfaction and relationship quality (including relationship satisfaction). For the purpose of these analyses, body dissatisfaction was defined as negative self-evaluation of one’s own physical body (Stice & Shaw, 2002). Relationship satisfaction was defined as one’s interpersonal evaluation of their personal feelings toward their partner and the attraction to the relationship (Rusbult & Buunk, 1993). Although concepts such as sexual satisfaction/functioning and relationship commitment are conceptually similar to relationship satisfaction, they were determined to be representative of different constructs. Therefore, studies measuring these constructs without including measures of relationship quality or relationship satisfaction were not included in the present analyses.

Second, the studies included must have used quantitative analyses. Studies assessing qualitative perspectives on body dissatisfaction and relationship quality were therefore not considered for inclusion. We conceptualized effect sizes as correlation coefficients between body dissatisfaction and relationship satisfaction. If the correlation coefficient was positive, then there was a positive association between body dissatisfaction and relationship satisfaction. In other words, individuals who are more dissatisfied with their body would have higher relationship satisfaction. If the correlation coefficient is negative, it would mean that there was a negative association between body dissatisfaction and relationship satisfaction. In other words, individuals who are more dissatisfied with their body would have lower relationship quality. Studies in which no effect size was provided were not included, on the condition that a correlation was not able to be calculated. Most of the included research consisted of cross-sectional, correlational studies. However, experimental and longitudinal research was not automatically excluded, as it is possible that correlations were reported or calculable from the provided information.

Due to multiple factors related to the coding of participant demographics as moderators, studies were not excluded based on participant characteristics. Therefore, no exclusion criteria were set for participant sexual orientation, gender identity, age, or other demographic characteristics. Studies utilizing data from either both or one partner were also included. Studies were not excluded for failing to report all potential moderators. Included studies also did not need to be in English. If a study seemingly addressed the desired constructs, attempts were made to translate it, first using online translation software (e.g., Google Translate). If translation software did not adequately translate the article, speakers of the language were sought out for assistance in translating the article. In the few cases that we were unable to translate the article, it was not included in the analyses (e.g., Abolghasemi et al., 2013).

Literature search

Our review of the literature began with the formulation of key search terms. For body dissatisfaction, the terms body dissatisfaction and body satisfaction were considered. For relationship satisfaction the terms used were relationship quality, relationship satisfaction, and quality of relationship. Multiple, related terms were used to maximize search results. Searches consisted of combining one key body satisfaction term and one key relationship satisfaction term, resulting in six possible combinations of search terms. Each of these six combinations were then searched for across six search engines and databases. These included Google Scholar, PsychINFO, Web of Science, Ebsco, PROquest, and Pub Med. All searches were conducted between October to December 2018, with a supplementary search conducted in June and July 2021. The authors also posted messages to call for unpublished data to several academic or professional organizations, including Society for Personality and Social Psychology, and Association for Behavioral and Cognitive Therapies, as well as the “Levine TinyLetter” email listserv. The summary of the searches can be found in the PRISMA chart (see Figure 1).

Figure 1.

Prisma style chart.

Coding procedure

Once the results of the literature search were compiled, we began the coding process. Four coders initially used the title and abstracts of studies to determine if the article would be fit for the present meta-analysis. Articles in which the title/abstract clearly appeared to be assessing the desired constructs were included in further coding procedures, whereas articles in which the title/abstract clearly appeared to not be assessing the desired constructs were removed. Articles deemed to be ambiguous or not explicit in their measurement of body dissatisfaction were included in further coding procedures (and removed if later determined to not satisfy inclusion criteria).

Piloting. This coding procedure was piloted on the first 50 studies within the spreadsheet in order to establish and improve inter-rater reliability. Researchers first independently coded 20 studies to pilot the coding process. Where discrepancies were identified, all four researchers discussed their strategy, a consensus was reached, and the coding protocol was revised to provide more structure and uniformity. After this initial discussion, the researchers then independently coded an additional 30 studies. Again, the researchers met to discuss any discrepancies, come to a consensus, and revise the coding protocol as appropriate. After piloting, minor changes were made to the coding procedure. These changes consisted of adding options for studies with mixed or unreported gender, sexual orientation, and relationship status. After piloting the first 50 studies, the remaining studies were divided among the four coders, with each coder being assigned ∼500 articles during the initial coding and ∼100 during the supplemental search. However, the percent agreement for inter-rater reliability was not recorded for each step of the coding procedure. As such, two coders were assigned a percentage (10%) of the final studies that were selected at random to recode as a secondary check for agreement across variables of interest. There was 100% agreement for the sample size, gender, percent female, age, age range, sexual orientation, relationship length, and BMI, and a 67% agreement for study effect sizes (correlations between body dissatisfaction and relationship satisfaction), resulting in an overall agreement of 96%. After removing studies that did not satisfy the inclusion criteria, a final sample of 56 total studies from 43 articles were used in further analyses (see Figure 1).

Coding of study features. After eliminating studies that were not applicable for the present analyses, coding was divided into three aspects: publication (article) characteristics, participant characteristics, and methodological characteristics. Publication characteristics included inputting the full and short citations of the article, publication year, publication status (e.g., published, submitted, dissertation, etc.), and publication language. The included studies consisted of published articles, dissertations, and theses. If the study was not in English, the published language of the study was reported. Of the final 43 articles, most were in English, with two in French.

Participant characteristics included gender, the percentage of the sample that was female, mean age, age range, sample type (i.e., student sample, community sample, other), study format (e.g., in-person, online, mail-in), whether or not the study was conducted with a clinical sample, mean socioeconomic status, relationship status, number of partners, sexual orientation of the relationship, mean relationship length, and mean body mass index (BMI), defined as weight in kilograms divided by the square of the body height.

Methodological characteristics consisted of the sample size, body dissatisfaction, relationship quality/satisfaction, the type of correlation calculated, and type of study (i.e., cross-sectional, longitudinal). The final variable coded was the primary effect size of interest—the correlation between body dissatisfaction and relationship satisfaction itself. In cases where the study did not report a single correlation but rather the intercorrelations of subscales addressing the construct, a composite correlation was calculated using the predictor and criterion correlations, as well the reliabilities of the scales. This method of calculating the composite utilized methods outlined in Schmidt and Hunter (2015). If studies reported the correlation between body satisfaction and relationship satisfaction or quality instead of dissatisfaction, then the inverse correlation was computed and reported. Studies did not need to provide all the described information to be included in analyses; if studies included a correlation and did not report a coded characteristic (e.g., mean BMI), those aspects were treated as missing. See Table 1 for a brief description of study features.

Table 1.

Characteristics of the studies included in the meta-analysis.

Study	N	% Female	Mean age	Relationship length (years)	BMI	BD measure	RS measure	r
Gagnon-Girouard et al. (2014)	103	100	25.11	N/A	23.26	Contour drawing rating scale (CDRS)	Dyadic adjustment scale (DAS)	−0.22
Gagnon-Girouard et al. (2014)	103	0	26.46	N/A	34	Contour drawing rating scale (CDRS)	Dyadic adjustment scale (DAS)	−0.15
Giebel (2011)	437	60.2	23.56	N/A	N/A	Body esteem scale (BES)	Relationship assessment scale (RAS)	−0.216
Goldhaber (2007)	254	100	37	10.09	25.11	Body shape questionnaire (BSQ)	Dyadic adjustment scale (DAS)	−0.25
Juarez and Pritchard (2012)	256	100	N/A	N/A	N/A	Body dissatisfaction subscale of the revised eating disorder inventory (EDI-3)	Triangular theory of love scales, significant others scale, trust scale	−0.17
Juarez and Pritchard (2012)	170	0	N/A	N/A	N/A	Body dissatisfaction subscale of the revised eating disorder inventory (EDI-3)	Triangular theory of love scales, significant others scale, trust scale	−0.17
Kelson (1989)	123	100	24	N/A	N/A	Body Cathexis/Self-Cathexis scale (BC-SC)	Four items on perceived relationship satisfaction (not on a scale)	−0.47
Kidwai (2013)	207	100	23.4	N/A	N/A	Body shape questionnaire (BSQ)	Perceived relationship quality inventory (PRQC)	−0.19
Lee (2011)	139	100	20.69	2.33	23.17	Multidimensional body-self relations questionnaire appearance subscales (MBSRQ-AS)	Dyadic adjustment scale (DAS), perceived relationship quality components inventory (PRQC)	−0.41
Lehmann et al. (2014)	731	52.12	38.6	N/A	N/A	Body image scale (BIS)	Satisfaction with relationship status scale	−0.19
McLean (2015)	138	100	35	N/A	N/A	Objectified body consciousness scale	Relationship rating form	−0.19
Meltzer and McNulty (2010)	53	100	23.9	N/A	25.15	Body esteem scale (BES)	Semantic differential (SMD)	−0.31
Millard (2005)	214	75.7	36.22	0.29	29.04	Contour drawing rating scale (CDRS)	Relationship assessment scale (RAS)	−0.28
Opperman (2011)	88	100	20.8	2.14	25.4	Body image self-consciousness scale (BISC)	Global measures of relationship satisfaction	−0.23
Opperman (2011)	79	0	21.4	2.04	25.1	Body image self-consciousness scale (BISC)	Global measures of relationship satisfaction	−0.02
Pascoal et al. (2015)	65	0	39.97	10.52		Global body dissatisfaction scale (GBD)	Global measure of relationship satisfaction	−0.23
Pascoal et al. (2012)	279	0	36.05	N/A	N/A	Global body dissatisfaction scale (GBD)	Global measure of relationship satisfaction	−0.2
Pascoal et al. (2012)	390	100	36.05	N/A	N/A	Global body dissatisfaction scale (GBD)	Global measure of relationship satisfaction	−0.12
Penhollow (2006)	95	100	68	N/A	N/A	Body esteem scale (BES)	Three items on relationship satisfaction (not on a scale)	−0.01
Penhollow (2006)	127	0	68	N/A	N/A	Body esteem scale (BES)	Three items on relationship satisfaction (not on a scale)	−0.13
Pullmer et al. (2018)	67	100	28.39	N/A	24.93	Body areas satisfaction scale (BASS)	Couples satisfaction index	−0.34
Quinn-Nilas et al. (2016)	88	100	20.8	2.14	25	Body esteem scale for adolescents and adults (BESAA)	Global measure of relationship satisfaction	−0.28
Radoš et al. (2014)	150	100	28.7	6.6	N/A	Body image self-consciousness scale (BISC)	Perceived marriage quality index	−0.21
Ramseyer Winter (2017)	399	100	20.15	3.57	23.66	Body appreciation scale (BAS)	Relational health indices-peer subscale (RHI-P; modified for romantic relationships)	−0.38
Robertson (2009)	91	80.21	N/A	2.32	N/A	Body image satisfaction subscale of the body image and body change questionnaire	Perceived relationship quality scale--relationship satisfaction subscale	−0.29
Sanchez et al. (2008)	155	N/A	N/A	N/A	N/A	Objectified body conscious scale	Eight items on relationship satisfaction created for study	−0.19
Stapleton and Gergis (2015)	169	72.7	23.71	N/A	N/A	Situational inventory of body image dysphoria (SIBID)	Relationship assessment scale (RAS)	−0.26
Tarjan (2005)	107	100	13.88	N/A	20.43	Satisfaction with appearance and satisfaction with weight subscales of the body esteem scale (BES)	Dating relationship questionnaire (DRQ), dating activity questionnaire (DAQ)	−0.49
Ambwani and Strauss (2007)	113	100	20.06	N/A	22.98	Body esteem scale (BES)	Four subscales of romantic love experiences scale (RLES)	−0.27
Ambwani and Strauss (2007)	107	0	20.22	N/A	22.92	Body esteem scale (BES)	Four subscales of romantic love experiences scale (RLES)	−0.31
Ayers (2011)	237	100	21.23	2.32	24.54	Weight concern subscale of body esteem scale (BES)	Relationship assessment scale (RAS)	−0.2
Barnes (2017)	136	0	N/A	N/A	N/A	Modified male body attitudes scale-revised (MBAS-R)	Relationship assessment scale (RAS)	−0.15
Benson (2011)	88	100	20.8	2.14	24.99	Body dissatisfaction subscale of the EDI-2 (evaluative BI), appearance & attribution subscales of the body esteem scale for adolescents & adults (affective BI); body image avoidance questionnaire (behavioral BI), body image self-consciousness scale	Global measure of relationship satisfaction	−0.23
Braithwaite (2003)	200	100	19.8	N/A	N/A	Appearance schemas inventory	Relationship assessment scale (RAS)	−0.26
Breuer (2013)	849	0	23.59	N/A	N/A	Body esteem scale for adolescents and adults; body dissatisfaction subscale of EDI-2; body image self-consciousness scale (BI during sexual activity); drive for muscularity scale; body image avoidance questionnaire	Global measure of relationship satisfaction	−0.1
Carriere and Kluck (2014)	248	100	20.38	N/A	23.59	Shape concerns & weight concerns subscales of the EDE-Q	Relationship assessment scale (RAS)	−0.25
Cummins (2014)	43	100	20	N/A	N/A	Body image satisfaction scale	Relationship satisfaction scale	−0.52
Dolejsova (2018)	49	100	30.2	5.52	N/A	Body shape questionnaire (BSQ)	Dyadic adjustment scale (DAS)	−0.48
Ellis-Ordway (2016)	64	100	N/A	15	30.33	Body shape questionnaire (BSQ)	Couple satisfaction index	0.029
Ellis-Ordway (2016)	64	0	N/A	15	29.34	Body shape questionnaire (BSQ)	Couple satisfaction index	0.266
Evans and Wertheim (1998)	360	100	22.9	N/A	N/A	Body dissatisfaction subscale of eating disorder inventory (EDI)	Three items on relationship satisfaction (not on a scale)	−0.32
Finn et al. (2017)	213	100	N/A		N/A	Body image scale (BIS)	Relationship assessment scale (RAS)	−0.2
Finn et al. (2017)	56	0	N/A		N/A	Body image scale (BIS)	Relationship assessment scale (RAS)	−0.36
Côté et al. (2021)	231	100	30.09	7.18	23.56	Contour drawing rating scale (CDRS)	Dyadic adjustment scale (DAS)	−0.3
Côté et al. (2021)	231	0	32.11	7.18	24.45	Contour drawing rating scale (CDRS)	Dyadic adjustment scale (DAS)	−0.08
Markey et al. (2020)	106	0	23.76	3.2	27.46	Contour drawing rating scale (CDRS)	Marital interaction questionnaire	0.03
Markey et al. (2020)	106	100	23.76	3.2	24.27	Contour drawing rating scale (CDRS)	Marital interaction questionnaire	−0.15
Markey et al. (2020)	144	0	33.72	5.6	26.28	Contour drawing rating scale (CDRS)	Marital interaction questionnaire	−0.1
Markey et al. (2020)	144	100	33.72	5.6	29.38	Contour drawing rating scale (CDRS)	Marital interaction questionnaire	−0.03
Kashubeck-West et al. (2018)	217	100	24.26		N/A	Eating disorder inventory (EDI)	Relationship assessment scale (RAS)	−0.16
Hassani et al. (2020)	116	100	N/A	N/A	N/A	Souto & Garcia’s body satisfaction questionnaire	Quality of marriage index (QMI)	−0.87
Hassani et al. (2020)	49	0	N/A	N/A	N/A	Souto & Garcia’s body satisfaction questionnaire	Quality of marriage index (QMI)	0.22
Sáez et al. (2019)	206	100	19.83	N/A	24.2	Body dissatisfaction subscale from eating pathology symptoms inventory (EPSI)	Quality of marriage index (QMI)	−0.18
Krisher (2020)	198	50	34.68	5.63	25.4	Body assessment scale	Relationship assessment scale (RAS)	−0.22
Sommantico et al. (2021)	255	0	36.1	7.63	N/A	Male body attitudes scale-revised (MBAS-R)	Gay and lesbian relationship satisfaction scale (GLRSS)	−0.73
Cobb et al., (2013–2015)	246	50	26.7	4.19	25.66	Body image questionnaire-self subscale (BIQ-S)	Couples satisfaction Index-16	−0.24

Meta-analytic procedures

We conducted this meta-analysis using the {metafor} package for the R statistical computing environment. We used random-effects models for this meta-analysis. Contrary to fixed-effect models, random-effects models do not assume only one true effect size, and the effect size can vary by studies (Borenstein, 2009). Because studies included in this meta-analysis have different sample sizes, when calculating the average effect size in the meta-analysis, we added inverse variance weights to each study, where the weight assigned to each study is the inverse of that study’s variance. In order to examine variation in effect sizes a homogeneity analysis using the Q-statistic was conducted. Moderators were likewise tested with random effects meta-regression models.

Results

Descriptive statistics

This meta-analysis includes k = 56 effect sizes in total, and a total sample size of n = 10,353. The homogeneity analysis was significant, Q (55) = 1050.08, p < .001, revealing that there was more variability in the effect sizes than would be expected due to sampling error alone. The mean age across all the studies was 28.39. Thirty-two out of 56 studies had 100% female representation in their sample. The mean BMI was 25.49.

Overall model

The overall model suggests that there is a negative correlation between body dissatisfaction and relationship quality, r_xy = −.24, p < .001, 95% CI [-.29, −.19] (see Table 2). Consistent with the findings from most research in this area, these results indicate that when individuals have higher levels of body dissatisfaction, they report lower levels of relationship quality. Conversely, those with lower levels of body dissatisfaction had higher levels of relationship quality. The forest plot shows the estimated results from all the studies included in our meta-analysis (see Figure 2).

Table 2.

Results of meta-analytical model of the association between body dissatisfaction and relationship satisfaction.

K	r	CI 95%		p	Homogeneity analysis
		Lower	Upper		Q	df	p
56	−.24	−.29	−.19	<.001	1050.08	55	<.001

Note. K = total number of studies, r = correlation coefficient, CI = Confidence Interval, Q = weighted Sum of Squared deviations.

Figure 2.

The forest plot for the meta-analysis from all studies.

Publication bias

We examined the impact of publication bias using funnel plot (see Figure 3) and Egger et al.’s (1997) test for funnel plot asymmetry. The test for asymmetry was significant, z = 3.26, p = .001, which suggested that the funnel plot was asymmetric. However, a visual inspection of the funnel plots suggested that this may be due to influential cases (i.e., outliers), rather than missing studies. To address this, we ran sensitivity analyses for outliers, and we found two outliers, which are the female sample of Hassani et al. (2020) and Sommantico et al. (2021). We reran the model without the two outliers and the funnel plot was symmetric (see Figure 4), which suggested that the asymmetry was likely caused by the inclusion of outlying studies rather than the exclusion of studies. We also noted that the Q statistic from a model excluding these two outliers was still significant, Q (53) = 154.19, p < .001. After removing the two outliers, the overall model still suggests that there is a negative correlation between body dissatisfaction and relationship quality, r_xy = −.21, p < .001, 95% CI [-.25, −.18].

Figure 3.

The funnel plot for the meta-analysis from all studies.

Figure 4.

The funnel plot for the meta-analysis from studies with outliers removed.

Exploratory moderator analyses

BMI. BMI was found to moderate the negative relationship between body dissatisfaction and relationship satisfaction. Higher BMI resulted in a more positive relationship between body dissatisfaction and relationship quality, F (1, 26) = 15.70, p < .001, β = .03, 95% CI [.02, .05] (see Table 3 and Figure 5).

Table 3.

Results of meta-analytical model of the association between body dissatisfaction and relationship satisfaction as moderated by demographic and relationship variables (Entered Separately).

Moderators	df	F	p	Beta	CI
BMI	(1, 26)	15.70^***	<.001	.030^***	(.02, .05)
Relationship length	(1, 22)	1.96	.18	.02	(-.007, .038)
Gender	(1, 53)	4.53^*	.04	−.001	(-.002, −.0001)
Sexual orientation	(5, 51)	21.59^***	<.001	Not stated: −.33^***	Not stated: (-.44, −.22)
				Heterosexual: −.16^**	Heterosexual: (-.24, −.07)
				Same-sex relationships: −.07	Same-sex relationships: (-.32, .19)
				Others: −.27^***	Others: (-.37, −.16)
				Mixed: −.27^***	Mixed: (-.37, −.18)
Mean age	(1, 43)	2.69	.11	.004	(-.001, −.008)

Note. Beta = standardized coefficient, CI = Confidence Interval.

Figure 5.

The association between body dissatisfaction and relationship quality as moderated by BMI, relationship length, and gender (measured by percentage of females).

Relationship length. The length of romantic relationships did not moderate the negative relationship between body dissatisfaction and relationship satisfaction, F (1, 22) = 1.96, p = .18, β = .02, CI [-.007, .038] (see Table 3 and Figure 5).

Gender. Studies with higher female representation in their sample (higher percent female) moderated the negative relationship between body dissatisfaction and relationship satisfaction. Studies with higher female representation resulted in a more negative relationship between body dissatisfaction and relationship quality, F(1, 53) = 4.53, p = .04, β = −.001, CI [-.002, −.0001] (see Table 3 and Figure 5).

Sexual Orientation of the Relationships. Sexual orientation variable was coded as a categorical variable (0 = not stated, 1 = heterosexual, 2 = same-sex relationships, 3= other, 4 = mixed). The results of this meta-analysis showed that sexual orientation was a significant moderator (Table 3), not stated: β = −.33, p < .001, 95% CI [-.44, −.22]; heterosexual: β = - .16, p < .001, 95% CI [-.24, −.07]; same-sex relationships: β = −.07, p = .61, 95% CI [-.32, .19]; other: β = −.27, p < .001, 95% CI [-.37, −.16]; mixed: β = −.27, p < .001, 95% CI [-.37, −.18]. This means that the type of romantic relationships did moderate the association between body dissatisfaction and relationship satisfaction. Specifically, all relationships except those stated as same-sex relationships, were significant moderators.

Mean age. Age did not moderate the relationship between body dissatisfaction and relationship satisfaction, F(1, 43) = 2.69, p = .11, β = .004, 95% CI [-.001, −.008] (see Table 3).

BMI, relationship length, and female representation. After considering each moderator individually, an exploratory model with three of the moderators was created to see if entering them simultaneously would affect the association between body dissatisfaction and relationship satisfaction. When entering BMI, relationship length, and female representation simultaneously into the model, the model was significant, F(3, 15) = 11.68, p < .001. When examining the individual moderators, BMI significantly moderated the relationship between body dissatisfaction and relationship satisfaction, β = .03, p = .01, 95% CI [0.01, 0.06]. Female representation also significantly moderated this relationship, β = −.002, p = .006, 95% CI [-0.003, −0.001]. However, relationship length did not moderate the association between body dissatisfaction and relationship satisfaction, β = .01, p = .06, 95% CI [-0.001, −0.03] (see Table 4).

Table 4.

Results of meta-analytical model of the association between body dissatisfaction and relationship satisfaction as moderated by demographic and relationship variables (Entered Simultaneously).

Moderators	df	F	p	Beta	CI
	3, 15	11.68^***	<.001
BMI			.01	.030^*	(0.01, 0.06)
Relationship length			.06	.01	(-0.001, −0.03)
Gender			.006	−.002^**	(-0.003, 0.001)

Note. Beta = standardized coefficient, CI = Confidence Interval.

Discussion

The main goal of this meta-analysis was to quantitatively synthesize research on the association between body dissatisfaction and relationship quality in order to determine the strength and direction of this relationship. The analyses supported our hypothesis that there is a negative relationship between these two constructs, such that as body dissatisfaction decreases, relationship quality increases.

This finding is consistent with most of the previous research on the association between body dissatisfaction and relationship satisfaction. For example, Friedman et al. (1998) found that higher relationship quality is related to lower body dissatisfaction for men and women. The results of this meta-analysis could potentially contribute to the literature on objectification theory. Indeed, research suggested that when someone has a high level of self-objectification, they are also likely to have higher body dissatisfaction (Fredrickson & Roberts, 1997). Additionally, self-objectification and partner-objectification could have a negative impact on romantic relationship satisfaction (Zurbriggen et al., 2011). Although the current meta-analysis did not test objectification directly, it supports the body of evidence regarding the negative relationship between body dissatisfaction and relationship satisfaction, which could contribute to the further development and refinement of objectification theory. Additionally, the current meta-analysis also contributes to the romantic relationship literature and has practical implications that may be informative of the development of interventions to help people improve their relationship quality via modifications to their body dissatisfaction.

Moderators

BMI. BMI was found to be a significant moderator of the relationship between body dissatisfaction and relationship quality. BMI has been previously associated with body dissatisfaction (Jones et al., 2004), implying that higher BMI would be associated with less relationship satisfaction as a result of greater body dissatisfaction. However, results of the present study indicate that as BMI increased, the relationship between body dissatisfaction and relationship quality became more positive. That means, for individuals with high BMI, if they have high body dissatisfaction, their relationship quality will be higher compared to individuals with low BMI. While this finding was unexpected, there are multiple potential reasons for the effect.

First, the effect of BMI on the study variables does not occur in isolation of the other study variables. Relationship length could potentially have impacted how BMI affected participant relationship quality. For example, as relationships persist over time, individuals may gain weight as a result of less importance being placed on appearing physically “attractive” (per society’s current thin standard) to one’s partner. Future analyses should be conducted to better understand the effect of BMI with these other variables taken into consideration.

Second, the nature of the sample may have restricted the range of BMIs in participants. The weighted average BMI of the sample (both male and female) was approximately 25.49. In terms of BMI categories this would place our sample’s average BMI just barely above the threshold for the “overweight” category (BMI ≥25). The mean BMI of the sample was lower than the U.S. average BMI of 26.5 (male and female; Centers for Disease Control and Prevention [CDC], n.d.). Therefore, it may be the case that participants whose BMI falls within the “overweight” or “obese” ranges were underrepresented in the included studies.

Third, it was possible that participants with a higher BMI were less concerned with an externalized self-perception or the societal pressure to achieve a slim figure. This rejection of societal pressure may have been influenced in part by the push in some spaces for body positivity, in which extreme (thin) body ideals are replaced with broader acceptance and celebration of a variety of body shapes and sizes (Cohen et al., 2019). It is noteworthy, however, that there is debate about the true inclusivity of larger or fat bodies within the body positive movement (Cwynar-Horta, 2016). If folks with a higher BMI were less concerned with the overarching society’s standards of body size and shape, they may have a higher willingness to show intimacy in close relationships, which could be associated with higher relationship quality.

Relationship Length. There was no effect of relationship length on the association between body dissatisfaction and relationship quality. This is possibly the result of relationship length only being reported in 24 studies out of the total 56. With less than half of the studies reporting relationship length, the sample size might not have been large enough to see an effect. It is possible that relationship length actually measures another covariate and does not occur in isolation. Future research is warranted in order to understand this unique relationship and to determine if relationship length plays a greater role as a moderator than previously thought.

Gender. The moderating effect of gender (i.e., measured by the percentage of females in the study) on the relationship between body dissatisfaction and relationship quality in study samples was significant. It suggested that there was a stronger negative relationship between body dissatisfaction and relationship quality. This moderating effect was consistent with previous research. Following the ideas presented by Ambwani and Strauss (2007) regarding female socialization, body image, self-esteem, and females’ experiences in romantic relationships, it may be that low relationship quality can decrease female self-esteem which can increase body dissatisfaction. Body dissatisfaction may then result in decreased relationship satisfaction. Notably, self-objectification has been studied more extensively in women than in men (Moradi & Huang, 2008).

Additionally, females have been shown to place greater importance on their appearance than males (Quittkat et al., 2019). Often, many societies objectify women’s body and appearance and equate thinness with beauty for females but do not hold the same standards for attractiveness or engage in as much objectification of males (Brown & Konner, 1987; Fredrickson & Roberts, 1997; Pingitore et al., 1997). Relatedly, men engage in greater partner-objectification, especially when they have female partners, again showing that it is a female’s appearance that others focus on and give value to, with this objectification associated with lowered relationship satisfaction (Sáez et al., 2019; Zurbriggen et al., 2011). When men broadly perceive women as objects, they are more likely to dehumanize their female partner and engage in greater partner-objectification, with women reporting decreased relationship and body dissatisfaction as a result (Sáez et al., 2019). Clearly, women appear to experience a variety of internal and external pressures that men do not that influence feelings concerning their body and their romantic relationships.

Sexual Orientation of the Relationships. The sexual orientation of the relationship did moderate the association between body dissatisfaction and relationship quality. Specifically, when each type of sexual orientation was considered (heterosexual, gay/lesbian, mixed, other, or not stated), all but same-sex relationships were significant moderators. Breaking this down further, when the sexual orientation of the relationship was heterosexual, not stated, mixed, or other, there is a negative association between body dissatisfaction and relationship satisfaction. Past research supports some of these results, as heterosexual women, and both gay men and lesbian women have reported greater body dissatisfaction, all at similar levels (e.g., Beren et al., 1996; Koff et al., 2010; Siever, 1994) and there is little difference in relationship satisfaction across most orientations (e.g., Cusack et al., 2012; Lavner, 2016) suggesting the possibility of a moderating impact of sexual orientation of the relationship across many orientations. However, what was surprising was the non-significant association for same-sex relationships. It is possible that four of the five orientations considered were significant moderators because they were the most commonly coded conditions. Due to the small sample size for same-sex relationships, there may not have been enough power to detect a moderating effect. The non-significant result for the same-sex relationships may be attributed to the fact that gay and lesbian relationships were both included in this category, yet both groups may not experience body dissatisfaction in the same way, leading to inconclusive and non-significant results. As mentioned earlier, gay men experience greater body dissatisfaction compared to their heterosexual counterparts (e.g., Dahlenburg et al., 2020). This could be related to research that has found gay men reporting having a higher concern for their physical appearance and feeling pressure to maintain a particular “ideal” body type (i.e., slim, muscular), similar to the pressure women may face (Frederick & Essayli, 2016; Ruiz de Assin Varela et al., 2022; Sánchez et al., 2009). Conversely, lesbian women may indicate less body dissatisfaction than their heterosexual counterparts, but this difference isn’t always as pronounced, and results are mixed (Alvy, 2013; Hayfield et al., 2017; Moreno-Domínguez et al., 2019; Siever, 1994). This could be due to lesbian women not having the same appearance-related concerns and practices as heterosexual women (i.e., body hair concerns, cosmetic usage; Hayfield et al., 2017), perhaps because they are not as concerned about the “male gaze” (Moreno-Domínguez et al., 2019). However, as noted above, women, regardless of sexual orientation do appear to be at risk for greater body dissatisfaction compared to men (Koff et al., 2010). As such it may be that for women, sexual orientation is not the most influential variable while for men, it is. With this in mind, had the current work considered gay men and lesbian women separately, instead of including them in the same category, we may have discovered another significant moderator. Finally, many studies did not mention the sexual orientation of the relationship. It might be challenging to identify a moderation effect with a lack of pure heterosexual samples and pure same-sex samples.

Mean Age. Participants’ age did not moderate the relationship between body dissatisfaction and relationship quality. It is possible that body dissatisfaction negatively affects relationship quality regardless people’s age. Of note, the mean ages for most of the study samples were between 20-40 years, limiting the range of ages included in the analyses. Thus, it might be hard to identify a moderation effect for the mean age.

Work has also explored how age, and particularly how one ages, influences body image, with mixed results. There is evidence to suggest that body dissatisfaction remains stable over the lifespan, for both men and women (Quittkat et al., 2019; Webster & Tiggemann, 2003). Yet others have noted slight decreases in body dissatisfaction and greater body appreciation as one ages (e.g., Hockey et al., 2021; Tiggemann & McCourt, 2013). As studies containing a variety of age ranges were included in the present meta-analysis, the lack of significant moderation could be attributed to the mixed results from past research as well.

BMI, relationship length, and female representation. When BMI, relationship length, and female representation were entered simultaneously into an exploratory model as moderators, results indicated that, once again, BMI and female representation were significant moderators while relationship length was not. In providing control for other variables, these results show that BMI and female representation (gender) remained influential and significant variables to both body dissatisfaction and relationship satisfaction. These results were expected because they were significant when considered as the only moderator of interest for the current study. Additionally, previous research had already indicated that both BMI and gender should show strong moderating effects (e.g., Ålgars et al., 2009; Ambwani & Strauss, 2007; Zurbriggen et al., 2011). The lack of significance for relationship length in this model, was somewhat expected, despite literature to suggest otherwise (e.g., Laus et al., 2018) because it was not significant when considered on its own for this meta-analysis. Even when controlling for two strong mediators, relationship length did not moderate the relationship. This is possibly because not all studies reported relationship length, leading to a smaller sample of viable data as well as more missing data. Had all studies included in the meta-analysis reported relationship length, it is possible that relationship length would in fact moderate the association.

Limitations and future directions

Although the literature search did produce a fair number of studies which qualified for inclusion, it is likely that we were unable to include all studies relating to the association between body dissatisfaction and relationship satisfaction. We attribute this to accessibility issues and publication bias. When conducting the literature search, we only had access to published work, along with dissertations and theses that were available via the databases provided by the university or organizations in which researchers were members. Our search also lacked conference papers, presentations and posters related to the topic as they could not be easily accessed. Some studies were also written in non-English languages and, despite attempts to translate these studies, some had to be excluded due to this language barrier. There was also the issue of low response rate when we posted messages to call for unpublished data to several academic and professional organizations. Additionally, we also showed that there were publication bias concerns via Egger et al.’s (1997) test for funnel plot asymmetry, as journals may be less inclined to publish non-significant findings. In order to remedy many of the limitations cited above, future research should attempt to complete a more exhaustive literature search that will specifically look for unpublished data and pursue further accessibility to published data.

Future work in this area should also consider body satisfaction or positive body image rather than body dissatisfaction, as these are separate constructs (Wood-Barcalow et al., 2010) and when completing the literature search and coding process, results yielded a fair number of studies concerning body satisfaction. Also, it would be wise to consider sexual satisfaction instead of relationship satisfaction. Our literature result yielded many studies that focused on sexual satisfaction as an outcome which seems to imply that there is sufficient information and data for an additional meta-analysis. As with considering sexual satisfaction instead of relationship satisfaction, it is also prudent to consider other forms of interpersonal relationships, such as peer or family relationships. Our literature search found many studies that considered relationships besides romantic relationships as part of the body dissatisfaction/relationship satisfaction association. Finally, this meta-analysis only included studies that used correlational data and there are other methodological approaches used in related studies that could be included in future research (e.g., longitudinal association; APIM models).

Conclusion

This meta-analysis attempted to discern the relationship between body dissatisfaction and relationship satisfaction. A negative relationship was found between these two variables and BMI and sexual orientation were found to moderate this association. These results provide support for the idea that one’s perception of their body is directly related to their perception of their romantic relationship. As work continues to explore the intersectionality of body image and romantic relationships, it is crucial to review and summarize the current research to provide a clear framework from which to explore new associations and effects. One such consideration is expanding the current meta-analytic research to consider sexual satisfaction in lieu of or alongside relationship satisfaction, as work already suggests its important role (e.g., Meltzer & McNulty, 2010; van den Brink et al., 2017). Overall, this meta-analysis provides a comprehensive quantitative summary of the association between body dissatisfaction and relationship satisfaction.

Footnotes

Acknowledgements

We would like to express our special thanks to Megan Galinsky for helping us on literature search and the coding process.

Author notes

Lijing Ma is now at the University of San Francisco. Hannah F. Fitterman-Harris is now at the University of Louisville. Eyad J. Naseralla is now at Buffalo State College.

Declaration of conflicting interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

Open research statement

As part of IARR's encouragement of open research practices, the authors have provided the following information: This research was not pre-registered. The data used in the research are not available. The materials used in the research are not available.

ORCID iDs

Dana L Stiles

Lijing Ma

Eyad J Naseralla

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