A systematic review and meta-analysis on the relationship between body dissatisfaction and morbid exercise behaviour

Background: The present study aimed to quantify the relationship between body dissatisfaction and morbid exercise behaviour (MEB). Methods: The electronic databases MEDLINE, PsycINFO, Web of Science, SciELO, and Dissertations & Theses Global were searched from incep-tion to September 2020. Pooled effect sizes corrected for sampling errors (r⁺) were computed using a bare-bones meta-analysis. The robustness of the results was examined by influence analyses. The presence of moderators was examined by inspection of the variance in r⁺ attributable to sampling errors and 80% credibility intervals, followed by subgroup analysis and univariable/multivariable meta-regressions. Publication bias was examined by visual inspection of funnel plot symmetry, cu-mulative meta-analysis, and Egger’s test. Results: A total of 41 effect sizes from 33 studies (n = 8747) were retrieved. Results showed a significant and near to moderate effect size (r⁺ = 0.267, 95% CI = 0.226 to 0.307), and this did not differ by gender, BMI, age, percentage of Whites, study quality, or MEB measure. Conversely, effect sizes were found to be stronger in published and more recently conducted studies. Conclusion: The findings indicate that body dissatisfaction is one of the likely causes underlying MEB. This suggests the need for further longitudinal research aimed at confirm-ing the potential causal nature of this relationship.