Body image intervention to improve health outcomes in lupus: a pilot study

J Clin Rheumatol. 2014 Dec;20(8):403-10. doi: 10.1097/RHU.0000000000000141.


Purpose: Systemic lupus erythematosus (SLE) can be disfiguring, disabling, and debilitating. In this proof-of-concept study, our goal was to determine the feasibility and effectiveness of a novel body image (BI) intervention in improving (1) BI and (2) health outcomes among women with cutaneous SLE.

Methods: A tailored weekly intervention for 10 weeks consisting of education, cognitive behavioral therapy, and cosmetic training was offered, along with usual fscare, to 10 SLE patients with inactive to mildly active disease and cutaneous involvement. For comparison, we followed up 5 patients with inactive to mildly active SLE and cutaneous involvement, receiving only usual care. Data on outcomes were obtained at baseline, immediately postintervention, and 18 and 24 weeks postintervention using the following tools: Body Image in Lupus Scale (BI), Multidimensional Body Self-Relations Questionnaire-Appearance Scale, State Trait Anxiety Index and Center for Epidemiological Studies Depression (psychological health), and LupusPRO (lupus health outcomes). Paired t tests (2-tailed) were done for between-groups comparisons. P ≤ 0.05 was considered significant.

Results: The mean ages of the intervention and control groups were 44.4 (SD, 8.7) and 43.2 (SD, 12.2) years, respectively. Scores on measures of BI, psychological well-being, and quality of life improved over time only in the intervention group; the benefits were retained over time. The observed effect size of the improvements in BI was large.

Conclusions: Body image is modifiable in SLE. The results suggest that our intervention is feasible for SLE populations and that the SLE patients who participated improved on several measures of BI and overall well-being.

Publication types

  • Comparative Study

MeSH terms

  • Adaptation, Psychological
  • Body Image*
  • Case-Control Studies
  • Chi-Square Distribution
  • Cognitive Behavioral Therapy / methods
  • Combined Modality Therapy
  • Cosmetic Techniques
  • Female
  • Follow-Up Studies
  • Health Status
  • Humans
  • Linear Models
  • Lupus Erythematosus, Cutaneous / diagnosis
  • Lupus Erythematosus, Cutaneous / psychology
  • Lupus Erythematosus, Cutaneous / therapy*
  • Lupus Erythematosus, Systemic / diagnosis
  • Lupus Erythematosus, Systemic / psychology
  • Lupus Erythematosus, Systemic / therapy*
  • Patient Education as Topic / methods*
  • Pilot Projects
  • Quality of Life*
  • Reference Values
  • Risk Assessment
  • Severity of Illness Index
  • Surveys and Questionnaires
  • Treatment Outcome