body image research paper outline

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The Meaning and Factors That Influence the Concept of Body Image: Systematic Review and Meta-Ethnography from the Perspectives of Adolescents

Glòria tort-nasarre, mercè pollina pocallet, eva artigues-barberà.

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Correspondence: [email protected]

These authors contributed equally to this work.

Received 2020 Dec 22; Accepted 2021 Jan 24; Issue date 2021 Feb.

Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/ ).

Community care nurses educate adolescents about body image, but their interventions appear to be ineffective. Body dissatisfaction predicts unhealthy behaviors among adolescents. This study aimed to understand the meanings and factors that influence the concept of body image through a systematic review and meta-ethnography of qualitative studies from the perspective of adolescents. Ten studies published from 2009–2019 were identified by a search of relevant systematic databases between September and December 2019. The review followed the seven steps of meta-ethnography developed by Noblit and Hare, including a line-of-argument. The synthesis revealed six themes: self-perception of body image; opinions of friends and colleagues; opinions of family; specific features of the school environment; expectations perceived across the mass-media; and strategies, practices, and self-management of body image. An explanatory model was developed that showed adolescents’ development of body image and the path towards its establishment. In conclusion, these results should be considered to implement strategies to promote a healthy body image in adolescents by community health and mental health nurses.

Keywords: adolescents, body image, dissatisfaction, distortion, self-esteem, self-image, systematic review, meta-ethnography

1. Introduction

Body image (BI) is the internal representation of one′s external appearance [ 1 ] and encompasses self-perceptions related to the body and personal attitudes, including thoughts, beliefs, feelings, and behaviors [ 2 ]. It is a multidimensional representation [ 3 ] made up of four components: global subjective satisfaction (evaluation of the body); affection (feelings associated with the body); cognitions (investment in appearance and beliefs about the body); and behaviors (avoidance of situations of body exposure) [ 1 ]. Therefore, BI is a complex phenomenon that includes many components related to gender, ethnic and sociocultural factors [ 2 , 4 ]. Effective measures regarding BI must address individual feelings, including satisfaction/dissatisfaction; physical self-awareness; beliefs; ideas; and behaviors regarding appearance [ 4 ].

Body dissatisfaction is defined as negative thoughts and feelings of a person about his/her body. It is related to negative evaluations of body size, shape, and weight; this generally implies a perceived discrepancy between the evaluation of one’s body and the ideal body [ 1 , 5 ]. The prevalence of body dissatisfaction in adolescents is varied in different western countries; according to the results of the cross-sectional HBSC (Health Behavior in School-aged Children) 2013–2014 study of European and American adolescents, at the age of 15, 40% of girls and 22% of boys are dissatisfied with their body weight [ 6 ].

Dissatisfaction with BI during the early stages of adolescence has been related to poorer self-esteem and anticipates different issues: depressive symptoms; higher body mass index; less physical activity; clinical eating disorders, poorer dietary quality, and disordered eating (i.e., fashionable dietary behaviors and the use of food for emotional regulation); and behaviors aimed at losing weight (i.e., diets, food restrictions, and modification of eating habits) that, at the same time, could lead to distortion of one’s own BI [ 7 , 8 ]. Thus, some authors associate certain internal factors of BI with: body dissatisfaction; concepts of the body [ 9 ], perceptions of beauty and ideals of appearance transmitted by society and media [ 10 , 11 ]; attitude towards the self and towards others [ 9 ]; and gender differences and perspectives [ 12 ]. Likewise, other authors identify the media together with family and friends as external factors that influence BI [ 7 , 9 , 12 ]. Education, tutors and material status may also be factors associated with determining BI assessment [ 13 , 14 , 15 , 16 , 17 ]

Independent BI interventions have been multiple and heterogeneous [ 18 , 19 ]. Several studies show that small effects in improving BI are achieved by using techniques such as: discussing the role of cognition in BI; restructuring cognition; changing negative body language; teaching monitoring; using guided imagery, exposure exercises, and size estimation exercises; and training in stress management and in prevention of relapse, e.g., using behavior change techniques [ 19 ]. Finally, to be effective, health promotion strategies must be focused on BI based on the voice of adolescents, their experiences, and their social and cultural framework. From here, we considered it important to conduct a review of qualitative studies on the meaning of BI in adolescents from western countries. The results of our research must guide strategies for promoting positive BI, and preventing dissatisfaction about BI, in the community setting. We addressed several questions: What are the central themes addressed by qualitative studies on the meaning of BI in adolescents from western countries? What factors influencing BI are explored? Where does qualitative research on BI and dissatisfaction during adolescence bring us?

The objective of this study was to analyze the meaning of, and factors influencing, the body image construct, from the perspectives of adolescents in western countries, through an interpretative systematic review of qualitative studies.

3.1. Design

We performed a systematic review and an interpretative synthesis, following the meta-ethnography model proposed by Noblit and Hare [ 20 ].

3.2. Search Strategy

We carried out our research between September and December 2019. We previously determined the inclusion and exclusion criteria ( Table 1 ).

Eligibility criteria.

The inclusion criteria for the sample selection required that the original studies described the meaning, attribution, and experiences of BI in healthy adolescents. Moreover, data from these primary studies had to be obtained from the perspective of adolescents. The original reports must have used a qualitative approach in relation to data collection and data analysis. Studies using mixed methods were eligible for inclusion if it was possible to extract the results derived from qualitative research.

We preliminarily identified studies through searching relevant electronic databases, by using Medical Subject Headings (MeSH) terms and text words.

Table 2 describes the final search strategy, which was adapted to the selected databases according to the specific language used in each one.

Database search strategy.

We searched the Web of Science, PubMed, PsycINFO, CINAHL, Scopus, and the Cochrane Register. We set the publication date for the search from 2009 to 2019 and considered only peer-reviewed studies published in English. Finally, we complemented the process by searching for key authors. Using the last strategy we found several studies, but they were not incorporated as they did not meet the inclusion criteria and were not exactly focused on the subject of the review.

3.3. Selection and Summary of the Studies

The main investigator (GTN) performed the systematic literature search and was responsible for reviewing the n = 147 potential studies according to title, abstract and full text. Studies were excluded when they did not meet the inclusion criteria, did not focus sufficiently on the topic, were from specific ethnic groups, or data had not been collected from an adolescent perspective. Disagreements were resolved by discussion and by reference to the full article by another investigator (EAB). Finally, the research team (GTN, MPP, EAB) agreed on the studies ( n = 10) that should be included in the synthesis. The flowchart is displayed in Figure 1 .

PRISMA Flow-Diagram of Screening Process for Review.

3.4. Quality Assessment

The ten included papers were assessed for quality by the review team independently using the Critical Appraisal Skills Programme (CASP) tool [ 21 ]. None were excluded according to quality criteria.

This research did not require approval, since all the studies included in the review had already been approved by their respective ethics committee.

3.5. Synthesis

The ten studies were synthesized using Nobit and Hare′s [ 20 ] seven-stage method. In the first phase, we identified the topic of interest provided by the qualitative studies. The second phase involved selecting the studies to include in the synthesis. This phase generated a repeated process of reading the studies to identify a list of metaphors in each of them and the affiliation of disparate and common themes. We drew a map of the units of meaning, codes, and themes of the phenomenon under study. We used the ATLAS-TI vs.7 software (Development GmbH. Berlin. Germany) for this phase. The topics in each article were initially identified by the principal investigator (GTN), and later discussed and analyzed by the entire research team (GTN, MPP, EAB). Disagreements were resolved by rereading from top to bottom all selected articles. Once we identified the main concepts in each article, we made a search for the presence of these concepts in the rest of the documents. During this process, we ensured that each key concept took on similar meanings in all documents. Moreover, we identified those that were unique or specific to one or more studies.

We started the synthesis with the first published article [ 22 ], then worked through the studies in chronological order of publication. We performed the comparison process by identifying the themes in the first study, and then adding others as they emerged ( Table 3 ).

Quotations from participants and authors to illustrate each theme.

Subsequently, we developed a “line of argument” [ 20 ]. In this phase, it was possible to reorganize the results generating a new interpretation of the phenomenon explained by the data. In this way, we achieved a synthesis that was not only the sum of the individual parts of each article, but also provided a meticulous interpretation, and preserved the integrity of each study. This phase was carried out by GTN and then discussed by the full group of researchers. Finally, we obtained an explanatory model of the construct, the meaning, and the factors that contribute to developing BI in adolescence in a western context.

4.1. Characteristics of Included Studies

We summarize the main characteristics of the 10 articles included in the synthesis in Table 4 .

Characteristics of included studies in the review.

All the manuscripts are from scientific journals and published in the English language. The studies were carried out in six countries: three in Ireland [ 22 , 26 , 28 ], two in Sweden [ 24 , 31 ], two in the USA [ 9 , 30 ], one in India [ 23 ], one in Norway [ 27 ], and another in the UK [ 29 ]. Eight of these studies use qualitative designs [ 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 ], and the other two use mixed methods [ 9 , 30 ]. Likewise, all perform thematic content analysis. As data collection method, five studies apply focus groups [ 22 , 26 , 27 , 28 , 29 ], three use semi-structured interviews [ 23 , 24 , 25 ] and two employ focus group and individual survey [ 9 , 30 ].

4.2. Description of Themes

We extracted six themes that influence the process of developing BI, according to the opinion of adolescents: (1) self-perception of BI; (2) opinions of friends and colleagues; (3) opinions of family and parents; (4) specific features of the school environment that influence BI; (5) perceived expectations of BI across the mass-media; and (6) strategies, practices, and self-management for BI. These themes are closely related to each other. Figure 2 illustrates the line-of-argument synthesis that demonstrates the key processes in understanding adolescents′ meaning of BI.

Line-of-argument: explanatory model.

4.2.1. Self-Perception of BI

Six of the studies provide self-perception data that influence the desire for an ideal BI [ 9 , 22 , 23 , 26 , 27 , 31 ]. Adolescents explain how self-esteem, self-confidence, insecurity, acceptance, self-protection, and anxiety are part of their internal dialogue and beliefs about their BI. Some young people express concern about physical appearance, such as being too fat, gaining weight, aspiring to be prettier, putting on makeup to cover acne [ 22 , 23 ]. Therefore, they express a desire for a different BI. They show negative emotions, such as anger, sadness, guilt or frustration [ 9 , 22 , 23 ]. Some are aware that they must stop focusing on their body to have a healthier self-esteem. Self-confidence is crucial [ 24 , 26 ], as well as appreciating themselves as they are [ 22 ]. Satisfaction with BI is related to acceptance [ 24 , 27 ]. In two articles [ 9 , 25 ], adolescents gave more importance to interior happiness, intelligence, and kindness, than to physical appearance.

4.2.2. Relevance of the Opinions of Friends and Colleagues on BI

Eight studies examine the influence of peers on the ideal of BI [ 9 , 22 , 23 , 24 , 26 , 27 , 28 , 29 ]. Participants express thoughts and emotions about the pressure of being accepted; the fear of being rejected, excluded, or judged; and the feeling of being watched, compared, or criticized for their physical appearance [ 9 , 22 , 27 , 28 , 29 ]. Others claim that they do not compare themselves to friends and aspire to the ideal of BI that they define [ 23 , 24 ]. Body weight is a point of constant vigilance and criticism, jokes, teasing, and exclusion among peers. Such situations can last over time and affect mental health by producing low self-esteem, eating disorders, self-harm, and even suicide [ 22 , 28 ]. The motivation to be accepted drives adolescents to follow fashion trends, and change their appearance by dieting, fasting, and practicing physical exercise [ 26 ]. Consequently, adolescents copy standard models and talk about losing weight, dieting, wearing clothes that make them more attractive, and practicing sports.

4.2.3. Relevance of the Opinions of Family and Parents on BI

Six studies provide data related to the influence of parents on BI in terms of dissatisfaction and satisfaction [ 9 , 23 , 24 , 26 , 29 , 30 ]. Several adolescents comment on the importance of pressure derived from the family, specifying that it influences then via the way they dictate diet and how they model eating habits and self-confidence [ 29 ]. It was sometimes shown that mothers persuade their daughters to copy the styles and fashion imposed by celebrities [ 26 ]. Adolescents think that their parents are concerned about their health: they encourage them to a healthy, non-sedentary lifestyle and healthy eating [ 23 ]. Other studies show that parents express opinions about clothes and haircuts, and judge them according to their own ideals [ 24 ]. Other parents pressure their children to lose weight and conform to standard models [ 9 ]. Among the actions undertaken by adolescents because of the messages received by parents, we identify factors that facilitate and predispose the appearance of unhealthy behaviors or reinforce pre-existing ones.

4.2.4. Relevance of Specific Features of the School Environment That Influence the BI

Only two of the selected articles provide results on how the school and teachers influence adolescents′ beliefs about BI [ 29 , 30 ]. In Brunette et al. [ 30 ] some adolescents express how the school environment encourages them to learn strategies that help to mitigate the harmful aspects of negative comparison between equals, including those received through the mass media. They also mention the benefit of voluntarily participating in a school group dealing with BI. In the study of Sharpe et al. [ 29 ] some participants point to teachers as a valuable source of support and give some recommendations.

4.2.5. Perceived Expectations on BI across the Mass Media

Seven studies provide data on the relationship between mass-media and the perception of satisfaction or dissatisfaction with BI [ 9 , 22 , 23 , 25 , 26 , 27 , 30 ]. Some participants comment that they are influenced by the image of certain international actresses or celebrities [ 22 , 26 , 27 ]. Some adolescents, especially girls, copy and imitate fashion, clothing, and hairstyles of celebrities to feel more comfortable with their individual appearance [ 23 , 26 ]. There are also mixed opinions on the role of the media in developing dissatisfaction with the weight of adolescent women [ 23 ]. Some girls convey that they are aware that companies use appearance and BI for commercial purposes [ 25 ].On an emotional level, the images spread by the mass media make them feel frustrated if they do not achieve the ideals [ 9 ]. Other teens instead feel uncomfortable with the messages and decided not to look at them [ 25 ]. Some participants comment that selfies are an important part of their life. They add that they need to receive likes to feel comfortable with their BI and increase their level of self-esteem [ 30 ].

4.2.6. Strategies, Practices, and Self-Management for the Ideal BI: Diet and Physical Exercise

Seven of the studies refer to the use of diet and exercise as self-management practices related to physical appearance [ 22 , 23 , 24 , 26 , 27 , 28 , 29 ]. Diet and exercise are used as strategies for weight loss [ 24 , 26 ], sometimes including fad diets [ 22 ]. However, some people are not conscious of such diets [ 23 ] and inadvertently engage themselves in unhealthy behaviors [ 26 ]. The goal is to become equals [ 28 , 29 ], mostly through diet for females and bodybuilding for males [ 26 , 27 , 28 ]. Therefore, they pretend to look like celebrities [ 26 ] and attract male attention [ 22 , 29 ].

Positive peer influences are manifested by congratulations, sources of encouragement, and opinions to motivate dieting, physical activity, and exercise and to counteract useless pressures [ 28 , 29 ]. In the same way, support and motivation by mothers represent positive influences [ 23 ]. Sports stars and dancers influence healthy behaviors [ 26 , 27 ]. However, some adolescents already conceive physical fitness and caring for the body as a part of health care, turning exercise into a natural and important part of life, generating joy, fun, and friendship [ 24 ]. One of the studies [ 29 ] propose different prevention strategies with early interventions on body dissatisfaction and diet. The effectiveness of the last strategy is shown in the study by Brunette et al. [ 30 ], along with self-acceptance and acceptance of differences, trust, and diversity.

4.3. Explanatory Model

The explanatory model derived from these results shows that the BI elaboration process is a dynamic, multidimensional, and complex phenomenon. It responds to internal and external stimuli experienced by the adolescent himself, and not simply social pressure, friendship, and school environment. According to this model, the reevaluation of oneself is a crucial element that influences the meaning of, and satisfaction or dissatisfaction with, BI. Beliefs and emotions reinforce an evaluation of oneself that leads one to accept or reject bodily self-image. As a result of this reevaluation, some of the adolescents diet and exercise as a self-management strategy to achieve an ideal weight or image that matches the canons of beauty. However, the resistance to accept one’s body does not necessarily imply unhealthy diets or disproportionate physical exercise as strategies for weight control. Individual coping is crucial for addressing one′s image and adolescent identity. We show that there are barriers and obstacles to, and also positive appreciations for, the achievement of a healthy BI in adolescence. However, there are adolescents with an efficient perceived self-efficacy and with positive appreciations about their body, even when it does not fit into the beauty canons established in Western society. All these factors should be considered in prevention programs, and promotion of a healthy BI.

5. Discussion

This synthesis suggests that the BI construct in adolescents has multiple meanings and that it does not necessarily imply dissatisfaction when there is a mismatch between actual and desired BI. BI is established in a much more complex way than simply through the messages received by the mass media and the pressure from friends. The family and the school environment play a decisive role as protective factors when applicable, providing tools to promote self-esteem, security, and confidence. We identified six themes from the analysis of the various studies.

Self-perception of BI defines the way of thinking and feeling about oneself in relation to body image. Messages about the body can be interpreted in a distorted way [ 32 ]. Therefore addressing misperceptions about weight is not enough for the prevention and promotion of a healthy body image in adolescents [ 33 , 34 ]. The studies analyzed show that the problems of distortion of body image facilitate behaviors aimed at losing weight. Dissatisfaction with body image during the early stages of adolescence has been related to poorer self-esteem [ 7 ], more in adolescent girls than in boys [ 35 ].

Relevance of the opinions of friends and colleagues on BI relates to the messages that adolescents receive from their friends. However, Willis et al. [ 36 ] provide results that contradict the common perception that overweight or obesity in adolescents is related to body dissatisfaction. Some of the overweight teens do not support the perception of friends or family about BI.

Relevance of the opinions of family and parents on BI. Both the negative influence of friends and family members are considered barriers to a healthy BI; however, they can be facilitators when messages are received positively by the adolescent [ 37 ]. Adolescents with high levels of body dissatisfaction may also experience higher levels of depression and less positive social interactions that lead to a decrease in family connection [ 38 ]. Consequently, considering the point of view of each adolescent, it is essential to include the role of parents in health educational interventions to develop a healthy BI.

Relevance of specific features of the school environment that influence BI. There are few studies which investigate the influence of school and teachers on the development of BI. Several studies show the benefits of including programs to promote a healthy BI in schools [ 39 ], thus evidencing the important role that school plays as a primary context of socialization [ 40 ].

Perceived expectations of BI across the mass-media. Exposure of physical appearance in social networks is related to different factors: (1) dissatisfaction with weight; (2) drive for thinness and ideal internalization; (3) self-objectification, especially in adolescent girls [ 10 , 41 ]; and (4) increased concerns and beliefs related to appearance [ 42 ]. Some of them are aware of the manipulation of the media and are critical of the pressure exerted about obtaining the ideal BI [ 43 ]. Nevertheless, the influence of media on adolescent girls should also be considered. Consequently, media literacy is considered necessary [ 25 ], as well as the development of prevention strategies. The latter include promoting skills to use the internet and mass media and training adolescents to develop a healthy BI.

Strategies, practices, and self-management for the ideal BI. The results of the synthesis agree with the study of Pollina et al. [ 44 ] in which it is shown that body dissatisfaction predicts unhealthy behaviors among boys and girls, with different patterns between gender. This dissatisfaction also generates problems of distortion of BI. Moreover, it facilitates behaviors aimed at losing weight (i.e., diets, food restrictions, and modification of eating habits), which are patterns of eating behavior that predict obesity in the future [ 45 ].

The present synthesis also yields an explanatory model on the meaning of the BI construct and the process of its elaboration. This model can promote approaches focused on health, well-being, and social justice by emphasizing contextual factors, and not exclusively focusing on weight, BMI, and individual responsibility, as pointed out by Tylka [ 46 ]. Obtaining the desired and satisfactory BI can prevent risk behaviors related to (1) dietary habits; (2) exercise; (3) medication; (4) situations of bullying and exclusion; (5) emotional discomfort around self-esteem, self-confidence, and self-acceptance; and (6) mental health diseases, such as distortion of BI, anxiety and depression, which can last into adulthood and old age. In conclusion, in our study, we are create the basis to address a major problem in public health. The results of the present synthesis also reinforce the proposals [ 47 , 48 ] for exploring positive BI in adolescents more deeply.

6. Strengths and Limitations of the Review

The strength of the review is reflected in the systematic identification of articles, using a broad and specific search strategy and multiple databases. Furthermore, this rigor is improved by applying the CASP score.

One possible limitation is due to the nature of the methodology, which is related to the use of different qualitative designs. In this review, however, we place the focus on the substantive area provided in each study.

Future research is necessary to determine the extent to which the present results could be generalized in other social and cultural contexts. Indeed, most of the studies reviewed are from western countries or western models of societies in which family, friends, and social factors play the same role.

7. Implications for Practice

A model has been developed that can help health professionals and educators to reorient the focus of interventions and programs devoted to this issue.

We should make an effort to create intervention tools to provide adolescents with a distanced, critical, and reflective point of view on the inputs they receive.

To prevent problems and promote public health by providing adolescents with information, instruments, and strategies would help empower adolescents to form the most positive perspective on BI and motivate them to engage in healthy behaviors for to maximize their satisfaction with their BIs. The results reported here may also help investigators formulate intervention strategies for improving BI among pre-adolescent children.

8. Conclusions

The present review shows the construct, the meaning, and the key factors that influence the development of BI, according to the perspective of adolescents. The synthesis presents strategies that have a negative impact on the health of adolescents, and factors that are a protective framework for a healthy BI.

The results provide relevant information for nursing professionals who should consider the design and implementation of educational programs on BI and health promotion in childhood and adolescence. These interventions should consider multiple levels, the perspectives of adolescents and the specific needs of each subgroup: girls, boys, peers, friends, etc. In addition, our synthesis identifies protective factors for a healthy BI, such as positive school environment and teacher support, as well as the need for strategies to deal with the impact of mass media messages. These are necessary to understand the needs of adolescents and develop individualized care plans in the earlier stages of life.

Author Contributions

G.T.-N., E.A.-B.; Contributed materials, analysis tools: G.T.-N., M.P.P., E.A.-B. Wrote the paper: G.T.-N., M.P.P., E.A.-B.; Conceived and designed the study: G.T.-N., E.A.-B.; Performed the systematic search and study selection: G.T.-N., E.A.-B. Quality Assessment: G.T.-N., E.A.-B.; Applied synthesis method G.T.-N., E.A.-B. All authors have read and agreed to the published version of the manuscript.

This research received no external funding.

Institutional Review Board Statement

Not applicable.

Informed Consent Statement

Data availability statement.

The research team has the data under their control. The data will be available to anyone who requests it if the demand is reasonable.

Conflicts of Interest

None declared.

Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations.

• 1. Grogan S. Body Image: Understanding Body Dissatisfaction in Men, Women and Children. 3rd ed. Routledge; New York, NY, USA: 2016. [ Google Scholar ]
• 2. Cash T.F. Encyclopedia of Body Image and Human Appearance. Volume 1. Academic Press; London, UK: 2012. Cognitive-behavioral perspectives on body image; pp. 334–342. [ Google Scholar ]
• 3. Sands R. Reconceptualization of body image and drive for thinness. Int. J. Eat. Disord. 2000;28:397–407. doi: 10.1002/1098-108X(200012)28:4<397::AID-EAT7>3.0.CO;2-U. [ DOI ] [ PubMed ] [ Google Scholar ]
• 4. Cash T.F., Smolak L. Body Image: A Handbook of Science, Practice, and Prevention. 2nd ed. The Guilford Press; New York, NY, USA: 2011. [ Google Scholar ]
• 5. Tiggemann M. Sociocultural perspectives on human appearance and body image. In: Cash T.F., Smolak L., editors. Body Image: A Handbook of Science, Practice, and Prevention. 2nd ed. The Guilford Press; New York, NY, USA: 2011. p. 490. [ Google Scholar ]
• 6. Inchley J., Currie D., Young T., Samdal O., Torsheim T., Augustson L., Mathison F., Aleman-Diaz A., Molcho M., Weber M., et al. Growing up Unequal: Gender and Socioeconomic Differences in Young People’s Health and Well-Being: International Report from the 2013/14 Survey. [(accessed on 18 November 2020)];2016 Available online: http://www.euro.who.int/__data/assets/pdf_file/0003/303438/HSBC-No.7-Growing-up-unequal-Full-Report.pdf?ua=1 .
• 7. Vaquero-Cristóbal R., Alacid F., Muyor J.M., López-Miñarro P.Á. Imagen Corporal: Revisión Bibliográfica. Nutr. Hosp. 2013;28:27–35. doi: 10.3305/nh.2013.28.1.6016. [ DOI ] [ PubMed ] [ Google Scholar ]
• 8. Hart L.M., Damiano S.R., Cornell C., Paxton S.J. What parents know and want to learn about healthy eating and body image in preschool children: A triangulated qualitative study with parents and Early Childhood Professionals. BMC Public Health. 2015;15:1–13. doi: 10.1186/s12889-015-1865-4. [ DOI ] [ PMC free article ] [ PubMed ] [ Google Scholar ]
• 9. Heidelberger L., Smith C. Low-Income, African American and American Indian Children’s Viewpoints on Body Image Assessment Tools and Body Satisfaction: A Mixed Methods Study. Matern. Child. Health J. 2018;22:1327–1338. doi: 10.1007/s10995-018-2513-2. [ DOI ] [ PubMed ] [ Google Scholar ]
• 10. Meier E.P., Gray J. Facebook photo activity associated with body image disturbance in adolescent girls. Cyberpsychol. Behav. Soc. Netw. 2014;17:199–206. doi: 10.1089/cyber.2013.0305. [ DOI ] [ PubMed ] [ Google Scholar ]
• 11. Bixby H., Bentham J., Zhou B., Di Cesare M., Paciorek C.J., Bennett J.E., Taddei C., Stevens G.A., Rodriguez-Martinez A., Carrillo-Larco R.M., et al. Rising rural body-mass index is the main driver of the global obesity epidemic in adults. Nature. 2019;569:260–264. doi: 10.1038/s41586-019-1171-x. [ DOI ] [ PMC free article ] [ PubMed ] [ Google Scholar ]
• 12. Valverde P.R., de los Santos F.R., Rodríguez C.M. Diferencias de sexo en imagen corporal, control de peso e Índice de Masa corporal de los adolescentes españoles. Psicothema. 2010;22:77–83. [ PubMed ] [ Google Scholar ]
• 13. Bray I., Slater A., Lewis-Smith H., Bird E., Sabey A. Promoting positive body image and tackling overweight/obesity in children and adolescents: A combined health psychology and public health approach. Prev. Med. 2018;116:219–221. doi: 10.1016/j.ypmed.2018.08.011. [ DOI ] [ PubMed ] [ Google Scholar ]
• 14. O’Dea J.A., Caputi P. Association between socioeconomic status, weight, age and gender, and the body image and weight control practices of 6- to 19-year-old children and adolescents. Health Educ. Res. 2001;16:521–532. doi: 10.1093/her/16.5.521. [ DOI ] [ PubMed ] [ Google Scholar ]
• 15. Regnier F., Bihan E.L., Tichit C., Baumann M. Adolescent body dissatisfaction in contrasting socioeconomic milieus, coming from a French and Luxembourgish context. Int. J. Environ. Res. Public Health. 2020;17:61. doi: 10.3390/ijerph17010061. [ DOI ] [ PMC free article ] [ PubMed ] [ Google Scholar ]
• 16. Story M., French S.A., Resnick M.D., Blum R.W. Ethnic/racial and socioeconomic differences in dieting behaviors and body image perceptions in adolescents. Int. J. Eat. Disord. 1995;18:173–179. doi: 10.1002/1098-108X(199509)18:2<173::AID-EAT2260180210>3.0.CO;2-Q. [ DOI ] [ PubMed ] [ Google Scholar ]
• 17. Sundgot-Borgen C., Friborg O., Kolle E., Engen K.M.E., Sundgot-Borgen J., Rosenvinge J.H., Pettersen G., Klungland Torstveit M., Piran N., Bratland-Sanda S. The healthy body image (HBI) intervention: Effects of a school-based cluster-randomized controlled trial with 12-months follow-up. Body Image. 2019;29:122–131. doi: 10.1016/j.bodyim.2019.03.007. [ DOI ] [ PubMed ] [ Google Scholar ]
• 18. Hart L.M., Cornell C., Damiano S.R., Paxton S.J. Parents and prevention: A systematic review of interventions involving parents that aim to prevent body dissatisfaction or eating disorders. Int. J. Eat. Disord. 2015;48:157–169. doi: 10.1002/eat.22284. [ DOI ] [ PubMed ] [ Google Scholar ]
• 19. Alleva J.M., Sheeran P., Webb T.L., Martijn C., Miles E. A meta-analytic review of stand-alone interventions to improve body image. PLoS ONE. 2015;10:e0139177. doi: 10.1371/journal.pone.0139177. [ DOI ] [ PMC free article ] [ PubMed ] [ Google Scholar ]
• 20. Noblit G., Hare R. Meta-Ethnography: Sinthesizing Qualitative Studies. Sage; Newbury Park, CA, USA: 1988. [ Google Scholar ]
• 21. Critical Appraisal Skills Programme; CASP Critical Appraisal Skills Programme. CASP Qualitative Checklist. [(accessed on 10 January 2020)];2018 :1. Available online: http://www.casp-uk.net/casp-tools-checklists .
• 22. Mooney E., Farley H., Strugnell C. A qualitative investigation into the opinions of adolescent females regarding their body image concerns and dieting practices in the Republic of Ireland (ROI) Appetite. 2009;52:485–491. doi: 10.1016/j.appet.2008.12.012. [ DOI ] [ PubMed ] [ Google Scholar ]
• 23. Dhillon M., Dhawan P. “But I am fat”: The experiences of weight dissatisfaction in Indian adolescent girls and young women. Women’s Stud. Int. Forum. 2011;34:539–549. doi: 10.1016/j.wsif.2011.08.005. [ DOI ] [ Google Scholar ]
• 24. Frisén A., Holmqvist K. What characterizes early adolescents with a positive body image? A qualitative investigation of Swedish girls and boys. Body Image. 2010;7:205–212. doi: 10.1016/j.bodyim.2010.04.001. [ DOI ] [ PubMed ] [ Google Scholar ]
• 25. Holmqvist K., Frisén A. “I bet they aren’t that perfect in reality:” Appearance ideals viewed from the perspective of adolescents with a positive body image. Body Image. 2012;9:388–395. doi: 10.1016/j.bodyim.2012.03.007. [ DOI ] [ PubMed ] [ Google Scholar ]
• 26. Kierans J., Swords L. Exploring the Appearance Culture in Early Adolescence: A Qualitative Focus Group Approach in the Republic of Ireland (ROI) J. Adolesc. Res. 2016;31:671–699. doi: 10.1177/0743558415604219. [ DOI ] [ Google Scholar ]
• 27. Kvalem I.L., Strandbu Å. Body Talk-Group Specific Talk? A Focus Group Study of Variations in Body Ideals and Body Talk among Norwegian Youth. Young. 2013;21:327–346. doi: 10.1177/1103308813506147. [ DOI ] [ Google Scholar ]
• 28. Kenny U., O’Malley-Keighran M.P., Molcho M., Kelly C. Peer Influences on Adolescent Body Image: Friends or Foes? J. Adolesc. Res. 2017;32:768–799. doi: 10.1177/0743558416665478. [ DOI ] [ Google Scholar ]
• 29. Sharpe H., Damazer K., Treasure J., Schmidt U. What are adolescents’ experiences of body dissatisfaction and dieting, and what do they recommend for prevention? A qualitative study. Eat. Weight Disord. Stud. Anorex. Bulim. Obes. 2013;18:133–141. doi: 10.1007/s40519-013-0023-1. [ DOI ] [ PubMed ] [ Google Scholar ]
• 30. Burnette C.B., Kwitowski M.A., Mazzeo S.E. “I don’t need people to tell me I’m pretty on social media:” A qualitative study of social media and body image in early adolescent girls. Body Image. 2017;23:114–125. doi: 10.1016/j.bodyim.2017.09.001. [ DOI ] [ PubMed ] [ Google Scholar ]
• 31. Holmqvist K., Frisén A. From negative to positive body image: Men’s and women’s journeys from early adolescence to emerging adulthood. Body Image. 2019;28:53–65. doi: 10.1016/j.bodyim.2018.12.002. [ DOI ] [ PubMed ] [ Google Scholar ]
• 32. McCabe M.P., Mavoa H., Ricciardelli L.A., Waqa G., Fotu K., Goundar R. Sociocultural influences on body image among adolescent boys from Fiji, Tonga, and Australia. J. Appl. Soc. Psychol. 2011;41:2708–2722. doi: 10.1111/j.1559-1816.2011.00846.x. [ DOI ] [ Google Scholar ]
• 33. Deschamps V., Salanave B., Chan-Chee C., Vernay M., Castetbon K. Body-weight perception and related preoccupations in a large national sample of adolescents. Pediatr. Obes. 2015;10:15–22. doi: 10.1111/j.2047-6310.2013.00211.x. [ DOI ] [ PubMed ] [ Google Scholar ]
• 34. Dey R., Clark B.R., Ackermann N., Racette S.B. Weight status perception and weight loss intention among urban youth. Obes. Res. Clin. Pract. 2019;13:391–394. doi: 10.1016/j.orcp.2019.04.004. [ DOI ] [ PMC free article ] [ PubMed ] [ Google Scholar ]
• 35. Gatti E., Ionio C., Traficante D., Confalonieri E. “I like my body; therefore, i like myself”: How body image influences self-esteem—A cross-sectional study on Italian adolescents. Eur. J. Psychol. 2014;10:301–317. doi: 10.5964/ejop.v10i2.703. [ DOI ] [ Google Scholar ]
• 36. Wills W., Backett-Milburn K., Gregory S., Lawton J. Young teenagers’ perceptions of their own and others’ bodies: A qualitative study of obese, overweight and “normal” weight young people in Scotland. Soc. Sci. Med. 2006;62:396–406. doi: 10.1016/j.socscimed.2005.06.014. [ DOI ] [ PubMed ] [ Google Scholar ]
• 37. McLaughlin E.A., Belon K.E., Smith J.E., Erickson S.J. Mothers’ and daughters’ beliefs about factors affecting preadolescent girls’ body satisfaction. Body Image. 2015;13:9–17. doi: 10.1016/j.bodyim.2014.11.002. [ DOI ] [ PubMed ] [ Google Scholar ]
• 38. Crespo C., Kielpikowski M., Jose P.E., Pryor J. Relationships between Family Connectedness and Body Satisfaction: A Longitudinal Study of Adolescent Girls and Boys. J. Youth Adolesc. 2010;39:1392–1401. doi: 10.1007/s10964-009-9433-9. [ DOI ] [ PubMed ] [ Google Scholar ]
• 39. Lombardi K., Beatty S., Devine A., Wallace R., Costello L. Fat talk: Influences on body image in childcare. Health Promot. J. Austr. 2019:hpja.272. doi: 10.1002/hpja.272. [ DOI ] [ PubMed ] [ Google Scholar ]
• 40. Vidal I.R. El papel de las relaciones y la satisfacción vital en la percepción de la auto-imagen en una muestra de adolescentes mexicanos. Arch. Med. 2019;19:111–123. [ Google Scholar ]
• 41. Baker N., Ferszt G., Breines J.G. A Qualitative Study Exploring Female College Students’ Instagram Use and Body Image. Cyberpsychol. Behav. Soc. Netw. 2019;22:277–282. doi: 10.1089/cyber.2018.0420. [ DOI ] [ PubMed ] [ Google Scholar ]
• 42. Fardouly J., Willburger B.K., Vartanian L.R. Instagram use and young women’s body image concerns and self-objectification: Testing mediational pathways. New Media Soc. 2018;20:1380–1395. doi: 10.1177/1461444817694499. [ DOI ] [ Google Scholar ]
• 43. Ahern A.L., Bennett K.M., Kelly M., Hetherington M.M. A qualitative exploration of young women’s attitudes towards the thin ideal. J. Health Psychol. 2011;16:70–79. doi: 10.1177/1359105310367690. [ DOI ] [ PubMed ] [ Google Scholar ]
• 44. Pocallet M.P., Barberà M.E.A., Clapes T.G., Bonet M.B., Solé T.P., Solans N.S., Calvet E.R., Mora J.R.M., Bravo M.O. Cross-sectional study on body image and self-esteem among adolescents in Catalonia. Health Educ. Public Health. 2019;2:164–169. [ Google Scholar ]
• 45. Stice E. Risk and maintenance factors for eating pathology: A meta-analytic review. Psychol. Bull. 2002;128:825–848. doi: 10.1037/0033-2909.128.5.825. [ DOI ] [ PubMed ] [ Google Scholar ]
• 46. Tylka T.L. Overview of the field of positive body image. In: Daniels E.A., Gillen M.M., Markey C.H., editors. Body Positive: Understanding and Improving Body Image in Science and Practice. Cambridge University Press; New York, NY, USA: 2018. pp. 6–33. [ Google Scholar ]
• 47. Halliwell E. Future directions for positive body image research. Body Image. 2015;14:177–189. doi: 10.1016/j.bodyim.2015.03.003. [ DOI ] [ PubMed ] [ Google Scholar ]
• 48. Tylka T.L., Wood-Barcalow N.L. What is and what is not positive body image? Conceptual foundations and construct definition. Body Image. 2015;14:118–129. doi: 10.1016/j.bodyim.2015.04.001. [ DOI ] [ PubMed ] [ Google Scholar ]

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Body image: A better perspective

Many people think of body image as a women’s issue or a young person’s issue. in actuality, we all  have a perceived body image that affects so many aspects of our lives — including the opportunities we seek. .

What exactly is body image, and how can we cultivate a better, more healthy image so that we get the most out of life? To learn more, we talked to Dr. Kristine Luce , p sychologist and clinical associate professor in psychiatry and behavioral sciences at Stanford University School of Medicine. 

Your body image is defined by your personal perception. 

Dr. Luce defines body image as how a person thinks of, feels about and perceives their own body, and how a person imagines others perceive their body.

“Body image is an aspect of identity. Most people tend to self-identify by segmenting their lives into different roles. For example, a person may self-identify according to their profession, relationships, hobbies, etc. Body image is one aspect of a person’s complete identity, and within it a person can hold many perceptions, even contradicting perceptions.”

Although body image is commonly understood as having to do with weight and shape, the term actually encompasses all aspects of a person’s perceived physical appearance  — including age, facial attributes and gender. 

Body image exists on a continuum.

Dr. Luce views body image along a continuum, with “positive body image” on one end, “negative body image” on the other and the middle composed of varying aspects of both. 

Dr. Luce describes a positive body image as a healthy self-image, in which a person has self-compassion and appreciation for their body. They recognize the amazing functions of their body and don’t let how they feel about their appearance limit how they live their life. On the other end of the spectrum, a person with a negative body image tends to be strongly self-critical and less attuned to the beneficial capabilities and functions of their bodies. 

Most people, however, do not fall on one extreme or the other. The vast majority of people have varying degrees of appreciation and criticism for their bodies. Terms like “positive” and “negative” tend to be inadequate for fully capturing a person’s felt experience, which is generally more nuanced than binary. For example, when speaking about body image, a person may “fragment” and speak about parts of their bodies they like, and parts that they don’t like. Others might describe feeling positive about their bodies overall, but still want to change certain physical aspects.

A person’s body image is dynamic and ever changing throughout the lifespan. People tend to move along a continuum of how they perceive themselves at various stages of life, such as when they age or gain or lose weight.

Many factors contribute to a person’s body image.

Dr. Luce explains that we are constantly inundated with body image messages from many different sources, including history, economics, religion, family of origin and the media, which is the most prevalent.

Luce describes a series of studies conducted in Fiji before western TV was brought to the island. At that time there were no known cases of eating disorders in Fiji. The studies revealed that the first cases of eating and body image disorders emerged after western TV was brought to their culture, indicating that media presence was at least a contributing factor in how people perceived their bodies. 

“Culture has long influenced body image by defining and dictating what is attractive. The media is a strong force that can shape and influence culture, for better or for worse.” 

Other societal factors, including economic history and religion, can also contribute to one’s body image. Luce mentions that a higher body weight used to be a sign of fertility and wealth when resources were more scarce, but as resources have become more accessible, thinness or fitness is seen as a symbol of wealth because it indicates more time for self-care. For some religious groups, a thinner appearance could indicate a greater ability for fasting, which is associated with the virtue of self-control and used as a measure of spiritual virtue. 

Finally, an individual’s personal history and upbringing can influence the way they perceive themselves and their bodies. For example, if someone is raised in a household or social environment in which a person’s value is very closely tied to their physical appearance, a person may begin to perceive their bodies as a measure of their self-worth. 

With the constant onslaught of information we are receiving about how we think we should look, Dr. Luce assures us it is understandable if we feel pressure to look a certain way. 

Body image can impact the choices we make in our lives.

Put simply, overconcern about appearance can limit what opportunities a person seeks. Dr. Luce gives several examples of this phenomenon, termed “self-handicapping” in social psychology. Self-handicapping is a cognitive strategy in which people avoid an opportunity to protect their self-esteem against the possibility of failure. For example, if a person makes the assumption that they will be discriminated against because of their appearance, they may not go for a promotion. 

“Research on this subject shows that a strong enough limiting self-belief can restrict access and experiences throughout the lifespan. This is based on an assumption that may or may not be true.”

Other common examples of self-handicapping due to body image include postponing dating until reaching a particular appearance or avoiding visiting the doctor until reaching a desired weight. According to Luce, these are paradoxical approaches that rarely work, and often bring us further from our desired outcomes. 

“When you think about it, most people want to look a certain way for more access in life, whether it be jobs, partners, health or something else. By avoiding promotions, dating and doctor visits due to body image concerns, our access to our desired outcomes becomes more and more limited. On the other hand, people who feel positively in their bodies are more likely to seek out opportunities in all of these areas.”  

Negative body image persists throughout different demographic groups.

According to Luce, there used to be evidence that negative body image occurred more for women than for men, and more for white women than for other ethnic groups — but the gap has narrowed over time.

“In the last 20 to 30 years, there has been a proliferation of body image marketing to every ethnic group and gender. Now you can find body image advertising that targets everybody, thus increasing body image concerns and eating disorders across all types of people. I call it, ‘equal opportunity in the direction we were not hoping for.’”

Research conducted in the 1980s showed it was rare for people to feel positive in their bodies, which is a feeling that still persists, according to a 2018 poll .

There are many strategies for cultivating a more positive body image.

Dr. Luce encourages her patients to act according to their values rather than their negative self-beliefs. An example of this would be encouraging someone to go to the beach, if that is what they enjoy, even though they might also feel uncomfortable in a bathing suit. This is called a “cognitive dissonance intervention,” based on the theory that increasing the tension (or dissonance) between a person’s thoughts and actions will eventually create a new belief. Dissonance interventions are really about being aware of one’s values, living in alignment with them and not letting one’s beliefs limit opportunities in life. 

“Sometimes the discomfort gets better at first, and sometimes it takes a while. But feeling the warmth of the sun or the coolness of the water can make the volume of those negative thoughts turn down, or at least fade them into the background.”

Another intervention, applied on a more macro scale, is counter-attitudinal marketing, which features people of various body sizes, shapes and ethnicities in advertisements.

“I used to have a lot of optimism around counter-advertising and counter-marketing as a strategy for improving body image across culture. I still believe it can work for people who are open to it.” 

However, counter-attitudinal ads represent a very small percentage of mass media and social media images. The vast majority of media displays are not representative of the average body type: many are altered by image editing applications like Photoshop and filters, and some even represent an unhealthy body image. By understanding this fact, and being selective of our media exposure, we can begin to combat some of the negative effects of body image marketing.  Luce acknowledges this is not an easy feat:

“Negative body image beliefs are deeply entrenched for some people and changing these thoughts, for some, can be very challenging.” 

Luce goes on to describe how undoing a belief can be harder than building a new one, especially when we are exposed to so many media images and messages that are constantly reinforcing certain ideas. 

  Dr. Luce also encourages us to think about the way we speak about bodies and how this might affect body image for ourselves and our communities. 

“We can all refuse to engage in conversations about other people’s bodies. By choosing to not engage in appearance-based conversations, we can influence the world by modeling our values.”

A similar strategy is reconsidering our appearance-based decisions as a message to the world. Dr. Luce admits that she doesn’t color her hair because she doesn’t want to give into the pressures around ageism. However, she acknowledges this type of action can be challenging because ageism and appearance-based discrimination exists in many fields. 

“I am a psychologist in academia, so looking ‘old and wise’ is still valued. I recognize there are many people who feel they have to look a certain way to keep their jobs.”

Although we may not all be able to take such a strong action, everybody can do something to show the perception of feeling comfortable in the body they have. By choosing an alternative action that goes against societal pressures around body image, we can make changes that influence ourselves and the world around us.

Dr. Luce closes with a note of encouragement. “Body image is not static. Throughout life we move along a continuum of how we perceive ourselves. Regardless of how we feel about it at any given moment, we can have a full and meaningful life in the bodies we have.”

Mia Primeau July 2020

Select resources: Stanford Health Image Body Program The Body Positive Stanford Research Project Stanford Children’s Health: Boost Your Teen Daughter’s Body Image National Eating Disorders: The Body Project

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Body Image, Overview

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• Jennifer S. Mills 2  

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Introduction

First described nearly a century ago, “body image” can be loosely defined as the mental representation of our bodies that we hold in our minds. Originally, it was believed that body image is a mirror image of what objectively exists in the world, but that certain pathologies could interfere with this perceptual process (e.g., phantom limb pain or anorexia nervosa). However, more recent literature suggests that body image is strongly influenced by a variety of factors, including, but not limited to, psychological, social, cultural, biological, historical, and individual factors (Cash & Smolak, 2011 ).

In clinical psychology, body image is a construct that is implicated in both eating disorders and body dysmorphic disorder. Many individuals with these conditions experience an inability to objectively perceive their body’s appearance, size, or shape. Body dissatisfaction, or a negative evaluation of the size, shape, or appearance of one’s body, has been linked to numerous...

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Bordo, S. (1993). Anorexia nervosa: Psychopathology as the crystallization of culture. Unbearable weight: Feminism, western culture and the body (pp. 139–164). California: University of California Press.

Google Scholar  

Bruch, H. (1962). Perceptual and conceptual disturbances in anorexia nervosa. Psychosomatic Medicine, 24 , 187–194.

PubMed   Google Scholar  

Cafri, G., Yamamiya, T., Brannick, M., & Thompson, J. K. (2005). The influence of sociocultural factors on body image: A meta-analyses. Clinical Psychology: Science and Practice, 12 , 421–433.

Cash, T. F. (2004). Body image: Past, present and future. Body Image: An International Journal of Research, 1 (1), 1–5.

Cash, T. F., & Smolak, L. (Eds.). (2011). Body image: A handbook of science, practice, and prevention (2nd ed.). New York: Guilford Press.

Cole, E., & Daniel, J. H. (2005). Featuring females: Feminist analyses of media . Washington, DC: American Psychological Association.

Fisher, S. (1990). The evolution of psychological concepts about the body. In T. F. Cash & T. Pruzinsky (Eds.), Body images: Development, deviance, and change (pp. 3–20). New York: Guilford Press.

Hesse-Biber, S. N. (2007). The cult of thinness . New York: Oxford University Press.

Hughes, B. (2000). Medicine and the aesthetic invalidation of disabled people. Disability and Society, 15 , 555–568.

Jacobi, C., Hayward, C., de Zwaan, M., Kraemer, H. C., & Agras, S. (2004). Coming to terms with risk factors for eating disorders: Application of risk terminology and suggestions for a general taxonomy. Psychological Bulletin, 130 (1), 19–65.

Kilbourne, J. (1994). Still killing us softly: Advertising and the obsession with thinness. In P. Fallon, M. Katzman, & S. Wooley (Eds.), Feminist perspective on eating disorders (pp. 395–418). New York: Guilford.

Mills, J. S., Polivy, J., Herman, C. P., & Tiggemann, M. (2002). Effects of exposure to thin media images: Evidence of self-enhancement among restrained eaters. Personality and Social Psychology Bulletin, 28 , 1687–1699.

Mills, J. S., Roosen, K., & Vella-Zarb, R. (2011). The psychology of body image: Understanding body image instability and distortion. In S. B. Greene (Ed.), Body image: Perceptions, interpretations, and attitudes (pp. 59–80). New York: Nova Science Publishers.

Schilder, P. (1950). The image and appearance of the human body . New York: International Universities Press.

Slade, P. D. (1988). Body image in anorexia nervosa. The British Journal of Psychiatry, 153 (2), 20–22.

Smeets, M. A. M. (1997). The rise and fall of body size estimation research in anorexia nervosa: A review and reconceptualization. European Eating Disorders Review, 5 , 75–95.

Stice, E., Shaw, H., & Marti, N. (2007). Eating disorder prevention programs: A meta-analytic review. Psychological Bulletin, 130 , 206–227.

Swami, V., et al. (2010). The attractive female body weight and female body dissatisfaction in 26 countries across 10 world regions: Results of the International Body Project I. Personality and Social Psychology Bulletin , 36 (3), 309–325.

Wardle, J., Haase, A. M., & Steptoe, A. (2006). Body image and weight control in young adults: International comparisons in university students from 22 countries. International Journal of Obesity, 30 , 644–651.

Online Resources

Body Image Handbook . http://www.body-images.com/research/books_audio.html

Body Image: An International Journal of Research . http://www.journals.elsevier.com/body-image/#description

Centre for Appearance Research. http://www1.uwe.ac.uk/hls/research/appearanceresearch

Dove Self-Esteem Project. http://www.dove.ca/en/Social-Mission/Self-Esteem-Resources/

Eating Disorder Research Society. www.edresearchsociety.org

International Association for Eating Disorders. www.aedweb.org

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Roosen, K.M., Mills, J.S. (2014). Body Image, Overview. In: Teo, T. (eds) Encyclopedia of Critical Psychology. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-5583-7_403

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Systematic review of body image measures

Affiliations.

• 1 Department of Psychology, University of Gothenburg, Box 500, 405 30 Gothenburg, Sweden. Electronic address: [email protected].
• 2 Behavioural Science Institute, Clinical Psychology, Radboud University, Postbus 9104, 6500, Nijmegen, the Netherlands. Electronic address: [email protected].
• 3 Centre for Appearance Research, University of the West of England, Coldharbour Lane, Bristol, BS161QY, UK. Electronic address: [email protected].
• 4 Centre for Appearance Research, University of the West of England, Coldharbour Lane, Bristol, BS161QY, UK. Electronic address: [email protected].
• 5 Department of Psychology, University of Gothenburg, Box 500, 405 30 Gothenburg, Sweden. Electronic address: [email protected].
• 6 School of Health Sciences, University of Aveiro, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal; Cintesis, University of Aveiro, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal. Electronic address: [email protected].
• 7 School of Health Sciences, University of Aveiro, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal; Cintesis, University of Aveiro, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal. Electronic address: [email protected].
• 8 School of Psychology, University College Dublin, Belfield, Dublin 4, Ireland. Electronic address: [email protected].
• 9 APPEAR, Department of Applied Psychology, Northeastern University, Boston, USA; Department of Psychiatric Emergency & Acute Care, Lapeyronie Hospital, CHRU Montpellier, France. Electronic address: [email protected].
• 10 School of Psychology, University College Dublin, Belfield, Dublin 4, Ireland. Electronic address: [email protected].
• PMID: 31394462
• DOI: 10.1016/j.bodyim.2019.06.006

This systematic review synthesizes and critically appraises measurement properties of influential body image measures. Eight measures that met the definition of an assessment of body image (i.e., an individual's cognitive or affective evaluation of their body or appearance with a positive or negative valence), and scored high on systematic expert priority ranking, were included. These measures were: the Body Appreciation Scale (original BAS and BAS-2), the Body Esteem Scale for Adolescents and Adults, the Body Shape Questionnaire, the Centre for Appearance Research Valence Scale, the Drive for Muscularity Scale, two subscales of the Eating Disorders Examination Questionnaire, one subscale of the Eating Disorder Inventory 3, and two subscales of the Multidimensional Body Relations Questionnaire. Articles assessing these scales' psychometric properties (N = 136) were evaluated for their methodological quality using the Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) checklist, and a best evidence synthesis was performed. The results supported the majority of measures in terms of reliability and validity; however, suitability varied across populations, and some measurement properties were insufficiently evaluated. The measures are discussed in detail, including recommendations for their future use in research and clinical practice.

Keywords: Body image; Clinical practice; Measurement properties; Psychometric; Self-report questionnaire; Systematic review.

Copyright © 2019 Elsevier Ltd. All rights reserved.

Publication types

• Systematic Review
• Body Image / psychology*
• Psychometrics
• Reproducibility of Results
• Self Report
• Surveys and Questionnaires*