body image research paper

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Peer-reviewed

Research Article

Does Body Image Affect Quality of Life?: A Population Based Study

Affiliation Administrative Department, Mersin Public Health Directorate, Mersin, Turkey

Affiliation Department of Public Health, Süleyman Demirel University Faculty of Medicine, Isparta, Turkey

* E-mail: [email protected]

Affiliation Department of Communicable Diseases, Ceyhan Community Health Center, Adana, Turkey

Tufan Nayir,
Ersin Uskun,
Mustafa Volkan Yürekli,
Hacer Devran,
Ayşe Çelik,
Ramazan Azim Okyay

Published: September 20, 2016
https://doi.org/10.1371/journal.pone.0163290
Reader Comments

Body image (BI) can be described as the assessment of both positive and negative emotion for one’s own body parts and their characteristics by himself or herself. Current research has concentrated mostly on the status of negative BI as a risk factor for mental health problems rather than as a public health problem, thereby little is known about the effects of BI on quality of life. Thus, the purpose of this study was to assess the BI and Quality of Life (QoL) of individuals and to investigate the relationship between the two. Individuals over 15 living in Isparta city center constitute the universe of this cross-sectional analytical study, carried out in 2014. The BI of individuals was measured by the Body Image Scale and The QoL of individuals was measured using the World Health Organization (WHO) Quality of Life Scale Short Form. The mean age of the participants was 31.9 ± 13.0 and 56.0% were female, 36.8% were married and 81.7% had education above high school. 25.7% had at least one chronic disease and 17.7% received medication regularly. Having good-very good health perception, having higher income than expenses, making regular exercises were predictors in enhancing the quality of life in certain aspects, however having a good body image came out as a predictor enhancing the quality of life in all sub-domains. BI was found closely related with QoL in all sub-domains. Our findings suggest that greater attention should be to be given to BI as a strong predictor of QoL.

Citation: Nayir T, Uskun E, Yürekli MV, Devran H, Çelik A, Okyay RA (2016) Does Body Image Affect Quality of Life?: A Population Based Study. PLoS ONE 11(9): e0163290. https://doi.org/10.1371/journal.pone.0163290

Editor: Massimo Ciccozzi, National Institute of Health, ITALY

Received: July 4, 2016; Accepted: September 5, 2016; Published: September 20, 2016

Copyright: © 2016 Nayir et al. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: Data are available from Süleyman Demirel University Faculty of Medicine, Public Health Department, for researchers who meet the criteria for access to confidential data.

Funding: The authors received no specific funding for this work.

Competing interests: The authors have declared that no competing interests exist.

Introduction

Body image (BI) can be described as the assessment of both positive and negative emotion for one’s own body parts and their characteristics by himself or herself [ 1 ]. BI is a complicated construct that is composed of several components such as mental and emotional components, perceptual components and behavioral components [ 2 ].

It is well documented that a negative BI is associated with a range of adverse health outcomes, including low self-esteem, depressive mood and eating disorder symptoms [ 3 , 4 ].

However attention has concentrated mostly on the status of negative BI as a risk factor for mental health problems rather than as a public health problem in its own right, thereby little is known about the effects of BI on quality of life (QoL) [ 5 ].

The World Health Organization (WHO) defines QoL as the individual’s assessment of their position in life in the scope of culture and values, considering their goals, expectations, standards and concerns [ 6 ].

The concept of life quality closely related to health status, is one of the topics that is paid much attention by a large group of researchers engaged in the field of medicine and found worthy to investigate. The concept of life quality related to health, alternative explanations exist though, means “the perception of health and illness experience from the individuals’s point of view” [ 6 , 7 ].

As mentioned above not much attention was given to BI in terms of QoL. To the best of our knowledge, in Turkey, there is no previously conducted study investigating the association between BI and QoL. Therefore, the goal of this study is to assess the BI and QoL of individuals over 15 living in a city center and to investigate the relationship between the two.

Materials and Methods

Study design.

Individuals over 15 living in Isparta city center constitute the universe of this study which is a cross-sectional analytical study, carried out in 2014 (n:175.409). The sample size was calculated as 638 with an obesity prevalence of 30% with a 5% margin of error in OpenEpi Program (Open Source Epidemiologic Statistics for Public Health, Version 3.01, 2013). Using the cluster sampling method we reached a total of 650 people in 26 clusters and 25 people in each cluster.

The inclusion criterias for enrollment are to volunteer to participate in the study and to be over 15 years old. The exclusion criteria is to have mental retardation.

Data collection instruments

Socio-demographic characteristics (age, gender, education level, economical perception, having a chronic disease, smoking, drinking alcohol, doing sport, weight, height) and other characteristics (the thoughts and requests about the weight of himself/herself, family, friends and spouse/partner, the status of using any method to lose weight at the time of survey and in the past year, the status of skipping meals and snacking between meals etc.) were collected with a questionnaire prepared by authors and included 28 items.

The BI of individuals was measured by the Body Image Scale developed by Secord and Jourard [ 8 ] and adapted to Turkish by Hovardaoglu [ 9 ]. Body Image Scale consists of 40 articles aiming to measure the level of satisfaction of various body functions and various parts of the body of individuals. This scale is a quinary Likert-type scale evaluated from the total score obtained from the scale and can get a score ranging from 40 to 200. Higher scores got by an individual indicates a higher level of satisfaction of individual’s own body. The QoL of individuals was measured using the Turkish version (TR) of WHO Quality of Life Scale Short Form (WHOQOL-BREF) [ 10 ]. WHOQOL-BREF (TR), a type of scale having the reliability and validity study [ 11 , 12 ], consists of 26 quinary Likert-type questions, two of which are general questions and the rest of which are questions about four different fields (physical, psychological, social and environment). Culture Standardized (CS) Environmental Area, which is obtained considering the answers to the 27th question added as a national question during the study for adaptation to Turkish, is an additional field used in national studies. The scale not having a total score, each area is evaluated independently and can have a value between 4–20 points. The increasing points for each area indicates the increasing QoL for this field. In this study, scores of the QoL were calculated for all fields of WHOQOL-BREF (TR) scale.

Data was gathered by making surveys prepared by researchers using face to face interview method.

Statistical analysis

The dependent variables of the study were the scores of QoL and BI. Age, gender, education level, economical perception, having a chronic disease, smoking, drinking alcohol, doing sport, body mass index (BMI), the thoughts and requests about the weight of himself/herself, family, friends and spouse/partner, the status of using any method to lose weight at the time of survey and in the past year, the status of skipping meals and snacking between meals were independant variables. Data was evaluated using descriptive statistics, t-test, Pearson and Spearman correlation and linear regression analysis in computer. Statistical Package for the Social Sciences soft-ware (SPSS, Version 9.0, Inc. California, 1999) was used for all the statistical calculations.

Ethical considerations

This study was conducted in accordance with the ethical standards of the Declaration of Helsinki, which promotes respect for all human beings and protects their health and rights. The Ethics Committee of Süleyman Demirel University Faculty of Medicine approved this study.

After informing the participants about the purpose of the trial (investigation, research, study), and where and how the obtained data would be used, written consents were obtained. The written consent was a separate standard document prepared according to the ethics committee suggestion. The participants of this study were over 15 years old. For over 18, written informed consent was provided by the participant ownself and for between 16–18 the written informed consent to participate was provided by his/her legal representative.

The mean age of the study group was 31.9 ± 13.0 and 56.0% were female, 36.8% were married and 81.7% had education of high school or above. 70.5% perceived their income as middle income ( Table 1 ).

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https://doi.org/10.1371/journal.pone.0163290.t001

31.1% were smoking, 28.8% were drinking alcohol and 22.0% were making regular exercise. The average BMI of the study group was 24.0±4.4 and 36.0% were fat or overwight (BMI ≥25kg/m2). 25.7% had at least one chronic disease and 17.7% received medication regularly. 71.5% were skipping at least one meal during the day ( Table 2 ). The most skipped meal was lunch (49.0%). 84.2% of the group were snacking between meals and the most preferred snack was fruit with 49.7%.

https://doi.org/10.1371/journal.pone.0163290.t002

Specific Results on BI

The average of BI Score of the research group was 152.1±24.0. ( Table 3 ). The average of BI Scores of women, those with a chronic disease, those using medication, those skipping meals, those having the opinion that they are not normal by their family, friends, spouse and himself/herself, those having the consideration that they need to make changes in their weight by their family, friends, spouse and himself/herself and those having the history of dieting in the past year were lower than others.(p<0.001, p<0.001, p<0.001, p<0.05, p<0.001, p<0.001, p<0.001, p<0.001, p<0.001, p<0.001, p<0.001 and p<0.001 respectively) (Tables 2 and 4 ).

https://doi.org/10.1371/journal.pone.0163290.t003

https://doi.org/10.1371/journal.pone.0163290.t004

Being a woman decreased the BI score of 3.7 units, the individual’s own desire to make changes in body weight decreased the BI score of 7.7 units (p<0.05 and p<0.01 respectively). Working increased the BI score of 4.5 units, having good-very good economical sense increased the BI score of 6.8 units, having good-very good health perception increased the BI score of 9.3 units, smoking increased the BI score of 5.7 units and making regular exercise increased the BI score of 6.5 units. (p<0.05, p<0.05, p<0.001, p<0.01 and p<0.01 respectively) ( Table 5 ).

https://doi.org/10.1371/journal.pone.0163290.t005

Specific Results on QoL

The mean scores of WHOQOL-BREF (TR) regarding physical, psychological, social, environment and CS environmental areas were 15.4±2.8, 14.5±2.7, 14.8±3, 14.5±2.5 and 13.8±4.2 respectively. ( Table 3 ).

Physical domain scores were significantly lower for women, the married, the fat/overweight according to BMI, patients with chronic diseases, those using drugs, those having the opinion that they are not normal by their family, friends, spouse and himself/herself, those having the consideration that they need to make changes in their weight by their family, friends, spouse and himself/herself (p<0.01, p<0.01, p<0.01, p<0.001, p<0.001, p<0.001, p<0.01, p<0.01, p<0.001, p<0.001, p<0.001, p<0.001, p<0.001 and p<0.001 respectively) (Tables 2 and 4 ). Physical domain scores were higher for those having higher education than high school, those having good-very good economical sense, those having good-very good health perception, those drinking alcohol and those making regular exercises (p<0.05, p<0.001, p<0.001, p<0.001, p<0.01 and p<0.001 respectively) (Tables 1 and 2 ).

Psychological domain scores were significantly lower for women, patients with chronic diseases, those using drugs, those having the opinion that they are not normal by their family, friends, spouse and himself/herself, those having the consideration that they need to make changes in their weight by their family, friends, spouse and himself/herself (p<0.001, p<0.001, p<0.001, p<0.01, p<0.01, p<0.001, p<0.001, p<0.001, p<0.001, p<0.001 and p<0.001 respectively) (Tables 2 and 4 ). Psychological domain scores were higher for those having higher education than high school, those working, those having good-very good economical sense, those having good-very good health perception, those drinking alcohol and those making regular exercises (p<0.01, p<0.01, p<0.001, p<0.001, p<0.05, p<0.01 and p<0.001) (Tables 1 and 2 ).

Social domain scores were significantly lower for women, those having the opinion that they are not normal by their family, friends, wife and himself/herself, those having the consideration that they need to make changes in their weight by their family, friends, spouse and himself/herself (p<0.01, p<0.001, p<0.01, p<0.001 and p<0.01 respectively) (Tables 2 and 4 ). Social domain scores were higher for those having good-very good economical sense, those drinking alcohol, smoking and those making regular exercises (p<0.01, p<0.001, p<0.05, p<0.001 and p<0.001 respectively) (Tables 1 and 2 ).

Environmental domain scores were significantly lower for women, the married, those using drugs, those skipping meals, those having the opinion that they are not normal by their family, friends, spouse and himself/herself, those having the consideration that they need to make changes in their weight by their family, friends, spouse and himself/herself (p<0.001, p<0.05, p<0.01, p<0.05, p<0.01, p<0.001, p<0.001, p<0.001, p<0.01, p<0.01 and p<0.01 respectively) (Tables 2 and 4 ). Environmental domain scores were higher for those having higher education than high school, those having good-very good economical sense, those having good-very good health perception, those having more income than expenses, those drinking alcohol and those making regular exercises (p<0.01, p<0.001, p<0.001, p<0.001, p<0.01 and p<0.001 respectively) (Tables 1 and 2 ).

CS environmental domain scores were significantly lower for patients with chronic diseases and those using drugs, those skipping meals, those having the opinion that they are not normal by their family, friends, spouse and himself/herself, those having the consideration that they need to make changes in their weight by their family, friends, spouse and himself/herself (p<0.01, p<0.05, p<0.05, p<0.01, p<0.01, p<0.05, p<0.01, p<0.001, p<0.001, p<0.01, p<0.01 and p<0.01 respectively) (Tables 2 and 4 ).

As age and number of applications for health organizations increased, physical, psychological and environmental domain scores reduced (for age; p<0.001, p<0.05 and p<0.05 respectively, for applications for health organizations; p<0.001, p<0.001 and p<0.01 respectively). Furthermore, as age increased, social domain scores decreased (p<0.05). As BI score increased, QoL scores in five sub-areas also increased (for all p<0.001) ( Table 3 ).

Regression analysis results

As a result of regression analysis of variables associated with the univariate analysis with sub parameters of WHOQOL-BREF (TR) ( Table 5 );

Having good-very good health perception increased physical domain score by 1.1 units, making regular exercises increased physical domain score by 0.7 units (p<0.001 and p<0.01 respectively). A unit increase in applications for health organizations reduced physical domain score by 0.1 units (p<0.05).

Having higher income than expenses increased psychological domain score by 0.6 units, having good-very good health perception increased psychological domain score by 0.6 units (p<0.05 and p<0.01 respectively). Skipping meals during the day reduced psychological domain score by 0.4 units (p<0.05).

Drinking alcohol increased social domain score by 1.0 units (p<0.001).

Being married reduced environmental domain score by 0.4 units (p<0.05). Having good-very good economical perception increased environmental domain score by 0.8 units, having higher income than expenses increased environmental domain score by 0.8 units and having good-very good health perception increased environmental domain score by 0.5 units (p<0.01, p<0.001 and p<0.01 respectively).

A unit increase in BI score results in 0.1 unit increased for every five domains (for all p<0.001).

This study revaled that BI significantly affects the QoL in every sub-domain. It is very important to create a positive BI perception to improve the QoL of individuals. When risk groups and risk factors associated with negative BI is known, particular attention may be given to these groups. Similarly, knowing the factors which positively affect BI may give hints for possible interventions. The findings of this study provide us important evidence on this aspect. Being a woman affects BI negatively, making women a risk group. In this respect steps should be taken to ensure a positive BI in females. Individuals who have a desire to change in terms of BI, are also a risk group. BI is positive in the individuals with a good or very good health perception. Also, making regular exercises was found to improve BI. Thus, regular exercise programs that positively affect health perception should be encouraged.

In this study we assessed the factors that are independently associated with BI perception and QoL among individuals over 15 living in Isparta city center, while controlling for all other factors. Below, only the factors that displayed significant associations in the regression analysis were discussed.

Anticipated relation between gender and BI perception is verified by the results of this study: females tended to have a more negative BI perception compared to males. This is supported by other studies showing that women were more likely to perceive themselves as being overweight than men [ 13 , 14 ]. At this point it should be noted that in women, many unhealthy attitudes such as bulimia and anorexia are the results of dissatisfaction with self image, especially dissatisfaction with aspects associated to body weight [ 15 ].

We found that working and making regular exercises increased the BI score. Positive effects of exercise on BI have been firmly established in the literature [ 16 – 19 ]. There is also evidence that exercise improves BI, even though body weight and shape do not change [ 20 ]. However, exercising compulsively and excessively is a prevalent purging strategy used to make up for caloric intake or to alter one’s body weight, size, or shape, resulting in eating disorders related to body dissatisfaction, thus this fact should be considered while appraising exercise in regards to BI [ 21 ].

Having good-very good economical sense was found to increase the BI score in this study. Likewise, in a study conducted in Brazil in 2011 people with lower economic status were reported to be more dissatisfied with their current body silhouette [ 22 ]. However this result is controversial in the literature since some say BI dissatisfaction was most evident among people of higher socioeconomic classes [ 23 ]. The diversities in these studies are thought to be due to the differences in the methodologies.

In this study, it is found that having good-very good health perception increased the BI score. There are studies in line with our study, reporting body dissatisfaction was associated with the increased likelihood of impairment for certain aspects of health [ 24 , 25 ]. It is thought that personality characteristics related to body dissatisfaction, such as low self-esteem, depressive mood and perfectionism, may promote negative evaluation of physical health [ 26 ].

Interestingly we found that smoking increased the BI score. Although some local studies are in accordance with our results [ 27 , 28 ], it is widely accepted that smoking is associated with poor BI [ 29 – 32 ]. We believe that smoking may improve BI as a coping skill, however further research on this subject should be carried out.

In our study having good-very good health perception was a predictor in enhancing the QoL in physical, psychological and environmental domains. In the literature, it is well documented that several health problems, especially the chronic conditions are associated with a decreased QoL [ 33 – 35 ]. It is stated that subjective health parameters could be more significant factors of life satisfaction than objective ones [ 36 ]. Thus, it is not surprising that having a better health sense improves QoL.

We found that having higher income than expenses was a predictor in enhancing the QoL in psychological and environmental domains and having good-very good economical sense was a predictor in enhancing the QoL in environmental domain. Although there are studies in line with our study [ 37 , 38 ], the issue is inconclusive in the literature. For example, research by Kenny [ 39 ] and Stewart [ 40 ] reported that in middle-income countries and across several European countries, there was little proof of relationship between economic development and gross domestic product per capita and subjective well-being. The relation described in the present research is considered to be the result of richer individuals’ having more access to social activities/services enhancing their social attendance and hence their QoL.

Our results demonstrated making regular exercises was a predictor in enhancing QoL only in the physical domain. Making exercises and physical activity have been shown to maintain good QoL in several studies [ 41 , 42 ]. There is a positive association between physical activity and perception of QoL, which varies according to the domains of QoL assessed [ 43 ]. Further studies should be encouraged to investigate the association between physical activity and exercise and the different domains of QoL.

We found that skipping meals during the day was reducing the QoL in psychological domain. Although there are numerous studies investigating the association between nutrition and QoL [ 44 – 46 ], we did not come across much evidence particularly regarding skipping meals. In a study from Mexico, however, low QoL was reported to be associated with skipping meals, which is in line with our results [ 47 ]. Since there is not sufficient evidence to discuss the association found in this study, we suggest further studies to be conducted.

In our study drinking alcohol was a predictor in enhancing QoL in the social domain. Some researches indicated a linear or inverse J-shaped relationship between QoL and alcohol use, in such a manner that at the greater levels of use of alcohol, which includes individuals diagnosed with alcohol use disorders, QoL is lower as compared to standard or low risk users and abstainers [ 48 , 49 ]. The association identified in the present study is thought to be due to the fact that alcohol consumption at a moderate level of may be positive in terms of stress relief and psychological health [ 50 ].

Another interesting result found in this study is that being married was reducing the QoL in environmental domain. In the literature considerable evidence points to the enjoyment of better health and QoL among married older adults relative to their non-married peers [ 51 – 53 ]. However, being in line with our study, there are studies reporting younger married people did not have better QoL than their non-married peers [ 54 , 55 ]. We believe that the negative impact of marriage on QoL is likely to be due to the younger sample in this study.

As a final result, this study demonstrated that having a good BI came out as a predictor enhancing the QoL in all sub-domains. In accordance with our study, Mond et al. reported higher levels of body dissatisfaction were associated with poorer QoL [ 5 ]. This finding is notable because interest in BI has principally focused on for more adverse outcomes, such as low self-esteem, depressive mood and eating disorders [ 56 , 57 ].

Conclusions

In conclusion, as distinct from all of the other parameters used to assess QoL, BI was found closely related with QoL in all sub-domains. Our findings suggest that greater attention should be to be given to BI as a strong predictor of QoL. We expect that the data collected in this study will serve as a base for other researchers to investigate BI from a different point of view.

Supporting Information

S1 file. dataset..

https://doi.org/10.1371/journal.pone.0163290.s001

S2 File. Questionnaire.

https://doi.org/10.1371/journal.pone.0163290.s002

Author Contributions

Conceptualization: TN EU.
Data curation: MVY HD AÇ RAO.
Formal analysis: TN EU MVY HD AÇ.
Funding acquisition: TN EU MVY HD AÇ RAO.
Investigation: TN EU MVY HD AÇ RAO.
Methodology: TN EU.
Project administration: TN EU.
Resources: TN EU MVY HD AÇ RAO.
Software: TN EU MVY HD AÇ.
Supervision: TN EU.
Validation: TN EU MVY HD AÇ.
Visualization: MVY HD AÇ RAO.
Writing – original draft: TN EU RAO.
Writing – review & editing: TN EU RAO.
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6. World Health Organization (WHO). 1996. WHOQOL-BREF introduction, administiration scoring and generic version of the assessment, Field Trial Version. Geneva: WHO, Programme on Mental Health. Available: http://www.who.int/mental_health/media/en/76.pdf . Accessed 2014 Sep 6.
7. World Health Organization (WHO). WHOQOL User Manual. Geneva: WHO, Programme on Mental Health; 1998.

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Social media and body image: Recent trends and future directions

Affiliations.

1 School for Mass Communication Research, KU Leuven, Parkstraat 45, 3000, Leuven, Belgium. Electronic address: [email protected].
2 School of Psychology, UNSW Sydney, New South Wales, 2052, Australia. Electronic address: [email protected].
3 College of Education, Psychology and Social Work, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia. Electronic address: [email protected].
PMID: 35030460
DOI: 10.1016/j.copsyc.2021.12.002

This review presents recent trends in social media and body image research, with a particular focus on different social media platforms, features unique to social media, and potentially positive content for body image. First, it was found that visual platforms (e.g. Instagram) were more dysfunctional for body image than more textual platforms (e.g. Facebook). Second, taking and editing (but not posting) selfies resulted in negative effects on body image. Positive comments intensified the effects of exposure to idealized content. Third, of the forms of potentially positive content examined in recent research (i.e. fitspiration, disclaimer labels, and body positivity), only body positivity content had a positive effect on body image. Recommendations for future research are offered.

Keywords: Body image; Body positivity; Objectification; Social comparison; Social media.

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ORIGINAL RESEARCH article

Processing body image on social media: gender differences in adolescent boys’ and girls’ agency and active coping.

School of Psychology, Trinity College Dublin, Dublin, Ireland

Although scholars continue to debate the influence of social media on body image, increased social media use, especially engaging in appearance-related behaviors may be a potential risk factor for body dissatisfaction in adolescents. Little research has investigated how adolescents process appearance-related content and the potential strategies they use to protect body image perceptions on social media. To investigate coping strategies used by adolescents, four qualitative focus groups were conducted with 29 adolescents (23 girls) aged 15–16 years ( M = 15.31, SD = 0.47) in mixed-gender Irish secondary schools. Thematic analysis revealed that adolescents employed many different behavioral strategies such as avoiding negative content and selecting positive content. Cognitive processing strategies such as critically evaluating body-related content, psychologically distancing from and positively reframing challenging content were also used, although less frequently. Boys appeared to exhibit greater positive agency over their bodies and social media use and tended to use more active coping styles than girls. Efforts to promote body image on social media such as body positive pages and exposing artificial social media content were considered limited in their effectiveness.

Introduction

Body dissatisfaction, defined as “a person’s negative thoughts and feelings about his/her body” ( Grogan, 1999 , p. 2) is a leading cause of eating disorders, disordered eating, low self-esteem and poor psychological wellbeing ( Stice and Shaw, 2002 ; Paxton et al., 2006 ; Cruz-Sáez et al., 2018 ). Relatively high prevalence rates of body weight dissatisfaction have been reported cross culturally among adolescent girls [Mean = 48%, Range (26–62%)] and boys [Mean = 31%, Range (15–44%)] in 26 countries ( Al Sabbah et al., 2009 ). Social media is extensively used by adolescents ( Pew Research Center, 2018 ; Rodgers et al., 2020 ) and has received a lot of research attention as a possible risk factor for body dissatisfaction ( Rodgers and Melioli, 2016 ).

While the causes of body dissatisfaction are considered multifaceted, and include biological, evolutionary, psychological and sociocultural factors ( Polivy and Herman, 2002 ; Ferguson et al., 2011 ; Fitzsimmons-Craft, 2011 ), social media is a sociocultural factor that has been suggested by some to be linked to body dissatisfaction. However, the extent to which social media influences body dissatisfaction is debated and the evidence is inconsistent; some studies find associations between social media use and body dissatisfaction ( Fardouly et al., 2017 ; Scully et al., 2020 ), others find that social media use is associated with positive body image ( Cohen et al., 2019 ), some observe no direct relationships ( Ferguson et al., 2014 ; Cohen et al., 2017 ) and others suggest that social media may indirectly influence body dissatisfaction by increasing opportunities for other predictors of body dissatisfaction such as peer competition ( Ferguson et al., 2014 ). Furthermore, the inferences that can be drawn regarding social media effects may also be limited by methodological issues in the literature, such as the inability to capture the dynamic, interactive, and personalized nature of social media within a controlled environment or failure to use appropriate controls and procedures to account for demand characteristics ( Fardouly and Vartanian, 2016 ).

Nonetheless, concurring with previous systematic reviews (e.g., Holland and Tiggemann, 2016 ), a recent meta-analysis of 63 independent samples observed a small, positive, significant relationship between social media use and body image disturbance ( Saiphoo and Vahedi, 2019 ). It should be noted that the meta-analysis’ conclusions are constrained by the literature on which they are based, which as mentioned, has its limitations (i.e., demand characteristics, single-responder bias, common method variance, lack of preregistration, and the fact that many studies report simple bivariate correlations). These limitations may result in an over-estimate of the effect size; consequently, the small effects in this meta-analysis do not necessarily confirm the existence of effects and therefore must be considered as suggestive. 1 Even though the effect size was small, the authors noted that it is important to further explore the relationship between social media use and body dissatisfaction because social media is extensively used by adolescents. Adolescence is also a particularly vulnerable time for body image ( Voelker et al., 2015 ), and it is important to identify risk/protective factors for body dissatisfaction on social media to help foster more favorable body image during this sensitive developmental period.

Sociocultural theories of body image, such as the Tripartite model ( Thompson et al., 1999 ), propose that social media, influences body image perceptions by conveying messages that emphasize the importance of appearance and pressurize the attainment of unrealistic body ideals. These body-related messages are proposed to give rise to body dissatisfaction directly and indirectly via two mediating mechanisms: internalization of and appearance comparisons with body ideals. Body ideal internalization involves endorsing and pursuing body ideals as a personal body standard ( Thompson and Stice, 2001 ), while appearance comparisons involve evaluating one’s appearance relative to others ( Jones, 2001 ). Because the body ideals that individuals internalize are largely unrealistic and unattainable, failure to exemplify these ideals becomes a source of body dissatisfaction when these ideals are valued as a personal goal ( Thompson et al., 1999 ). Upward comparisons, comparisons with “superior” others highlight discrepancies between one’s own body and body ideals thereby giving rise to body dissatisfaction ( van den Berg et al., 2002 ).

Social media are highly visual, appearance focused platforms that extend opportunities to engage in these body dissatisfaction-inducing behaviors ( Rodgers and Melioli, 2016 ). Popular social media platforms used by adolescents such as Instagram and Snapchat ( Pew Research Center, 2018 ), contain a profusion of idealized body related content, which tend to endorse muscular ideals (characterized by a v-shaped torso, visible abs, large biceps, and low body fat,) and lean/athletic ideals (characterized by a toned body with low body fat,) for men/boys. Thin ideals (characterized by a lean physique with low body fat and a narrow waist), fit/athletic ideals (characterized by a lean and muscular physique), and curvy ideals (characterized by a thin waist and large bosom/bottom) are generally more relevant for women/girls ( Betz and Ramsey, 2017 ). Adolescents have been found to endorse and strive for these ideals, despite acknowledging the unrealistic nature of these bodies ( Edcoms and Credos, 2016 ; Burnette et al., 2017 ; Bell et al., 2019 ).

Consistent with the Tripartite model, comparisons with celebrities, sports stars, and peers who embody these ideals on social media have been reported by adolescents to give rise to feelings of body dissatisfaction ( Edcoms and Credos, 2016 ; Burnette et al., 2017 ). Additionally, posting and editing “selfies” (self-portraits of one’s face/body) on social media amplify adolescents’ tendencies to compare and critically evaluate their appearance ( Chua and Chang, 2016 ; Bell, 2019 ). Adolescent girls tend to engage more in these self-presentation behaviors than boys and tend to be far more invested and influenced by the feedback indices such as “likes” and “comments” received on these posts. Although boys tend not to be greatly affected by the number of “likes” they receive, they are concerned about receiving negative commentary from peers on social media ( Kenny et al., 2017 ).

Some studies suggest that girls’ body image perceptions are more strongly and negatively impacted by social media because they engage with and invest more in body-related content than boys ( Frisén and Holmqvist, 2010 ; McAndrew and Jeong, 2012 ; Chua and Chang, 2016 ). Boys have also been found to perceive social media as a more positive, motivating influence on their body image vs. girls who tend to report that social media exerts more negative effects on their body image ( Bell et al., 2019 ). Boys are also thought to be protected somewhat from exposure to aesthetic body ideals, because they value body functionality over aesthetics ( Grogan and Richards, 2002 ). However, recent meta-analyses suggest that the magnitude of social media’s influence on body image is the same for girls and boys ( Holland and Tiggemann, 2016 ; Saiphoo and Vahedi, 2019 ). It has also been suggested that social media’s impact on male body image may be underestimated because of boys’ tendencies to disclose or downplay body image issues because of stigma surrounding male body image ( Griffiths et al., 2014 ). However, given the methodological issues mentioned previously, the strength of relationship between social media and body image requires more robust examination.

Although appearance-related behaviors on social media have been suggested as a risk factor for body image ( Saiphoo and Vahedi, 2019 ), little research has investigated ways that adolescents manage challenging social media content or strategies they use to buffer the negative effects of these behaviors. It is important to understand the ways that users interact with social media, because the possible body-related outcomes arising from social media use are likely to be the result of complex, reciprocal transactions between the media content and the social media user ( Valkenburg and Peter, 2013 ; Perloff, 2014 ).

Additionally, while studies have investigated ways to protect and promote adolescent body image in general, social media is a unique sociocultural context that may require specific strategies to help improve body image ( Perloff, 2014 ). Existing approaches to addressing body-dissatisfaction on social media involve teaching social media literacy in order to reduce the credibility of media messages and subsequent body ideal internalization and appearance comparison behaviors ( McLean et al., 2017 ). Although one study found a social media literacy program to be effective in producing gains in body image outcomes in adolescent girls ( McLean et al., 2016b ), similar improvements were not observed in adolescent boys ( Tamplin et al., 2018 ); this is surprising because it would be anticipated that adolescent boys, who are largely unaware of photo-manipulation/editing of male bodies on social media ( Edcoms and Credos, 2016 ), would benefit from enhanced social media literacy. Although these findings are preliminary, meta-analyses from traditional media literacy interventions indicate that although media literacy programs are effective in increasing knowledge about the media, they do not substantially change body image outcomes ( McLean et al., 2016a ). This suggests that increasing knowledge about body ideals may not alone be sufficient to address body dissatisfaction and that other strategies/coping tools are required for adolescents to effectively manage problematic appearance-focused social media. Understanding the strategies (if any) that adolescents use can inform the design of interventions such that they target self-protective skills that are in need of cultivation or further development among adolescents. Probing adolescents’ self-protective strategies can also help identify the approaches that might be most effective in improving adolescent body image and can focus intervention efforts toward these.

Only one qualitative study (to the authors’ awareness) with 38 female adolescents aged 12–14 years has explored protective and promotive coping strategies used by adolescents on social media ( Burnette et al., 2017 ). While adolescents in this sample endorsed behaviors associated with body dissatisfaction on social media, including using photo-based platforms, engaging in appearance-related behaviors and making appearance comparisons ( Rodgers and Melioli, 2016 ), they identified several factors that helped protect their body image when using social media. Girls reported that they consciously avoided undesirable social media posts that invoked appearance comparisons or body image concerns as a way of protecting their body image. While this gave adolescents a sense of personal agency over social media use, it was not regarded as a wholly effectual strategy because it was difficult to avoid unsolicited body related content on social media. Participants also evinced high social media literacy levels as they were critical of the body ideals encountered on social media, regarding them as edited, photoshopped, and unrealistic. Participants were also aware of the concerted efforts that peers went to, to capture and post a “perfect” photo of themselves. The authors posited that adolescents’ skepticism and avoidance of idealized body-related content and their appreciation of diverse beauty standards was indicative of protective filtering.

Protective filtering is an aspect of positive body image that involves selectively internalizing messages that promote positive body image and rejecting negative body-related information ( Andrew et al., 2015 ). Protective filtering has been found to buffer the negative effects of exposure to idealized body-related content in the media in adults ( Andrew et al., 2015 ). Protective filtering also appeared to provide promotive benefits to adolescents’ body image in sample of Burnette et al. (2017) . However, it is unclear whether the findings of these focus groups are generalizable across adolescents because the sample was relatively small and came from a single-sex, private school that taught social media literacy and critical thinking skills and encouraged an ethos of body appreciation, diversity, and confidence, which was reported to facilitate this protective filtering of social media content. Outside of this study, little research has investigated if adolescents use protective filtering strategies on social media and whether these filtering skills can be fostered in adolescents, including those with negative body image.

It is also not known whether aspects of social media content may help encourage protective filtering; “body acceptance” and “body positive” messages have recently propagated the social media space and have been lauded by adult women as a promising way to buffer against problematic idealized content and decrease body dissatisfaction ( Convertino et al., 2019 ; Rodgers et al., 2019 ). It is not known whether adolescents engage with this content and whether it exerts protective effects on their body image perceptions ( Bell et al., 2017 ).

Furthermore, little is known about the strategies that adolescent boys use to protect and promote body image. To the authors’ awareness no study has investigated self-protective strategies used by adolescent boys on social media. This reflects a traditional research focus on female body image, as men/boys were thought to be less impacted by body-related issues ( Parent, 2013 ). However, body image has been recognized an increasingly important issue for boys ( Parent, 2013 ), and has been found to be influenced by social media to a similar extent in both boys and girls ( Saiphoo and Vahedi, 2019 ). Boys and girls may face different body-related challenges and pressures on social media ( Kenny et al., 2018 ; Rodgers et al., 2020 ), and subsequently may employ different strategies to manage these pressures.

This qualitative study explored adolescents’ processing and protective filtering of social media content and whether these strategies were perceived to provide protective benefits for body image. Both adolescent boys and girls were included in the study because little is known about coping or management strategies used, especially by boys, to address gender-specific issues on social media. This study aimed to inform intervention and prevention efforts in the area of body image on social media.

Materials and Methods

Focus groups investigated how adolescents managed challenging body-related content and promoted positive body image on social media. Focus groups were used because they provide a rich and ecologically valid insight into the opinions and lived experiences of participants in their own words and from their own perspectives ( Greene and Harris, 2011 ). Focus groups were favored over one-to-one interviews for this kind of exploratory work because they facilitate greater elaboration of ideas and provide a vocabulary to discuss topics ( Heary and Hennessy, 2006 ; Greene and Harris, 2011 ). In accordance with guidelines ( Heary and Hennessy, 2002 ), single sex focus groups consisting of 6–9 participants were conducted as adolescents have been found to be more comfortable about opening up and discussing sensitive issues in single rather than mixed sex groups.

Focus groups were guided using an interview schedule, which asked adolescents about their experiences and perceptions of body image on social media, the appearance-related challenges they faced on social media and the ways they manage these challenges. The results presented below will focus on adolescents’ management of challenging appearance-related content on social media, however; a brief outline of adolescents’ perceptions/experiences of social media will be provided to contextualize adolescents’ coping strategies. Given the exploratory nature of the research, conversations were allowed to flow freely, and the researcher was free to pursue related topics if they were mentioned.

Participants

A convenience sample of 29 participants, 23 girls, and 6 boys, aged between 15 and 16 years ( M = 15.31, SD = 0.47) were recruited from two mixed sex Irish secondary schools, one urban private school and one rural community school for a study investigating adolescents’ experiences and perceptions of body image on social media. The study was only open to fourth year students who used social media and who received parental consent to participate. Participants’ ethnicity and other sociodemographic information were not recorded. Four focus groups were conducted, three with girls only and one with boys only (see Table 1 ).

Table 1 . Composition and duration of adolescent focus groups.

Focus groups were audio recorded using an Olympus WS853 voice recorder and qualitative analysis software, MAXQDA (Version 2018.1) was used to analyze the data. The interview schedule included questions such as; (1) What social media activities/behaviors do you think help/harm body image perceptions? (2) What characteristics of social media platforms promote positive body image/negatively impact body image? and (3) How do you manage challenging appearance-focused content on social media?

Full ethical approval was received from the ethics committee at Trinity College Dublin. Permission from school principals was obtained to allow the study to be hosted in schools and for students to participate in the study. Informed consent from parents and informed assent from participants was obtained prior to study commencement. Focus groups were conducted on the school premises and participants were assigned to focus groups based on their class group. Participants’ gender, age, and school attended were obtained in demographic questionnaires that participants completed prior to the focus groups. Focus groups were conducted by two female researchers; the primary researcher led the discussion, while the secondary researcher took notes and kept track of time. Focus groups lasted approximately 30–50 min and participants were offered refreshments, thanked and debriefed afterward.

Data Analysis

Focus group discussions were transcribed verbatim by the primary researcher (CM) and were analyzed using thematic analysis. The analysis was guided by six step procedure of Braun and Clarke (2006) , which involved firstly becoming familiar with the data by transcribing data, reading transcripts and listening to audio recordings (Step 1). Then, initial semantic codes were generated and assigned to the data using MAXQDA software (Step 2). Semantic coding, which involves characterization of explicit, surface meaning of content was deemed the most appropriate form of coding of the personal experiences pertinent to the research question. Data was also coded according to an essentialist/realist perspective, which assumes a unidirectional relationship between meaning and experience. This approach allows for a straightforward exploration of motivations, experiences, and meaning, which were the focus of the research questions. These codes were organized into a coding frame containing concise labels and descriptions for codes was established. Related codes were grouped together to form themes and subthemes (Step 3). An inductive approach, which allows themes to emerge from the data rather than being informed by pre-existing literature, was applied to generate themes ( Thomas, 2006 ). These themes were refined by reviewing the data at the level of the coded extracts and entire data sets to ensure that distinct, coherent themes were generated (Step 4). Themes and subthemes were assigned names and definitions (Step 5).

To verify whether these themes characterized the data, inter-rater agreement was conducted both on codes within the coding frame and final themes identified in the data. As recommended by Breen (2006) , an independent researcher (not involved in hosting focus groups) used MAXQDA to review the coded transcriptions and indicate their agreement or disagreement with each of the pre-existing codes and themes; they could also suggest additional codes and themes. The primary researcher reviewed the additional codes/themes suggested by the independent researcher and adjusted coding schemes where appropriate, in consultation with the project lead (DH). According to Breen (2006) , to attain adequate consistency (reliability), code-to-sentence matches should occur for at least 80% of cases. Agreement between coders was calculated using the Kappa Coefficient ( Brennan and Prediger, 1981 ) was high, K = 0.92, indicating good inter-rater agreement. Finally, themes were described and contextualized within relevant literature on social media and body image in adolescents (Step 6). These steps were conducted in an iterative, recursive manner.

The researcher adopted a reflexive approach and acknowledged that their own biases and backgrounds shaped the data obtained and the way it was interpreted. The researcher recognized that as a white, Irish, educated woman in her mid-twenties, she could resonate with the struggles of body image and social media pressures to pursue body ideals (insider position) and could recognize that the body-related pursuits and pressures of men/boys and adolescents may differ from her own, and that adolescents’ experience of social media content and affordances may also be divergent (outsider position; Berger, 2015 ). She also recognized that her adult and female status may have affected adolescents’ interactions and the ways they disclosed information about body image and social media ( Berger, 2015 ; Dodgson, 2019 ).

Adolescents reported that they were prolific, habitual users of social media, showing preferences for appearance focused platforms; adolescents, especially girls explicitly reported that they felt social media exerted a mostly negative influence on their body image. Girls strove to attain female body ideals, while boys largely endorsed functionality ideals; appearance comparisons tended to induce body dissatisfaction when these appearance-related goals were not met. Adolescent girls were perceived to invest more in appearance-related behaviors on social media and to experience greater levels body-related pressure, dissatisfaction and self-criticism than boys. Appearance comparisons with peers, social media influencers, and celebrities were identified as the main sources of body dissatisfaction on social media. Thematic analysis revealed two key themes, and various subthemes pertaining to the management of body image on social media by adolescents.

Theme 1: Behavioral Strategies Used to Manage Problematic Social Media Content

Avoidant strategies.

Adolescents reported using avoidant strategies and unfollowing content that contained body-ideals and reducing their social media use. Female 22 “ stopped using [social media as much] ,” while Female 21 “ unfollowed all the celebrities and people with unrealistic body goal standards ” and it was commonly reported that “ not seeing it [social media] as much helped ” (Female 21).

Avoiding social comparisons was emphasized as a core strategy to protect body image. However, some participants felt that avoidance strategies were limited in their effectiveness because it was difficult evade appearance comparisons as body-related images “ were always just popping up ” (Female 2) and body-related content was “ kind of pushed at [them] sometimes ” (Female 2) irrespective of whether they were interested in it or not.

Active Selection of Positive Content

Boys believed that they could control the outcomes of social media use by selecting content that promoted their self-image. Boys reported that they “ [did not] really get negative thoughts from looking at [social media], usually [they] just look[ed] at positive stuff ” (Male 4).

However, girls reported that they did not actively select positive content as they felt that all body-related content on social media was damaging. Even content designed to improve body image, such as body-positive content, was viewed skeptically by girls. While girls acknowledged and lauded increased efforts to promote body-acceptance, they held reservations about the effectiveness of these efforts. Participants felt that there was a huge disparity between “ the picture ,” which “ portrays a different message to what it’s captioned ” (Female 22). Participants noted that while a picture may be accompanied by a wholesome caption advocating ostensibly positive messages, the picture itself, which was often appearance/body-focused and objectified, was sending the opposite message.

Female 16 “I think that, what people say when they post something, like what they say might be positive and well-meaning but nearly the pictures themselves speak for themselves and maybe what they are promoting in the pictures isn’t healthy even though they are saying ‘self-love’.”

Participants also found it difficult to endorse messages of body acceptance when they were delivered by individuals who embodied body ideals. Participants found it difficult to reconcile “ See[ing] a very skinny woman and she says ‘love your imperfections’ ” (Female 23) because they felt that it was easy for individuals who had perfect bodies to promote the notion of body acceptance as they seemingly had reason to be happy with their bodies. Participants found it difficult to believe that these individuals struggled with body image concerns and thus were reluctant to buy into the notions of acceptance that these individuals were promoting.

Female 7 “A lot of influencers do promote like body confidence and all that but that’s kind of easy for them to say at the same time because they do have the perfect body say for Instagram and all that sort of stuff.”

Other self-acceptance content was recently noted to contain diverse body types including “ plus size models rather than just the really stick thin skinny ones ” (Female 5), which was lauded because it provided a more realistic representation of body image and body types on social media. However, body ideal content with “ skinnier ones [sic: individuals] ” was observed to “ get more positivity back than the plus size ones [individuals] would ” (Female 2) and body ideals were the main attentional draw that influenced bodily self-perceptions. Furthermore, some participants still felt that this body-diversity content reflected extreme body types such as overweight bodies and therefore failed encompass “normal” bodies such as their own.

Female 3 “Nothing’s like normal if you know what I mean.”

Researcher “Right ok, so it’s extremes of all of them kind of?”

Female 3 “Yeah, yeah.”

Researcher “So, nothing in the middle?”

Female 3 “Yeah.”

Active Selection of Alternative Platforms

Although girls felt limited in their ability to engage in positive body-related content, especially on Instagram, some girls actively chose to engage with VSCO, an alternative social media platform that was considered less damaging for body image. VSCO was favored because it was not considered to be as “serious” as Instagram and did not contain feedback indices “likes,” “comments” or hierarchical structures such as “followers,” which were problematic features of Instagram. Girls felt that they “did not feel pressure ” and could post “ a picture on VSCO with no makeup on … but would not put [the same photo] up on Instagram ” (Female 2). Female 1 noted that on “ Instagram ‐ you have to look perfect because you can see how many likes you get and people feel pressured into, they want more likes and that, but you cannot see that on VSCO .”

VSCO appeared to provide an alternative venue for girls to safely explore their body image without fears of overt judgment from others. However, its use was mentioned by girls in one school, and even among this group Instagram surpassed VSCO in terms of popularity despite the negative effects associated with Instagram.

Theme 2: Cognitive Strategies

Psychological distancing strategies.

Psychologically distancing oneself from comparison targets was a common strategy utilized by both boys and girls. Focusing on differences between the goals and values of comparison targets vs. themselves served to increase the psychological distance from these targets in boys and lessen their desire or drive to attain these bodies. Male 1 reconciled that “ They’re [celebrities/sports stars/social influencers] kind of devoting their whole life to it ,” while Male 4 concurred “ Yeah that’s their job like .” Boys felt that they too could attain these ideals if they devoted themselves to this extent but felt secure in their own bodies because they did not hold the same investment or commitment as individuals who possessed body ideals.

Some girls attained psychological distance from targets by focusing on the manipulated, edited nature of the images. Female 10 noted that celebrities/social influencers on social media “use filters ” and reconciled that “ if [she] used them[filters] [she] would look way better . ” “Know[ing] that they [celebrities/social influencers] are photoshopped ” helped her to be less affected by them because she knew they were “ unrealistic looking .” Some girls also attempted to distance themselves from comparison targets by acknowledging that although they often liked the appearance of these individuals, they felt that their features were too extreme and ill-suited to their own appearance.

Female 10 “I like the way they look but I don’t think I’d like to look as … extreme as they do. I don’t think it looks normal. But I think it looks normal with them because they all look like that, but if I walked in like them, I’d look weird, I’d look like an alien.”

While this distancing strategy worked for some, most girls noted that idealized images negatively affected them regardless of the knowledge of their manipulation and this limited the effectiveness of psychological distancing.

Reframing Strategies

Both boys and girls reported that reflective practices such as taking a step back, conducting reality checks and looking at the bigger picture enabled them to reassure themselves. Other strategies mentioned by adolescents involved reframing or putting a positive spin on challenging content. One boy suggested that focusing on goals and achievement rather than focusing on discrepancies and feeling self-pity enabled him to process social media content in a healthier way.

Male 4 “Depends on what way you view it really. If you look at it like, saying they’re this and they’re that and I’m just here, you’re not – you’re always just going to be feeling shite like. You are not going to move forward at all. If you just take – just watch whoever, take inspiration, try work yourself, if you want to be like them, work yourself towards being like them.”

In addition, accepting one’s uniqueness and viewing difference as a good rather than negative thing was identified by a female participant as a way of framing body image in a positive light.

Female 21 “I think the problem overall is that we are looking at difference as if it were a problem, we are saying “Why don’t I look like that? Why can’t I be that person?” But I think we all just have to learn to accept that we are all different and we know these facts, but we chose to ignore them!”

Ceasing to judge others and oneself was also mentioned by a few participants, however, it was acknowledged that this was difficult to achieve. Although boys appeared to be less judgmental and more accepting of their bodies with Male 4 noting “ I am grand just the way I am ,” girls struggled to accept their bodies and avoid negative critical self-evaluations, with Female 5 stating “ You have to get a certain amount of likes … or else it’s not like good enough .”

Female 19 “The more you look at the photo you’re like ‘God I hate it’ you see things that other people wouldn’t see and you’re like ‘I hate everything about it’.”

One girl stressed the value of maintaining a compassionate mindset and endorsed the notion that everyone struggles with the same issues and not to be so harsh and critical toward oneself.

Female 21 “I think we always compare ourselves to the people we see on social media, so we don’t see their flaws, because we are busy pointing out our own in comparison to theirs. We don’t realise that not everyone is perfect as well. And because of that we are kind of blind.”

Female 21 “I just think that young girls need to stop comparing themselves and to take a minute to realise that we are all the same, we are all doing the exact same thing; We are all sitting at home, scrolling. And all the likes we receive, it’s just a double tap of the finger, that person probably doesn’t probably even look at it for more two seconds, we need to stop overthinking everything.”

However, these reframing strategies were only mentioned by a few individuals in focus groups and did not typically reflect the whole groups’ responses to body-related content on social media.

Some participants, particularly girls, reported that they felt social media negatively influenced their body image perceptions. Aligning with the literature, adolescents reported that appearance-focused activities like photo sharing/editing practices and appearance comparisons with celebrities, social media influencers, and peers led to feelings of body dissatisfaction ( Edcoms and Credos, 2016 ; Rodgers and Melioli, 2016 ; Burnette et al., 2017 ).

Limiting their social media use and avoiding, unfollowing, or ignoring problematic body related content were the strategies most used by adolescents to protect their body image on social media. However, as found by Burnette et al. (2017) , these strategies were considered limited in their effectiveness because of the difficulty in avoiding ubiquitous body-related content on social media. Adolescents were aware of targeted advertising and the fact that their newsfeeds were often propagated with content that they did not necessarily want or chose to see; this limited their perceived control over social media use, especially among girls.

Aligning with these control beliefs, girls tended to report more passive responses to social media such as “putting up” with problematic content. Some boys, on the other hand, reported that they actively sought out and selected positive content that inspired them to exercise or helped them improve in some way. It should be noted that the number of boys in the present study was relatively small. Adolescent girls did not appear to engage in such active selection strategies as they felt that any content related to body image exerted negative effects on them, including content designed to promote positive body image. Adolescent girls’ reservations about body positive/acceptance content is notable as it contrasts with the endorsement of the protective effects of this content for body image in the literature (e.g., Convertino et al., 2019 ; Rodgers et al., 2019 ); given the recency of its emergence, the limitations of body positive content may not have been extensively documented in the literature or it may be the case that this kind of content resonates with adult women but not adolescents. Although the influence of body positive content on adolescent body image perceptions requires further research, these findings indicate that adolescent girls experienced social media as a largely negative and disempowering space for body image.

However, VSCO was a photo-sharing platform that was preferred by some girls to Instagram because it did not contain feedback indices such as likes, comments, followers and subsequently did not put as much appearance-related pressure on girls. VSCO has not previously featured in body image research and is worthy of further research attention because it represents a platform that may contain protective features for body image, namely the lack of hierarchical popularity structures or feedback indices.

Some girls distanced themselves from body ideals by reminding themselves that body ideals were not attainable – a strategy also noted by Burnette et al. (2017) . However, most girls reported that their knowledge of unrealistic body ideals did little to protect their body image perceptions and they continued to compare despite this awareness. Girls also achieved psychological distance from body ideals by reasoning that while they admired certain body features on others, they did not desire them themselves because these features would be incompatible with their own appearance. Adolescent boys in this sample reported deprioritizing the importance of the muscular ideal and distancing themselves from comparison targets as a way of protecting body image perceptions. This low investment in body-related content was also identified by Holmqvist and Frisén (2012) as a feature that supported adolescent boys’ body image.

Adolescents exhibited a repertoire of strategies to protect and promote body image. The use of these strategies by adolescents and their perceived effectiveness varied. Passive and avoidance strategies were most commonly used but were limited in terms of perceived effectiveness, while active and acceptance strategies were considered effective but were least commonly employed, especially by girls. As these active and acceptance-focused strategies are considered components of positive body image ( Holmqvist and Frisén, 2012 ), enabling adolescents to employ more active cognitive processing and reframing strategies may enhance their resilience to social media content.

Adolescents in this sample did exhibit aspects of protective filtering (as observed by Burnette et al., 2017 ), in that they were critical of the extreme natures of body ideals and attempted to psychologically distance from and reduce comparisons with these ideals. They also expressed an appreciation of body diversity on social media. However, protective filtering involves both the rejection of negative body-related messages and the endorsement of positive messages ( Andrew et al., 2015 ). Contrasting with the findings of Burnette et al. (2017) , high social media literacy levels did not always serve protective effects for body image and adolescent girls in this sample were largely unable to internalize positive body-related messages and struggled to accept/appreciate their own bodies.

Boys appeared to hold more positive perceptions of social media’s influence on body image, processed body-related content in “protective ways” and exhibited higher levels of body-acceptance than girls. Mirroring the findings of the national study of adolescent boys in the United Kingdom of Edcoms and Credos (2016) , boys in this sample were less aware of photo-editing and manipulation of images of male bodies on social media and viewed body ideals as attainable with sufficient hard work and effort. It may be the case that social media is experienced as a less pressurizing and more motivating space for boys, encouraging them to hold these more positive evaluations of social media. Alternatively, boys may have deemed it acceptable to report beliefs that body ideals were attainable and that they were not negatively affected by social media in order to adhere to masculine gender roles of self-reliance and dominance ( Gattario and Frisén, 2019 ). Boys may also be less aware of manipulation/editing strategies or less critical in perceptions of body ideal attainability and this might protect them from feelings of disempowerment and dissatisfaction when exposed to body-related content.

Nonetheless, some boys and girls reported self-criticism, self-blame, and body-dissatisfaction from social media comparisons and for perceived failures to adhere to desired body standards. Knowledge/information about body ideals did not always appear to change how individuals felt about their body image. This suggests that enhancing social media literacy and knowledge is not alone sufficient to mitigate tendencies to engage in appearance comparison and body ideal internalization behaviors and help individuals to internalize positive body-related messages. Furthermore, relying on body positive/body acceptance content to promote positive body image is also not sufficient given adolescent girls’ skepticism of this content and its ability to improve their body image perceptions.

Self-compassion approaches are purported to target and change how individuals feel about their bodies by addressing self-criticism and shame at the root of body dissatisfaction ( Gilbert and Irons, 2005 ; Gilbert, 2010 ). Instead of trying to inhibit appearance comparisons like media literacy approaches, compassion focused approaches (e.g., Neff, 2003 ; Gilbert, 2009 , 2014 ) try to reduce the self-criticism arising from comparisons – an approach, which may be particularly beneficial in light if the highly self-critical attitudes held particularly by adolescent girls about their bodies. Compassion focused approaches have been found to be effective in reducing body dissatisfaction and disordered eating, in addition to promoting body appreciation and positive body image in adults ( Braun et al., 2016 ; Rahimi-Ardabili et al., 2018 ). However, the ability of compassion-focused approaches to improve body image outcomes has not been investigated in adolescents ( Rahimi-Ardabili et al., 2018 ).

Compassion-focused approaches may be particularly useful for improving adolescent body image on social media, as they can provide individuals with the skills to reframe self-critical thoughts and enhance their resilience to negative body-related messages on social media. Self-compassion may also enable adolescents, especially girls, to internalize positive body-related messages and foster greater levels of body appreciation ( Andrew et al., 2016 ). They therefore represent a new and potentially promising alternative for tackling body image concerns in adolescents.

Limitations

Although this study sought to capture a diversity of viewpoints by recruiting from heterogenous schools that differed in terms of school status (private vs. public) and school size (medium-large and small), the sample size of this study was small which limits the transferability of the findings. Furthermore, very few boys participated in the study, which further limits the conclusions that can be made about social media’s influence on their body image perceptions. Due to study, time pressures a pragmatic decision was made to proceed with the analysis and write-up with the imbalanced gender split. This difficulty in recruiting male participants has been noted in the research in this area, and it may be indicative of male stigma around body image and a reluctance among adolescents to discuss it as a topic ( Griffiths et al., 2014 ; Edcoms and Credos, 2016 ). Future research needs to identify ways of circumventing this stigma and encouraging boys to discuss body image and social media, because far less is known about adolescent boys’ experiences of social media and body image vs. girls, despite the finding that body dissatisfaction is a prevalent and problematic issue among boys and one that is influenced by social media use ( Saiphoo and Vahedi, 2019 ).

The focus group design may have influenced participant’s responses such that they may have provided socially desirable answers that may not have reflected personal opinions, or their opinions may have been swayed by or suppressed because of dominant members of the group. 2 This may be particularly true of boys, who are less likely to disclose body image concerns because of social norms, which dictate that body image is not an issue for males ( Hargreaves and Tiggemann, 2006 ; Yager et al., 2013 ). Furthermore, as the focus groups were conducted by female researchers only, boys may have been reluctant to discuss gender differences related to body image ( Allen, 2005 ), while girls, may have been more expressive of their concerns because they tend to prefer same-sex female facilitators ( Yager et al., 2013 ).

Some adolescents, especially girls, indicated that social media led them to feel dissatisfied with their bodies. Boys and girls appeared to employ different strategies to manage to address the gender-specific challenges they encountered online. Boys appeared to exhibit more agency and active coping strategies, which contrasted with girls who were less optimistic about their ability to control social media outcomes and who struggled to interpret body-related information in a positive, self-protective way. Future research should examine these gender differences in larger samples across diverse contexts.

Data Availability Statement

The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.

Ethics Statement

The studies involving human participants were reviewed and approved by School of Psychology, Trinity College Dublin. Written informed consent to participate in this study was provided by the participants’ legal guardian/next of kin.

Author Contributions

CM conceived, planned, and carried out the study, analyzed the data, and wrote the manuscript with input from DH, who was involved in the planning and supervision of the study. Both the authors contributed to the article and approved the submitted version.

This research did not receive any specific grant from funding agencies in the public, commercial and not-for-profit sectors.

Conflict of Interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Acknowledgments

We would like to acknowledge colleagues Ms. Selin Akkol-Solakoglu who assisted with focus groups and Ms. Molly Light who assisted with inter-rater agreements and the School of Psychology, Trinity College Dublin for their support.

1. ^ We wish to thank a reviewer of the paper for highlighting this issue.

2. ^ We would like to thank the reviewer for highlighting that demand characteristics may have influenced participant responses such that respondents are likely to just go with the theme of the questions, rather than spontaneously come to the conclusion that social media influences them in negative ways.

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Keywords: body image, adolescent(s), social media, body dissatisfaction, positive body image, coping strategies

Citation: Mahon C and Hevey D (2021) Processing Body Image on Social Media: Gender Differences in Adolescent Boys’ and Girls’ Agency and Active Coping. Front. Psychol . 12:626763. doi: 10.3389/fpsyg.2021.626763

Received: 06 November 2020; Accepted: 19 April 2021; Published: 21 May 2021.

Reviewed by:

Copyright © 2021 Mahon and Hevey. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Ciara Mahon, [email protected]

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Body Image Dissatisfaction in Young Adults: Impact of Social Media Use

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Body Image Distress and Its Associations From an International Sample of Men and Women Across the Adult Life Span: Web-Based Survey Study

Alyssa milton.

1 Brain and Mind Centre, The University of Sydney, Sydney, Australia

2 Sydney School of Medicine, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia

Ashlea Hambleton

3 Project Synergy, InnoWell Pty Ltd, Sydney, Australia

4 Inside Out Institute for Eating Disorders, Charles Perkins Centre, University of Sydney, Sydney, Australia

Anna Roberts

Tracey davenport.

5 The Movember Foundation, Australia, East Melbourne, Australia

Associated Data

Frequency statistics, chi-square, and analysis of variance comparing body image items by age and sex.

Linear regression of body image distress by age group.

Pearson correlations of body image items with health and well-being measures for each age group.

Previous research on body image distress mainly relied on samples that were small, generally homogeneous in age or sex, often limited to one geographical region, and were characterized by a lack of comprehensive analysis of multiple psychosocial domains. The research presented in this paper extends the international literature using the results of the web-based Global Health and Wellbeing Survey 2015. The survey included a large sample of both men and women aged ≥16 years from Australia, Canada, New Zealand, the United Kingdom, or the United States.

The main objectives of this study are to examine body image distress across the adult life span (≥16 years) and sex and assess the association between body image distress and various psychosocial risk and protective factors.

Data were extracted from the Global Health and Wellbeing Survey 2015, a web-based international self-report survey with 10,765 respondents, and compared with previous web-based surveys conducted in 2009 and 2012.

The body image distress of young Australians (aged 16-25 years) significantly rose by 33% from 2009 to 2015. In 2015, 75.19% (961/1278) of 16- to 25-year-old adults reported body image distress worldwide, and a decline in body image distress was noted with increasing age. More women reported higher levels of body image distress than men (1953/3338, 58.51% vs 853/2175, 39.22%). Sex, age, current dieting status, perception of weight, psychological distress, alcohol and other substance misuse, and well-being significantly explained 24% of the variance in body image distress in a linear regression ( F 15,4966 =105.8; P <.001).

Conclusions

This study demonstrates the significant interplay between body image distress and psychosocial factors across age and sex.

Introduction

There is a clear need to understand and address body image distress, particularly when considering the increasing prevalence rates of body image distress worldwide [ 1 - 3 ] and the noted relationship between body image distress and mental ill-health [ 4 ]. Furthermore, there is scant large-scale international research examining body image across the adult life span [ 4 ] and from the perspectives of both men and women [ 5 ].

Body image is a multifaceted construct encompassing one’s body-related self-perceptions and self-attitudes, including thoughts, feelings, behaviors, and beliefs toward the body [ 6 ]. Research suggests that body image dissatisfaction occurs when there is a discrepancy between how an individual views their body ( actual body image ) and how they want it to be ( ideal body image ) [ 7 , 8 ]. Dissatisfaction, overevaluation, and preoccupation are considered as contributing factors to body image distress [ 9 ]. Current body ideals predominantly promote thinness for women and muscularity for men [ 10 , 11 ]. Given the difference between current body ideals and the actual body shape and size of most of the population, it is not surprising that many people view their bodies negatively and experience distress because of this negative self-perception [ 12 ].

Body Image Distress Over Time

Body image is ranked as a top concern for young people [ 13 ]. Research suggests that the proportion of the population experiencing increased body image distress is increasing. It has been well documented that viewing appearance-focused media contributes to the development of body image concerns [ 14 , 15 ]. In the past 10 years, there has been a stark rise in multimedia platforms, such as Instagram, Snapchat, and TikTok. The imagery on social media is often filtered and edited in a way that promotes an unrealistic appearance ideal. Research has shown that social media use is associated with increased body image dissatisfaction [ 14 ] because it facilitates comparison, and appearance-related comments and praise are reinforced with likes, follows, and comments.

Body Image, Age, and Sex

The association between weight status (as measured by BMI) and body image dissatisfaction has been previously explored [ 16 ]. Research has demonstrated that increased BMI is associated with greater body image dissatisfaction in college students [ 17 ], help-seeking adults [ 18 ], adolescent men [ 19 ], and nonclinical samples of adult women [ 20 ]. Risk of body dissatisfaction is not restricted to individuals with higher BMI; adolescent women with either a healthy or an overweight BMI experience higher levels of body dissatisfaction, whereas underweight women have the highest levels of body satisfaction [ 19 ]. Similarly, in a sample of middle-aged women, 70% of participants reported a desire to be thinner, despite most being considered normal weight [ 21 ]. Overall, these findings fit the current cultural narrative that a thin body is both desirable and idealized in Western societies [ 22 ].

Although the research has mainly focused on young women, some studies indicate that body image concerns are pervasive across the adult life span [ 12 ] for both sexes [ 5 ]. The picture appears to be more complex for men [ 23 ]. For example, adolescent men tend to be equally divided between wanting to lose weight (predominantly high body fat) and gain weight (muscle mass) [ 5 , 24 ]. As men move into adulthood, there is an increase in the desire to lose weight [ 5 ]. Within cohorts of middle-aged women, only 11% of participants endorsed being satisfied with their bodies [ 25 ]. Women’s dissatisfaction with their bodies appears relatively stable across the adult life span [ 8 , 12 ]. However, some research suggests that the impact of body image on an individual’s self-esteem and self-concept may diminish over time [ 26 ]. Furthermore, there is more tolerance in what body sizes are considered acceptable with increasing age [ 4 , 27 ]. However, overall, body image research looking at age, sex, and weight is fragmented, and a comprehensive picture is lacking.

Body Image Distress and Psychopathology

Body image dissatisfaction in childhood and early adolescence can predict adverse health outcomes in later life, including engaging in dangerous weight control behaviors and general psychological distress [ 28 ]. As highlighted above, research with adolescents is much more extensive than with their adult counterparts, with several studies demonstrating an association between body dissatisfaction and anxiety [ 29 - 33 ], depression [ 29 , 30 , 34 - 37 ], self-harm [ 38 - 42 ], and low self-esteem [ 28 , 36 , 37 ].

Research has reported that body image dissatisfaction is associated with higher levels of depression, anxiety, disordered eating [ 43 - 45 ], and distress [ 46 ]. Furthermore, research has identified associations between body image with other aspects of health, such as tobacco smoking [ 47 ], alcohol misuse [ 48 ], poor self-esteem [ 18 , 49 , 50 ], and poor mental and physical health–related quality of life [ 46 ].

Conversely, optimism, positive affect, self-compassion, life satisfaction, and subjective happiness [ 51 - 61 ] are associated with positive body image. Social well-being has also been reported to play a part in both positive and negative body image, particularly in adolescents [ 59 , 62 - 64 ]. For example, Bearman et al [ 63 ] observed higher levels of body dissatisfaction in girls and boys who had deficits in their social support from parents and peers. Meanwhile, individuals with more supportive parental relationships have reported higher body image satisfaction [ 62 ].

Current Research

Previous research exploring body image distress mainly relied on small samples that were generally homogeneous in age or sex, lacked a comprehensive analysis of multiple psychosocial domains, and were limited to one geographical region. This study extends the international literature using the results of the Global Health and Wellbeing Survey 2015, a large web-based sample of both men and women (aged ≥16 years) from Australia, Canada, New Zealand, the United Kingdom, or the United States. Additional data sources included the headspace web-based Community Youth Survey (2009) and the Young and Well First National Survey on the web (2012).

This study has 3 main aims, including the assessment of (1) the changes in body image distress over time (between 2009 and 2015) for young people aged 16 to 25 years; (2) the associations between weight range (BMI), dieting status, and perceived body image distress by sex and age group; and (3) the association of various demographic, health, and well-being factors with body image distress or preoccupation.

Participants

Participants were a voluntary community sample of men and women (aged ≥16 years) who reported that they had lived in 1 of the 5 target countries (Australia, Canada, New Zealand, the United Kingdom, or the United States) for the best part of the past 12 months. A total of 16,510 people reviewed the consent and eligibility screen. Of the 16,510 people, the total eligible sample was 10,765 (65.2%) respondents. Of those excluded, 26.2% (4326/16,510) did not consent to participate, and 4.3% (710/16,510) were younger than 16 years.

Procedures and Recruitment

The primary study received institutional ethics approval from The University of Sydney Human Research Ethics Committee (protocol 2015/412). All procedures complied with the ethical standards of the relevant national and institutional committees on human ethics and the Helsinki Declaration of 1975, as revised in 2008.

The survey was hosted on the internet from July 1, 2015, to December 11, 2015. For optimizing recruitment in the 5 target countries, the following strategies were used: both paid and free advertising across multiple social media channels such as Facebook, Twitter, and YouTube for survey dissemination [ 65 ]; layering of recruitment messages [ 66 ]; passive web-based snowballing via social media to spread study information through sharing, liking, and tweeting [ 65 , 67 ]; and traditional snowballing [ 68 ]. Targeted recruitment based on age, sex, and region was carried out through paid advertising channels to maximize responses from groups hard to reach. Respondents consented on the website and were informed that their responses were confidential, nonidentifiable, and that they could cease participation at any time. Participants were informed that the survey would take between 20 and 45 minutes to complete depending on participant answers and the survey skip pattern. Any respondents indicating psychological distress or problematic alcohol or substance use in their responses were provided with the contact details of local support lines.

Items in this substudy were extracted from the Global Health and Wellbeing Survey 2015 [ 69 ], and where items could be compared, from the headspace web-based Community Youth Survey (2009) and the Young and Well First National Survey on the web (2012) . Areas of interest specific to this substudy are described in the following sections.

Demographics

The respondents first provided their sex (men and women) and age (16-25 years, 26-49 years, or ≥50 years).

Weight, Body Image, and Eating Behaviors

BMI was determined by asking respondents their weight (kg or lb) and height (meters or feet and inches). Respondents with a BMI less than 18.5 were classified as underweight , a BMI between 18.5 and 24.9 as healthy weight , a BMI between 25.0 and 29.9 as overweight , and a BMI higher than 30.0 as obese .

Current dieting status was determined by the question “Are you currently dieting?” adapted from Blashill and Wilhelm [ 70 ]; this item provided 3 response options (“yes, to lose weight”; “yes, to gain weight”; and “no”).

For assessing body image attitudes, respondents were asked to self-evaluate the importance of weight and shape for them over the past 3 months: “How much has your shape influenced how you feel as a person?” This question was answered on a 6-point Likert scale ranging from not at all to a great deal .

For assessing body image distress or preoccupation, respondents were asked, “Do you get very distressed or preoccupied by any specific aspect of your physical appearance?” using a dichotomous yes or no response option. If respondents indicated distress or preoccupation, a follow-up question asked which areas of their body they were concerned about, such as facial features , arms or legs , and weight [ 71 ]. This body image distress item was also asked in the web-based headspace Community Youth Survey in 2009 and the Young and Well National Survey on the web in 2012 with 16- to 25-year-old adults [ 71 ]. These data were used in this research for longitudinal cohort comparisons.

Mental Health and Well-being

Physical activity was measured by the International Physical Activity Questionnaire short form, which classifies individuals into 1 of 3 levels of physical activity ( inactive vs minimally active vs health-enhancing physical activity ) [ 72 ].

Current psychological distress was measured using the 10-item Kessler Psychological Distress Scale (K10) [ 73 ]. Total scores were grouped into 4 levels of psychological distress (10-15=low, 16-21=moderate, 22-29=high, and 30-50=very high) [ 74 ].

Respondents’ levels of suicidal thoughts and behaviors in the past 12 months were measured using the 5-item suicidal thoughts and acts subscale from the Psychiatric Symptom Frequency Scale [ 75 ].

The likelihood of alcohol or other substance misuse was calculated using 2 items. If respondents positively endorsed one of either item, “...recently thought that you should cut down...” or “...another person suggested you should cut down...,” they were categorized as having a possible alcohol or other substance misuse. Endorsement of both items resulted in probable alcohol or other substance misuse. Endorsement of neither item resulted in being placed in the not likely category.

Days out of role was extracted from the Brief Disability Questionnaire [ 76 ] to investigate functioning. The 7-item Personal Well-being Index [ 77 ] was used to assess subjective well-being.

Happiness was measured by the 4-item Oxford Happiness Questionnaire [ 78 ], and resilience was measured by the 4-item Brief Resilience Coping Scale [ 79 ].

Perceived social support and conflict in close relationships were measured by the 5-item Schuster Social Support and Conflict Scale [ 80 ].

Survey data were prepared and analyzed using IBM SPSS Statistics for Windows, Version 22.0 (IBM Corp, 2013). For addressing aim 1, body image distress data in 2009 and 2012 were compared with 2015 data using a one-sample two-tailed t test. To address aim 2, descriptive and frequency statistics were used to describe all weight, dieting, and body image items by basic demographics (sex and age). Chi-square and analysis of variance tests were completed to compare items by sex and age. For addressing aim 3, an initial scoping analysis using Pearson product-moment r correlations [ 81 ] was conducted to independently assess the strength of the relationship between body image distress and these health and well-being items (healthy weight; no vs yes based on BMI data), current dieting status ( no vs yes ), perception of weight ( about the right weight vs all others ), physical activity (International Physical Activity Questionnaire short form), psychological distress (K10), suicidal ideation (Psychiatric Symptom Frequency Scale), alcohol and/or other substance misuse, days out of role, well-being (Personal Well-being Index), happiness (Oxford Happiness Questionnaire), resilience (Brief Resilience Coping Scale), intimate bonds (Intimate Bond Measure), and social support (Social Support and Conflict Scale). A subsequent linear regression analysis was conducted to determine which of the health and well-being items significantly explained variance in body image distress when considered together while controlling for sex and age.

Respondent Participation Rates and Characteristics

Most of the eligible respondents were women (6464/10,765, 60.05%). Of the 10,753 respondents, 2874 (26.73%) were aged between 16 and 25 years, 2879 (26.77%) were aged between 26 and 49 years, and 5000 (46.49%) were aged ≥50 years. A breakdown of demographics by country, age, and sex is presented in Table 1 . Further demographic details can be found in related publications [ 82 , 83 ].

Participant demographics by country, age, and sex (N=10,765).

Characteristics			Total		Australia		Canada		New Zealand		United Kingdom		United States
Country, n (%)			10,765 (100)		3349 (31.11)		1888 (17.54)		1752 (16.27)		1938 (18)		1838 (17.07)

	Women	6464 (60.05)		2067 (61.72)		1097 (58.1)		1055 (60.22)		1176 (60.68)		1069 (58.16)
	Men	4301 (39.95)		1282 (38.28)		791 (41.89)		697 (39.78)		762 (39.32)		769 (41.84)
Age (years), mean (SD)			44.37 (19.68)		42.44 (18.71)		52.46 (17.84)		39.65 (19.51)		42.57 (19.40)		45.97 (21.07)

Main Findings

Aim 1: changes in body image distress over time across the life span.

Of those young Australians (aged 16-25 years) who completed the 2009 ( headspace web-based Community Youth Survey), 2012 (Young and Well First National Survey on the web), or 2015 (Global Health and Wellbeing Survey) surveys, self-reported body image distress rose by 33% from 2009 to 2015 (419/949, 44.2% reported distress in 2009; 1158/1731, 66.89% in 2012; and 300/388, 77.32% in 2015). The mean difference was significant across both the 2009 and 2012 time points (2009 vs 2015: t 387 =15.56, P <.001; 2012 vs 2015: t 387 =4.90, P <.001).

Aim 2: Body Image, BMI, and Dieting by Age and Sex

Table 2 displays frequency statistics for measures of body image items, BMI, and current dieting status by age band and sex from the Global Health and Wellbeing Survey 2015. Significance tests comparing items across sex and age are presented in Multimedia Appendix 1 . Approximately half of all respondents (2806/5513, 50.89%) reported feeling very distressed or preoccupied with their body image. Women reported higher levels of distress related to body image than men (1953/3338, 58.51% vs 853/2175, 39.22%). Respondents aged 16-25 years showed higher levels of body image distress than all other age groups, at 75.19% (961/1278), with distress decreasing as age increased.

Frequency statistics for measures of body image item by age and sex (maximum N=5517).

Body image item		Sex			Age bands (years)				Full sample
		Men	Women	16-25		26-49	≥50
		2175 (39.45)	3338 (60.55)	1278 (23.18)		1502 (27.24)	2733 (49.57)	5513 (100)
	Yes	853 (39.22)	1953 (58.51)	961 (75.19)		837 (55.73)	1008 (36.88)	2806 (50.89)
	No	1322 (60.78)	1385 (41.49)	317 (24.8)		665 (44.27)	1725 (63.12)	2707 (49.1)
		2169 (39.47)	3327 (60.53)	1275 (23.19)		1497 (27.24)	2724 (49.56)	5496 (100)
	1=not at all, n (%)	510 (23.51)	425 (12.77)	130 (10.17)		181 (12.09)	624 (22.91)	935 (17.01)
	6=a great deal, n (%)	256 (11.8)	771 (23.17)	330 (25.88)		321 (21.44)	376 (13.8)	1027 (18.69)
	Score, median (IQR)	3 (2-4)	4 (2-5)	4 (3-6)		4 (2-5)	3 (2-5)	4 (2-5)
		2115 (39.32)	3264 (60.68)	1248 (23.2)		1464 (27.22)	2667 (49.58)	5379 (100)
	Underweight	30 (1.42)	141 (4.32)	97 (7.77)		39 (2.67)	35 (1.31)	171 (3.18)
	Healthy weight	671 (31.73)	1344 (41.19)	721 (57.77)		580 (39.64)	714 (26.77)	2015 (37.47)
	Overweight	791 (37.39)	836 (25.62)	232 (18.59)		438 (29.94)	957 (35.88)	1627 (30.25)
	Obese	623 (29.46)	842 (28.87)	198 (15.87)		406 (27.75)	961 (36.03)	1565 (29.09)
		2176 (39.46)	3339 (60.54)	1279 (23.19)		1503 (27.25)	2733 (49.56)	5515 (100)
	Very underweight	25 (1.15)	19 (0.56)	16 (1.25)		9 (0.59)	19 (0.69)	44 (0.79)
	Slightly underweight	154 (7.08)	143 (4.28)	129 (10.09)		74 (4.92)	94 (3.44)	297 (5.39)
	About the right weight	646 (29.69)	1057 (31.66)	574 (44.88)		522 (34.73)	607 (22.21)	1703 (30.88)
	Slightly overweight	1000 (45.96)	1348 (40.37)	429 (33.54)		624 (41.52)	1295 (47.38)	2348 (42.57)
	Very overweight	351 (16.13)	772 (23.12)	131 (10.24)		274 (18.23)	718 (26.27)	1123 (20.36)
		2178 (39.48)	3339 (60.52)	1278 (23.16)		1503 (27.24)	2736 (49.59)	5517 (100)
	Yes, to lose weight	427 (19.61)	868 (25.99)	268 (20.97)		374 (24.88)	653 (23.87)	1295 (23.47)
	Yes, to gain weight	49 (2.25)	27 (0.81)	38 (2.97)		17 (1.13)	21 (0.77)	76 (1.38)
	No	1702 (78.15)	2444 (73.20)	972 (76.06)		1112 (73.99)	2062 (75.37)	4146 (75.15)

Only 17.01% (935/5496) of respondents in the full sample indicated that their weight and shape did not influence how they thought of themselves as a person. Women (425/3327, 12.77%) and the younger age bands (16-25 years: 130/1275, 10.19%; 25-44 years: 181/1497, 12.09%) were significantly less likely to endorse that their weight or shape did not influence their self-perception ( P <.001).

Although 57.77% (721/1248) of young people (16-25 years) were in the healthy BMI range, fewer (574/1279, 44.88%) considered themselves about the right weight. This pattern was repeated in women, of whom 41.19% (1344/3264) were in the healthy BMI range, but fewer (1057/3339, 31.66%) endorsed that they were about the right weight. The percentage of men who were in a healthy BMI range was 31.73% (671/2115), which reflected the rates of men who felt they were about the right weight (646/2176, 29.69%). In the older age brackets, more participants were in the obese BMI category (26-49 years: 406/1464, 27.75%; ≥50 years: 961/2667, 36.03%) than those who felt that they were very overweight (26-49 years: 274/1503, 18.23%; ≥50 years: 718/2733, 26.27%). Across the full sample, 23.47% (1295/5517) of all participants were currently dieting to lose weight, and 1.38% (76/5517) were currently dieting to gain weight. Across ages, not engaging in any dieting was relatively consistent (between 1112/1503, 73.99% and 972/1278, 76.06%). Women reported they were dieting to lose weight significantly more frequently (868/3339, 25.99%) than men (427/2178, 19.61%; P <.001).

For addressing aim 3, a series of linear regressions were conducted to examine the relationship between body image distress or preoccupation and health and well-being items. Table 3 presents the full sample results ( Multimedia Appendix 2 for each age group). Individual Pearson product-moment r correlations for each health and well-being item by body image distress are presented in Multimedia Appendix 3 . The regression model using the full sample significantly accounted for 24% of the variance in body image distress or preoccupation ( F 15,4966 =105.8; P <.001; R 2 adj =0.24). After controlling for sex (β=.12; P <.001) and age (β=−0.24; P <.001), 5 variables significantly explained model variance. This included current dieting status (β=.13; P <.001), perception of weight (β=.09; P <.001), psychological distress (β=.21; P <.001), alcohol and/or other substance misuse (β=.04; P <.001), and well-being (β=−0.07; P <.001). Specifically, respondents who were currently dieting reported body image distress or preoccupation more frequently. Those who did not report that they were about the right weight reported higher psychological distress and had a higher likelihood of problematic alcohol or other substance use and higher body image distress or preoccupation. Participants with higher personal well-being scores reported lower levels of body image distress or preoccupation.

Linear regression of body image distress ( F 15,4966 =105.8; P <.001; R 2 adj =0.24).

Variable		( )	value	β (95% CI)

	Healthy weight (no vs yes based on BMI)	0.04	.97	.00 (−0.03 to 0.03)
	Current dieting (no vs yes)	10.20	<.001	.13 (0.12 to 0.18)
	Perception of weight (about the right weight vs not)	6.06	<.001	.09 (0.07 to 0.13)
	Physical activity (IPAQ )	−0.03	.97	.00 (−0.02 to 0.02)
	Psychological distress (K10 )	9.45	<.001	.21 (0.01 to 0.01)
	Suicidal ideation (PSFS )	0.38	.71	.01 (−0.03 to 0.04)
	Alcohol and/or other substance misuse	2.82	<.001	.04 (0.01 to 0.04)
	Days out of role	−1.42	.16	−0.02 (−0.01 to 0.00)
	Well-being (PWI )	−3.37	<.001	−0.07 (0.00 to 0.00)
	Happiness (OHQ )	−0.40	.69	−0.01 (−0.01 to 0.00)
	Resilience (BRCS )	0.84	.40	.01 (0.00 to 0.01)
	Social support (SSCS )	−1.39	.16	−0.02 (−0.01 to 0.00)
	Intimate bonds (IBM )	−0.57	.57	−0.01 (0.00 to 0.00)
	Sex	9.46	<.001	.12 (0.10 to 0.15)
	Age	−16.57	<.001	−0.24 (−0.01 to −0.01)

a df =15,4966

b IPAQ: International Physical Activity Questionnaire short form.

c K10: 10-item Kessler Psychological Distress Scale.

d PSFS: Psychiatric Symptom Frequency Scale.

e PWI: Personal Well-being Index.

f OHQ: Oxford Happiness Questionnaire.

g BRCS: Brief Resilience Coping Scale.

h SSCS: Schuster Social Support and Conflict Scale.

i IBM: Intimate Bond Measure.

When analyzed separately by age group ( Multimedia Appendix 2 ), sex, current dieting status, perception of weight, and psychological distress consistently explained model variance across all age groups. Variation was found for happiness, alcohol or other substance misuse, and well-being items. Specifically, lower happiness also explained body image distress (β=−0.16; P =.003) in young people (aged 16-25 years). For those aged 26 to 49 years, alcohol and/or other substance misuse remained an item that explained body image distress (β=.07; P =.008). Conversely, for the ≥50 years age group, lower well-being continued to explain body image distress (β=−0.10; P =.001) variance.

Principal Findings

To our knowledge, this is the largest international study to examine body image distress—and other related factors, including self-reported and perceived weight range and dieting status—across time, age, and sex. Our findings show that body image distress has become a highly prevalent issue by 2015. Of concern, considerable levels of body image distress were present in women and young people, and multiple psychosocial risk factors were associated with this distress.

One of our key findings comes from the cross-sectional longitudinal Australian data. Self-reported body image distress in young people aged 16 to 25 years increased from 44.2% (414/949) of those surveyed in 2009 to three-quarters (961/1278, 75.19%) in 2015. This finding is consistent with the increasing prevalence rates of body image distress in countries such as the United States [ 1 ]. Furthermore, although there are some suggestions in the literature that concern regarding body image has increased in Australia [ 84 - 86 ], this is the first known study to report changes across these 3 time points using web-based samples. Our data indicate that the issue is much more prevalent. This increasing prevalence of body image distress corresponds with the rise of social media. During the time frame of the survey, Instagram was launched in 2010, Snapchat was released in 2011, and TikTok was released in 2016. As photographs and videos are central to the use of these platforms, and previous research has shown an association between body image distress and social media use, perhaps this increased level of distress has occurred in parallel with the rise of social media [ 14 , 15 ].

This rise in prevalence is particularly concerning, given our findings that body image distress was associated with increased levels of current dieting, poorer self-perception of weight , higher psychological distress, increased alcohol or other substance misuse, and poorer personal well-being. This is consistent with previous research where higher body image dissatisfaction directly correlated with poor mental health–related quality of life and psychosocial functioning [ 17 ]. Furthermore, literature examining body appreciation has reported associations with greater subjective happiness [ 56 ] and fewer days of feeling mentally or physically unhealthy [ 87 ]. It is unclear whether these factors are precipitating factors or consequences of body image distress. As 24% of the variability in body image distress was accounted for by these factors, future research could endeavor to explore what other factors are potentially missing from this model that also contribute to distress, such as social media use or history of disordered eating. Overall, when considering the rise of body image distress and its link to poorer psychosocial outcomes, a sharper focus on this area is needed.

Another important finding was that in our 2015 international sample, more than half of the participants’ BMI in the overweight or obese range (59.34%), with men reporting higher levels of obesity than women. This in itself is concerning, as obesity is considered one of the greatest health epidemics worldwide [ 88 - 91 ]. Furthermore, our findings demonstrated a notable sex difference concerning how men and women perceive their weight compared with their self-reported weight as measured by BMI. Specifically, despite a higher percentage of men having an overweight or obese BMI, more women (772/3339, 23.12%) considered themselves to be very overweight than men (351/2176, 16.13%). Although more women in this sample were in a healthy weight range (women: 1344/3264, 41.19%; men: 671/2115, 31.73%), only one-third of women believed they were about the right weight . This is consistent with data from previous studies demonstrating that women are more likely to perceive themselves as overweight compared with men [ 35 , 92 - 95 ]. In the literature, possible factors that may contribute to this discrepancy include self-esteem [ 96 ], sociocultural influences, and expectations [ 97 - 99 ].

Interventions in this area are relatively unexplored, particularly those targeting both men and women. Evidence-based interventions include self-monitoring, cognitive restructuring, exposure exercises, fitness training, mirror work [ 100 ], media literacy, self-esteem enhancement, and psychoeducation. However, these interventions only achieve minor improvements in body image [ 101 , 102 ]. Interventions with a greater focus on stress management training, cognitions, and negative body image causes appear to be more effective [ 101 ]. There is some evidence that self-compassion training can be beneficial for weight loss, nutrition behaviors, eating behaviors, and body image [ 103 ]. This training focuses on promoting self-worth, creating a more positive body image, and decreasing body dissatisfaction, and may be the way forward to improve health outcomes in distressed individuals.

These discrepancies between actual and perceived weight were not only a function of sex but also of age. Our 2015 survey results indicated that 57.77% of young people were in the healthy BMI weight range—the highest endorsement across all age groups. Despite this, three-quarters of young people reported body image distress. Again, this was the highest endorsement across all age groups. As participants aged, their BMI increased—with far more in the overweight and obese categories. However, the rate of body image distress declined as participants aged, as did the influence of weight or shape on how they viewed themselves as a person. Previous literature supports this phenomenon [ 104 - 107 ]. This change could be attributed to a shift in body comparisons with age-appropriate peers [ 8 ], less cultural fat phobia [ 105 - 107 ], or a focus on body function rather than body appearance [ 108 ].

Furthermore, research has theorized that people’s preoccupation and desire to change their body weight via dieting behavior becomes less salient with age [ 26 ]. Interestingly, our survey results demonstrated that approximately three-quarters of people reported they were not dieting, and this proportion remained relatively stable across each age group. Thus, although body image distress decreases with age, in line with the Webster and Tiggemann study [ 26 ], our contradictory finding is that dieting behaviors remain relatively consistent. Further research is needed to examine whether this is explained by the changes in people’s reasons for dieting as they age. For example, older people might be dieting for health or medical reasons rather than because of their body image concerns.

Implications for Policy and Practice

This study supports the clear link between body image distress and poorer health and well-being [ 28 ]. Prevalence rates of body image dissatisfaction have increased worldwide in the past 30 years [ 109 ]. Our research shows that this prevalence is 3 in 4 young people when using a web-based survey methodology. These are compelling statistics. In 2019, the Australian government invested US $146 million into the prevention, detection, assessment, and treatment of eating disorders [ 110 ]. Although this is timely, our findings on the inverse relationship between individual distress and psychosocial outcomes make a strong case for the need for prevention and early intervention before eating disorders emerge. This may include more comprehensive assessment when accessing health services and the use of health information technologies to improve support services [ 111 ]. Given our findings, such interventions may benefit from targeting across sex and age.

Previously, body image distress was thought to result from the discrepancy between actual and perceived body image. However, our results suggest that the rates of body image distress within some age groups far exceed the proportion of the population who experience a discrepancy, indicative of other factors contributing to distress. For example, research is needed to determine whether these results are related to the considerable increases in the use and availability of social media in the past decade [ 14 ]. Exposure to social media, particularly in an individual’s formative years, could have a considerable impact on a young person’s sense of self, quality of life, and body image than is currently known. Some studies have demonstrated that the use of highly visual social media such as Instagram or Snapchat is linked to upward social comparison and internalization of symptoms of body dysmorphia, resulting in increased body image distress [ 112 - 115 ]. The more time spent on social media, the more significant the body image concerns [ 116 - 118 ]. Photograph-based activity (eg, posting photographs and viewing or making comments on others’ photographs) is particularly salient in contributing to body dissatisfaction and disordered eating [ 14 ]. As the data in this study were from a web-based sample recruited using social media channels, the results may reflect the experience of body image distress of a web-based population, who may be more likely to be using other platforms such as Instagram.

Body image distress and dieting behaviors are well understood to be risk factors for disordered eating and the development of an eating disorder. Our results indicate a relationship between dieting behavior, psychological distress, and the self-perception of weight, in addition to alcohol and/or other substance use and well-being impact on body image distress. The triangulation of items such as those used in this survey (BMI vs distress vs dieting status, or BMI vs distress vs perceptions of weight) may be beneficial as a brief screening tool. Given the burden of completing lengthy psychometrics, how these brief screeners compare with lengthier eating disorder questionnaires should be explored.

Strengths and Limitations

A key strength of this study is that it is one of the largest samples to date, providing data on weight, perceptions of weight, dieting status, body image distress, and health and well-being. As outlined in the main report’s executive summary [ 69 ], a key limitation of the research is the nonepidemiological nature of the web-based research; targeting efforts were made for age, sex, and by country to address this. Although most individuals in the participating countries have widespread internet access [ 119 ], this study will also yield some level of internet bias, in that those who do not frequently access the internet or social media recruitment websites may not have participated. However, a major advantage to using a web-based surveying methodology is that previous research has found that it is associated with increased disclosure of sensitive information [ 120 ], such as the items asked in this survey. There is also the possibility of avidity bias occurring, as those with a greater interest in the subject may be more likely to participate [ 121 ]. However, overall, this research remains highly relevant, as it is the interactions between variables, not merely the statistical frequencies, that generate meaningful information. Furthermore, as we move further into the 21st century, web-based questionnaires may become more the norm than the exception.

Where possible, measures that have been tested for reliability and validity across general populations worldwide were used. For example, the K10 is the standard tool used to measure distress in Australia’s National Survey of Mental Health and Wellbeing (Burgess et al [ 122 ]) and is used widely in international studies. The BMI [ 121 ] is the most recommended and widely used tool for classifying weight range in adults [ 123 ]. However, the use of BMI is limited and has several deficiencies as a measure of obesity [ 124 ]. BMI is not a reliable reflection of health status, does not accurately reflect changes that occur with age, cannot account for muscle mass, and is a poor indicator of body fat percentage [ 123 ].

Furthermore, the participants were asked to self-report their height and weight. Responses may have been subject to bias as BMI is often calculated with overestimated height and underestimated weight data [ 125 ]. Furthermore, owing to the breadth and sheer size of the Global Health and Wellbeing Survey 2015, validated measures for eating disorders such as Eating Disorder Inventory, third edition [ 126 ] and the Eating Attitudes Test [ 127 ] were not viable to use. Instead, we asked brief questions (all adapted from established literature) on areas such as dieting status, perceptions of weight, and body image distress. Overall, the results are still meaningful. Although they may not be fully representative of the populations with eating disorders, they demonstrate a clear link between body image distress and health and well-being concerns.

This research demonstrates the significant interplay between body image distress and psychosocial risk factors, including currently dieting, worse perceptions of weight, elevated psychological distress, increased alcohol or other substance misuse, and poorer personal well-being. Considering that an increasing number of young people are experiencing body image distress, body image should be closely monitored, given its association with poorer health outcomes. Further research into tailored intervention and prevention strategies for those experiencing any level of body image distress, obesity, eating disorders, and other health-related concerns is needed.

Acknowledgments

The Global Health and Wellbeing 2015 Survey was commissioned by the Movember Foundation and conducted by the University of Sydney’s Brain and Mind Centre and the Young and Well Cooperative Research Center (Young and Well Cooperative Research Centre: 2011-2016). The authors would like to acknowledge the respondents who consented to participate on the web in the Global Health and Wellbeing 2015 Survey; the international consortia for the Global Health and Wellbeing 2015 Survey, including Professor Sagar Parikh, Professor Richard Porter, Professor Jan Scott, and Dr Michael Rovito; the Movember Foundation (Australia) lead on the project Therese Fitzpatrick; and the Brain and Mind Centre team: Victoria Baldwin, Lisa Whittle, Django White, Laura Ospina Pinillos, Sarah Piper, Hannah Yee, and Frank Iorfino. The authors would also like to acknowledge the Young and Well CRC and headspace for the 2012 and 2009 data sets. The Movember Foundation commissioned this research. This project is also supported by philanthropic funding, for which donors are families affected by mental illness who wish to remain anonymous. This study was also funded by a National Health and Medical Research Council Australia Fellowship (No. 511921, awarded to IH).

Abbreviations

K10	10-item Kessler Psychological Distress Scale

Multimedia Appendix 1

Multimedia appendix 2, multimedia appendix 3.

Conflicts of Interest: IH was an inaugural Commissioner on Australia’s National Mental Health Commission (2012-18). He is the codirector of Health and Policy at the Brain and Mind Centre (University of Sydney, Australia). The Brain and Mind Centre operates early-intervention youth services at Camperdown under contract to headspace. IH has previously led community-based and pharmaceutical industry–supported (Wyeth, Eli Lilly, Servier, Pfizer, and AstraZeneca) projects focused on the identification and better management of anxiety and depression. He was a member of the Medical Advisory Panel for Medibank Private until October 2017, a board member of Psychosis Australia Trust, and a member of the Veterans Mental Health Clinical Reference group. He is the chief scientific advisor to and a 5% equity shareholder in InnoWell Pty Ltd. InnoWell was formed by the University of Sydney (45% equity) and PwC (Australia; 45% equity) to deliver the Aus $30 (US $22.2) million Australian government–funded Project Synergy (2017-20; a 3-year program for the transformation of mental health services) and lead transformation of mental health services internationally through the use of innovative technologies. JB is chair of the National Advisory Council for Open Arms, Veterans, and Families Counseling Service. She is a well-being and digital health consultant to Bupa, a member of the Veterans Mental Health Clinical Reference group, and a chief investigator and author of the Defense and Veterans Transition and Well-being Study. She is the founder of and an equity shareholder in InnoWell. She is a professor of Social Innovation and Chair of the Center for Mental Health at Swinburne University and an adjunct professor of Social Impact and Entrepreneurship at Royal Melbourne Institute of Technology. TD is now the director of Research & Insights at the Australian Digital Health Agency. The other authors have no conflicts of interest to disclose.

COMMENTS

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This study aimed to further understand body image among men by examining differences in body dissatisfaction and physical appearance-related comparisons with peers and celebrities, self-compassion, depressive and anxiety symptoms, and explore the relationship between male body image dissatisfaction, self-compassion, and depressive symptoms.
Social media and body image
An extensive body of research has documented detrimental effects on women's body image from exposure to idealized images displayed in traditional media formats such as fashion magazines and television, especially for women with already high levels of body concern (for meta-analyses, see Ferguson, 2013; Grabe et al., 2008; Groesz et al., 2002; Want, 2009).
A systematic review exploring body image programmes and interventions
Among children and young people, body image concerns have been described as a 'normative discontent' (Cash and Henry, 1995), with 66% of young people under 18 reporting negative or very negative feelings about their body image most of the time (Women and Equalities Committee, 2021).Whilst some research reports that body image concerns are more prevalent in female adolescents, compared to ...
Are Body Image Issues Affecting Our Adolescents? A Cross-sectional
Body image perception is still naive, and this research will try to understand these unexplored areas, where there is paucity of body image-related studies. Objectives: The objective of the study is to find out the proportion of girls dissatisfied about body image, and the association of various factors with body image dissatisfaction and to ...
Frontiers
Body image disturbance is associated with several mental disorders. Previous research on body image has focused mostly on women, largely neglecting body image in men. Moreover, only a small number of studies have conducted gender comparisons of body image over the lifespan and included participants aged 50 years and older.
(PDF) The Effects of Social Media on Body Image ...
The research ascertained interesting personal perspectives and experiences regarding body image, based on phenomenological one-on-one interviews with 13 active women participants between the ages ...
Does Body Image Affect Quality of Life?: A Population Based Study
Body image (BI) can be described as the assessment of both positive and negative emotion for one's own body parts and their characteristics by himself or herself. Current research has concentrated mostly on the status of negative BI as a risk factor for mental health problems rather than as a public health problem, thereby little is known about the effects of BI on quality of life. Thus, the ...
Social media and body image: Recent trends and future directions
Abstract. This review presents recent trends in social media and body image research, with a particular focus on different social media platforms, features unique to social media, and potentially positive content for body image. First, it was found that visual platforms (e.g. Instagram) were more dysfunctional for body image than more textual ...
Frontiers
Future research needs to identify ways of circumventing this stigma and encouraging boys to discuss body image and social media, because far less is known about adolescent boys' experiences of social media and body image vs. girls, despite the finding that body dissatisfaction is a prevalent and problematic issue among boys and one that is ...
Social Media Use and Body Image Disorders: Association between
2.3.3. Body Image. The questionnaire's third part evaluated body image perception, using the Eating Disorder Inventory-2 (EDI-2) scale, translated and adapted in French [30,31]. It is a self-rated questionnaire evaluating psychological characteristics and symptoms associated with ED, using 11 subscales.
Sociocultural influences on adolescent boys' body image and body change
This paper is focused on a range of different measures of the body image and body change strategies of adolescent boys, and the impact of messages from parents, peers and the media on these factors. The research focuses on perceived sociocultural messages. It also examines the impact of a number of different messages from these sources ...
(PDF) Body Image Dissatisfaction in Young Adults: Impact of Social
of users. Body dissatisfaction, negative perceptions towar ds one' s own body image, may originate from per ceived pressure to. curate an ideal appearance. Images promoting an unattainable body ...
Body image and self-esteem.
Body image and self-esteem have long been known to be linked and are salient issues for young people, particularly during adolescence and puberty. These issues affect people throughout the life span, from childhood to old age. Past research has focused predominantly on body image and self-esteem in children and adolescents. More recently, research in this area has begun to focus on older people.
PDF Social Media and Body Image Concerns: Current Research and Future
This paper provides an overview of research on social media and body image. Correlational studies consistently show that social media usage (particularly Facebook) is associated with body image concerns among young women and men, and longitudinal studies suggest that this association may strengthen over time. Furthermore, appearance comparisons ...
Body image as a global mental health concern
Introduction. Body image is a multidimensional construct encompassing the thoughts, feelings, and behaviors of an individual related to their own appearance (Cash, 2004).Body image is often conceptualized as including both an evaluative aspect (satisfaction or concern with appearance) and an evaluation of the centrality of body image to an individual's identity (Jarry et al., 2019).
PDF Thesis Examining the Influence of Social Media on Body Image
The purpose of this thesis is to examine the potential influence of social media sites such as. sites, in the support or encouragement of eating disorders,body dysmorphic diso. omen are easily influenced and pressured by social media. dmany other social influences to. ed eating and behaviors, offer tips, and connect individualsto others w.
Body Image Distress and Its Associations From an International Sample
Body image is a multifaceted construct encompassing one's body-related self-perceptions and self-attitudes, including thoughts, feelings, behaviors, and beliefs toward the body . Research suggests that body image dissatisfaction occurs when there is a discrepancy between how an individual views their body ( actual body image ) and how they ...

Does Body Image Affect Quality of Life?: A Population Based Study

Introduction

Materials and Methods

Data collection instruments

Statistical analysis

Ethical considerations

Specific Results on BI

Specific Results on QoL

Regression analysis results

Conclusions

Supporting Information

S2 File. Questionnaire.

Author Contributions

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Social media and body image: Recent trends and future directions

Conflict of interest statement

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ORIGINAL RESEARCH article

Introduction

Materials and Methods

Participants

Data Analysis

Theme 1: Behavioral Strategies Used to Manage Problematic Social Media Content

Active Selection of Positive Content

Active Selection of Alternative Platforms

Theme 2: Cognitive Strategies

Reframing Strategies

Limitations

Data Availability Statement

Ethics Statement

Author Contributions

Conflict of Interest

Acknowledgments

Body Image Dissatisfaction in Young Adults: Impact of Social Media Use

Body Image Distress and Its Associations From an International Sample of Men and Women Across the Adult Life Span: Web-Based Survey Study

Ashlea Hambleton

Anna Roberts

Associated Data

Conclusions

Introduction

Body Image Distress Over Time

Body Image, Age, and Sex

Body Image Distress and Psychopathology

Current Research

Participants

Procedures and Recruitment

Demographics

Weight, Body Image, and Eating Behaviors

Mental Health and Well-being

Respondent Participation Rates and Characteristics

Main Findings

Aim 2: Body Image, BMI, and Dieting by Age and Sex

Principal Findings

Implications for Policy and Practice

Strengths and Limitations

Acknowledgments

Abbreviations

Multimedia Appendix 1

COMMENTS