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body image

On this page you’ll find:

  • What is Body Image?

  • Body Image and Dieting

  • Dieting During Adolescence

  • Body Image and Mental Health

  • Cosmetic Surgery


What Is Body Image?

Body image refers to the way we perceive our own bodies and the way we assume other people perceive us. “Body image involves our perception, imagination, emotions, and physical sensations of and about our bodies. It’s not static, but ever-changing; sensitive to changes in mood, environment, and physical experience. It is not based on fact. It is psychological in nature, and much more influenced by self-esteem than by actual physical attractiveness as judged by others. It is not inborn, but learned. This learning occurs in the family and among peers, but these only reinforce what is learned and expected culturally.” [Lightstone, 1991]

Some facts about body image:

  • The average size of the idealized woman (as portrayed by models), has stabilized at 13-19% below healthy weight. [Garner et al., 1980]
  • The thin ideal is unachievable for most women and is likely to lead to feelings of self-devaluation, dysphoria (depression), and helplessness. [Rodin et al., 1984]
  • 89% of women in a study of 3,452 women wanted to lose weight. [Garner, 1997]
  • Constant dieting and the relentless pursuit of thinness has become a normative (thought to be normal) behavior among women in Western society. [Rodin et al., 1984]
  • Thinness has not only come to represent attractiveness, but also has come to symbolize success, self-control, and higher socioeconomic status. [Forehand, 2001]
  • The weight-loss industry brings in at least $55.4 billion in revenue per year. [Marketdata Enterprises 2007]
  • A disturbed body image is a significant component of eating disorders and plays an important role in the development and continuation of eating disorders. [Stice 2002]

Body Image and Dieting

When women and girls experience poor body image, they often turn to dieting as a solution. There are numerous studies that cite the psychological connection between poor body image and dieting, and some studies are being published that detail the physical effects of dieting. In order to understand dieting and weight loss, it is important to have a good grasp of the possible mindset or intentions around it as well as the types of behaviors involved.  For a summary of the effects of dieting on eating disorders, see the article “Does Dieting Increase the Risk for Obesity and Eating Disorders?” in the 2006 edition of the Journal of the American Dietetic Association.[Spear, 2006]

Dieting During Adolescence 

  • Dieting is a common practice among adolescents, especially girls.
  • In a survey of adolescents in grades 9 through 12 (approximately ages 14-18), more than 59% of females and 29% of males were trying to lose weight. Over 18% of girls and 8% of boys had gone without food for 24 hours or more to lose weight in the last 30 days. Of the girls, 11.3% had used diet pills and 8.4% had vomited or taken laxatives to lose weight. [Centers for Disease Control, 2004]
  • 56.2% of teenagers ate less food, fewer calories, or foods low in fat to lose weight or keep from gaining weight; 65.7% exercised to lose weight. [Centers for Disease Control, 2004]
  • Adolescent girls who engaged in extreme weight-loss behaviors (vomiting and using laxatives or diet pills) were significantly less likely to eat fruits and vegetables compared with non-dieters and dieters using more healthful approaches. [Centers for Disease Control, 2004]
  • Dieting may compromise healthy growth and cause nutrient deficiencies. Adolescent girls most often diet to improve their appearance, and although this behavior is widespread, teenagers continue to be more overweight than ever before. [Calderon et al., 2004]
  • Eating disorders are 18 times more likely to develop in adolescent girls who dieted at a severe level than in those who did not diet. [Patton et al., 1999]
  • In one study, an eating disorder was 5 times more likely to develop in teens who dieted at a moderate level than teenagers who did not diet. [Patton et al., 1999]
  • Two-thirds of new cases of eating disorders arise in female adolescents who have dieted moderately. Eating disorders are largely predicted by higher rates of early dieting. [Patton et al., 1999]
  • The fact that someone is dieting increases the risk that she or he will overeat or binge to counteract the effects of calorie deprivation. Dieting encourages a shift from a reliance on physiological reasons for eating (feelings of hunger) to psychological control over eating behaviors (a person’s feeling that he or she shouldn’t eat so much, for example). Lowered body satisfaction, appearance satisfaction, and pressure to be thin all increase with an increase in binge eating. [Stice et al., 2002]
  • Dieting is the most important predictor of new eating disorders. Differences in the incidence of eating disorders between sexes were largely accounted for by the high rates of early dieting in the female subjects.[Patton et al., 1999]

Body Image and Mental Health 

In February 2007, The American Psychological Association (APA) released a report, Report of the APA Task Force on the Sexualization of Girls, examining and summarizing the best psychological theory, research, and clinical experience addressing the sexualization of girls via the media and other cultural messages [APA, 2007]. This superb report connects the dots between girls’ psychological health, their behaviors, and media influences. You’ll find many references to those findings below.When women and girls feel bad about their bodies, they often feel bad about themselves. This outcome is what the field of eating-disorders treatment is trying to capture when pointing out the seriousness of poor body image. Yet weight-loss products focus on instilling feelings of body hatred in consumers. See the section on weight-loss marketing for detailed facts.

  • The thin ideal is unachievable for most women and is likely to lead to feelings of self-devaluation, dysphoria (depression), and helplessness. [Rodin et al., 1984]
  • Studies also show that self-objectification is associated with negative mental-health outcomes in adolescent girls. In early adolescence, girls who had a more objectified relationship with their bodies were more likely to experience depression and had lower self-esteem. [Ward, 2002]
  • Among African-American and white adolescent girls, self-objectification is a significant predictor of depression, body shame, and disordered eating, even when controlling for race, grade in school, and body-mass index.[Ward and Rivadeneyra, 1999]
  • One study exposed undergraduate women to 40 full-page photographs from CosmopolitanVogue, and Glamour magazines. Young women exposed to images of idealized models indicated more eating-disorder symptoms than women in the control group, as well as more negative mood states and lower self-esteem. [Zurbriggen and Morgan, 2006]

Attitudes

  • Girls and young women who more frequently consume or engage with mainstream media content also support the sexual stereotypes that paint women as sexual objects. [Ward, 2002;Ward and Rivadeneyra, 1999;Zurbriggen and Morgan, 2006]
  • Media exposure has been found to constrain young women’s conceptions of femininity by putting appearance and physical attractiveness at the center of women’s values.
  • Frequent viewing of reality TV programming among young women is associated with a stronger belief in the importance of appearance. [Tolman et al., 2006]
  • When they were asked to rate the importance of particular qualities for women, white and African-American high school students who consumed more mainstream media attributed greater importance to sexiness and beauty than did students who consumed less media. [Ward, 2004;Ward and Averitt, 2005]

Self-esteem

In psychology, self-esteem (also called self-worth, self-confidence, and self-respect) reflects a person’s overall self-appraisal of their worth. According to the Report of the APA Task Force on the Sexualization of Girls (2007), low self-esteem is associated with health-compromising behaviors in adolescence, such as substance use, early sexual activity, eating problems, and suicidal ideation. Surprisingly, there is little longitudinal research addressing this issue. Just at the time when girls begin to develop their identities, they are more likely to suffer losses in self-esteem.

  • In the eighth grade, girls who objectify their bodies more have much lower self-esteem. For this reason, diminishing self-esteem arising in early adolescence may make girls particularly vulnerable to cultural messages that promise them popularity, effectiveness, and social acceptance through the right “sexy” look. On the other hand, the drop in self-esteem may be a result of how responsive they are to these cultural messages. [McGeer and Williams, 2000]
  • In one study, white and African-American girls (ages 10 to 17 years) threw a softball as hard as they could against a distant gymnasium wall. The researchers found that the extent to which girls viewed their bodies as objects and were concerned about their bodies’ appearance predicted poorer motor performance on the softball throw. Self-objectification, it appears, limits the form and effectiveness of girls’ physical movements. [Van den Berg et al., 2007]
  • Perhaps the most insidious consequence of self-objectification is that it breaks down one’s thinking process. Ongoing attention to physical appearance leaves fewer resources available for other mental and physical activities.
  • While college students who were alone in a dressing room were asked to try on and evaluate either a swimsuit or a sweater. While they waited for 10 minutes wearing the garment, they completed a math test. The young women in swimsuits performed significantly worse on the math problems than did those wearing sweaters. No differences were found for young men. In other words, thinking about the body and comparing it to sexualized cultural ideals disrupted mental capacity in young women. [Fredrickson et. al., 1998]
    • This impairment also occurs among African-American, Latina, and Asian-American young women. [Hebl et al., 2004].
    • This impairment extends beyond mathematics to other cognitive domains, including logical reasoning and spatial skills. [Gapinski et al., 2003]
  • Low self-esteem is often associated with health-compromising behaviors in adolescence such as substance use, early sexual activity, eating problems, and thoughts that may lead to suicide. Surprisingly, there is little longitudinal research addressing this issue. [APA, 2007]
  • One longitudinal study examines the predictive association between self-esteem in young New Zealanders ages 9 to 13 years and a variety of health compromising behaviors at age 15. Low levels of self-esteem significantly predicted adolescent reports of problem eating, suicidal ideation, and multiple health-compromising behaviors. [McGeer and Williams, 2000]

Cosmetic Surgery 

  • General Facts Given that most images in everyday media are computer-manipulated to create completely unrealistic bodies, it is no wonder more and more people are turning to cosmetic surgery to get the body the media portrays. And since the images’ creation is artificial in the first place, it follows that no one can attain this body through natural—or healthy—means.This entire report (through the “Other Facts” section) was pulled from: Plastic Surgery Research.info, 2007:
    • Nearly 11.7 million cosmetic surgical and nonsurgical procedures were performed in the United States in 2007, according to statistics released today by the American Society for Aesthetic Plastic Surgery.
    • The Aesthetic Society, which has been collecting multi-specialty procedural statistics since 1997, says the overall number of cosmetic procedures has increased 457 percent since the collection of the statistics first began.
    • The most frequently performed procedure was Botox injections and the most popular surgical procedure was liposuction.
    • The number of surgical and nonsurgical procedures performed on men increased 17 percent between 2006 and 2007.
    • 22 percent of the aesthetic procedures were performed on racial and ethnic minorities. [Plastic Surgery Research.info, 2007]
  • Trends and Demographic Data
    • Top cosmetic procedures for WOMEN
      • Women had 91 percent of cosmetic procedures. The number of procedures (surgical and nonsurgical) performed on women was over 10.6 million, an increase of 1 percent from the previous year. Surgical procedures increased 9 percent; nonsurgical procedures decreased by less than 1 percent. Since 1997, surgical procedures increased 142 percent, while nonsurgical procedures have increased 743 percent.
    • Top cosmetic procedures for MEN
      • Men had 9 percent of cosmetic procedures. The number of procedures (surgical and nonsurgical) performed on men was just over 1 million, an increase of 17 percent from the previous year. Surgical procedures increased 5 percent; nonsurgical procedures increased 21 percent. Since 1997, surgical procedures have increased 3 percent while nonsurgical procedures have increased 886 percent.
    • Racial and Ethnic Distribution
      • Racial and ethnic minorities accounted for 22 percent of all cosmetic procedures in 2007. Hispanics again led minority racial and ethnic groups in the number of procedures: Hispanics, 9 percent; African-Americans, 6 percent; Asians, 5 percent; and other non-Caucasians, 2 percent.
    • Location and Fees
      • Almost fifty-four percent (54 percent) of cosmetic procedures in 2007 were performed in office-based facilities; 28 percent in freestanding surgicenters; and 17 percent in hospitals. Americans spent just over $13 billion on cosmetic procedures; $8.3 billion was for surgical procedures, and $4.7 billion was for nonsurgical procedures.
  • Quick Facts
    • There were nearly 11.7 million surgical and nonsurgical cosmetic procedures performed in the United States in 2007, as reported by the American Society for Aesthetic Plastic Surgery (ASAPS). Surgical procedures accounted for nearly 18% of the total, with nonsurgical procedures making up 82% of the total.
    • From 2006-2007, there was a 2 percent increase in the total number of cosmetic procedures. Surgical procedures increased by 8 percent, and nonsurgical procedures increased by 1 percent.
    • Since 1997, there has been a 457 percent increase in the total number of cosmetic procedures. Surgical procedures increased by 114 percent, and nonsurgical procedures increased by 754 percent.
    • The top five surgical cosmetic procedures in 2007 were: liposuction (456,828 procedures); breast augmentation (399,440 procedures); eyelid surgery (240,763 procedures); abdominoplasty (185,335 procedures); and breast reduction (153,087 procedures).
    • The top five nonsurgical cosmetic procedures in 2007 were: Botox injection (2,775,176 procedures); hyaluronic acid (1,448,716 procedures); laser hair removal (1,412,657 procedures); microdermabrasion (829,658 procedures); and IPL laser treatment (647,707 procedures).
    • Women had nearly 10.6 million cosmetic procedures, 91% percent of the total. The number of cosmetic procedures for women increased 1 percent from 2006.
    • The top five surgical procedures for women were: breast augmentation, liposuction, eyelid surgery, abdominoplasty and breast reduction.
    • Men had nearly 1.1 million cosmetic procedures, 9 percent of the total. The number of cosmetic procedures for men increased 17 percent from 2006.
    • The top five surgical procedures for men were: liposuction, eyelid surgery, rhinoplasty, breast reduction to treat enlarged male breasts, and hair transplantation.
    • People age 35-50 had the most procedures—5.4 million and 46 percent of the total. People age 19-34 had 21 percent of procedures; age 51-64 had 25 percent; age 65-and-over had 6 percent; and age 18-and-younger had less than 2 percent.
    • The most common procedures for age 18-and-under were: laser hair removal, microdermabrasion, chemical peel, otoplasty (ear reshaping) and rhinoplasty.
    • Traditional racial and ethnic minorities, as of last year, had approximately 21 percent of all cosmetic procedures, an decrease of 1 percent from 2006: Hispanics, 9 percent; African-Americans, 6 percent; Asians, 5 percent; and other non-Caucasians, 2 percent.
    • Where cosmetic surgeries were performed: office facility, 54 percent, hospital 17 percent; and free-standing surgicenter, 29 percent.
    • Of the doctors surveyed, 70 percent say they do not offer “spa” services (e.g. wraps, facials, massages) in conjunction with their medical practices. 86 percent of the doctors say they do not work in conjunction with medical spas where nonsurgical procedures, such as injections and laser procedures, are performed.
    • Americans spent just under $13.2 billion on cosmetic procedures last year.[Plastic Surgery Research.info, 2007]
  • Consumer Attitudes About Cosmetic Surgery Survey 2008
    • Americans’ general approval of cosmetic surgery
    • 56% of women say they approve of cosmetic surgery
    • 57% of men say they approve of cosmetic surgery
    • Would consider cosmetic surgery for self, now or in the future
      • 31% of women
      • 20% of men
    • Would not be embarrassed about having cosmetic surgery
      • 78% of women say that, if they had cosmetic surgery in the future, they would not be embarrassed if people outside their immediate family and close friends knew about it
      • 79% of men would not be embarrassed
    • Would consider cosmetic surgery for self, now or in the future, by age [includes both men and women]
      • 10% of Americans age 65 or older
      • 21% of 55-64 year olds
      • 27% of 45-54 year olds
      • 34% of 35-44 year olds
      • 34% of 25-34 year olds
      • 27% of 18-24 year olds
    • Would consider cosmetic surgery for self, now or in the future, by marital status [includes both men and women]
      • 26% of married Americans
      • 25% of unmarried Americans
    • Would consider cosmetic surgery for self, now or in the future, by race/ethnicity [includes both men and women]
      • 27% of white Americans
      • 24% of non-white Americans
    • Would consider cosmetic surgery for self, now or in the future, by child in household [includes both men and women]
      • 29% of Americans with child in household
      • 24% of Americans with no child in household

[Plastic Surgery Research.info, 2007]

  • Other Facts: Some practitioners have not completed the full five years of residency training required for certification by the American Board of Plastic Surgery, but they nevertheless (legally) perform procedures for which they might be inadequately trained, to augment their income. [Orecklin, 2004]
  • Breast Implants for High-School Graduation
    • In the United States, breast augmentation surgery can be performed on those under age 18 for medical reasons only. [Public Citizen Health Letter, 2004; Zuckerman, 2005]
    • The European Union Parliament is backing an age limit of age 18 on breast implants for cosmetic reasons; its recommendations are likely to be adopted by the European Commission. [Watson, 2003]
    • In the United States, however, there is a growing trend of parents giving implants as gifts to their graduating 18-year-old adolescents. The number of 18-year-olds who underwent breast-implant surgery nearly tripled from 2002 to 2003. [Zuckerman, 2005]
  • Extreme Makeover: Primetime Cosmetic Surgery. Cosmetic surgery went prime-time, with ABC’s Extreme Makeoverand other series.
    • In episodes of the program, participants chosen from the ranks of hundreds of thousands of willing “patients” undergo multiple surgical enhancements before a national audience of millions of voyeurs. [Turner, 2004]
    • Other, similar offerings have included Fox TV’s The Swan and MTV’s I Want a Famous Face, on which young men and women undergo cosmetic “enhancements” to make them look like stars such as Brad Pitt, Jennifer Lopez, and even Elvis Presley. 
    • Michael Jackson (with a reported four nose jobs, a chin implant, eyelid surgery, facelift, lip reduction, and assorted touch-ups) [Newman, 2000] and Cher (who may have undergone rib removal to create the illusion of a thinner waistline) [Henig, 1996] are among the celebrities well-known for their numerous cosmetic procedures.

The American Board of Plastic Surgery maintains statistics of cosmetic surgical procedures along with other societal facts around cosmetic surgery. The report can be viewed and downloaded at: http://www.cosmeticplasticsurgerystatistics.com/statistics.html