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Body ideals in women after viewing images of typical and healthy weight models
Body Image 10 (2013) 489–494
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Body Image journal homepage: www.elsevier.com/locate/bodyimage
Body ideals in women after viewing images of typical and healthy weight models Rebecca Owen a , Rebecca M.C. Spencer a,b,∗ a b
Department of Psychology, University of Massachusetts Amherst, Amherst, MA 01003, USA Neuroscience and Behavior Program, University of Massachusetts Amherst, Amherst, MA 01003, USA
a r t i c l e
i n f o
a b s t r a c t
Article history: Received 1 August 2012 Received in revised form 16 April 2013 Accepted 16 April 2013 Keywords: Body ideal Body image Body satisfaction Anxiety Media Healthy weight
Viewing thin models, pervasive in popular culture, is correlated with body dissatisfaction and anxiety in women. Whether or not the same is true when viewing healthy weight models is unknown. In this study we tested whether viewing healthy weight models increases the ideal female body size. Body image, anxiety, happiness and depression were measured in 44 female participants following viewing of images of thin or healthy weight models (within-subject separated by two weeks). We found that after viewing images of healthy weight models, women’s body ideals (as measured by a participant-adjusted virtual model) were significantly larger than when the same women viewed images of very thin models. This effect was greatest in those women with the highest levels of baseline anxiety (as measured by the Hospital Anxiety and Depression Scale). These results suggest that viewing healthy weight models results in more healthy body ideals than those typically promoted through media. © 2013 Elsevier Ltd. All rights reserved.
Introduction Throughout history body ideals, culturally determined preferred body shapes and sizes, have been promoted through art and publicly available media. These provide a historical record of how body ideals have changed over time. Until the early twentieth century, Western painters depicted the ideal female body as having a body mass index (BMI) between 27 and 30 (Bonafini & Pozzilli, 2010). By the mid-twentieth century, however, according to Western culture’s art, the ideal female body had shrunk to a BMI of around 19. Currently, the range of BMIs in which women are considered to be at a healthy weight is between 18.5 and 24.9 (Berrington de Gonzalez et al., 2010). However, the majority of idealized bodies have a body weight 15% less than the healthy weight (Martin, 2010). As such, one can conclude that the current idealized female body portrayed in the media is an unhealthy body weight for most women based on the recommended BMI for healthy women. Concurrent with the shift in female body ideals has been an increase in disordered eating and body dissatisfaction among women, particularly in Western cultures (Sypeck, Gray, & Ahrens, 2004). Moreover, exposure to media in which a very thin ideal female body (that is, a woman with a BMI under 18.5) is portrayed
∗ Corresponding author at: Department of Psychology, 419 Tobin Hall, 135 Hicks Way, Amherst, MA 01003, USA. Tel.: +1 413 545 5987. E-mail address: [email protected] (R.M.C. Spencer). 1740-1445/$ – see front matter © 2013 Elsevier Ltd. All rights reserved. http://dx.doi.org/10.1016/j.bodyim.2013.04.005
in a positive light is correlated with a drop in female body satisfaction and an increase in body image related anxiety (Anschutz, Engels, Becker, & van Strien, 2008; Bell, Lawton, & Dittmar, 2007; Fister & Smith, 2004; Groesz, Levine, & Murnen, 2002; Hawkins, Richards, Granley, & Stein, 2004; Quigg & Want, 2011; Swami et al., 2010; Tucci & Peters, 2008). Jarry and Kossert (2007) found that being exposed to the current ideal body size and shape encouraged healthy women with low self-esteem to judge their own worth by their appearance, creating a desire in participants to enhance self-esteem by lowering their BMI. Not surprisingly, viewing thin models is correlated with negative mood. Harper and Tiggemann (2008) found that looking at images of very thin models was correlated with negative mood in female participants. Similarly, women whose bodies were close to the cultural body ideal reported feeling happier than women whose bodies were further from the cultural body ideal (Stokes & Frederick-Recascino, 2003). Subjective negative affect in response to viewing images of thin models is supported by objective measures of the neurophysiological response to such stimuli. Friederich et al. (2007) used functional neuroimaging to measure brain responses of healthy young women viewing images of slim idealized bodies and comparing their own bodies to those displayed. While comparing their own bodies to images of slim idealized bodies, female participants showed brain activation in the fusiform gyrus, the right inferior parietal lobule, the right lateral prefrontal cortex and the left anterior cingulate, areas that Uher et al. (2005) proposed compose the body shape processing network. More importantly,
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participants report higher levels of anxiety while viewing images of slim models and this anxiety is positively associated with activation in the fear network (including the amygdala, dorsal anterior cingulate, rostral prefrontal cortex and the inferior lateral prefrontal cortex). Friederich and colleagues thus concluded that because fear network activation occurred during the period in which participants were processing body shapes of slim idealized bodies, their findings confirm previous hypotheses that body dissatisfaction exists at a neurobiological level. The fear response (e.g., fear of gaining weight) when viewing thin models may underlie body dissatisfaction that, in turn, may lead to eating disorders. As a result of evidence that viewing very thin models can be detrimental to female viewers’ body satisfaction and anxiety, research has begun to explore mechanisms to reduce this detrimental effect, such as viewing healthy weight models instead of very thin models. Fister and Smith (2004) found that women at risk for eating disorders were less likely to act on urges to diet after viewing images of healthy weight models than after viewing images of very thin models. Likewise, Tucci and Peters (2008) found that when female students were shown images of models from magazines, they experienced decreased body satisfaction after viewing images of very thin models and increased body satisfaction after viewing overweight models (a BMI of 25–29.9). Many studies have confirmed that viewing overweight models increases female viewers’ body satisfaction based on an array of body satisfaction measures (Brown & Dittmar, 2005; Groesz et al., 2002; Papies & Nicolaije, 2012; Posavac, Posavac, & Posavac, 1998; Quigg & Want, 2011; Yamamiya, Cash, Melnyk, Posavac, & Posavac, 2005). However, it is possible that viewing overweight models may have a negative impact in spite of increasing satisfaction; if average weight individuals consider their own body more preferable to that of someone further from a small body ideal, then they are still upholding the belief that positive body satisfaction comes from being thin. Viewing healthy weight models (a BMI between 18.5 and 24.9) rather than overweight models may present an optimal alternative. Using healthy weight models in media (e.g., the Dove Campaign for Real Beauty) may be a means to increase body satisfaction without promoting a small body ideal. However, body ideal and emotional responses to normal body weight models have not been investigated. In this study, we tested the hypothesis that viewing a slideshow of images of healthy weight models would increase the size of participants’ body ideal relative to body ideals reported after viewing a slideshow of images of very thin models. We also investigated whether this shift in body ideal would vary more for those with high baseline anxiety relative to those with low baseline anxiety. Finally, we tested whether participants would have significant differences in positive and negative affect after viewing each set of images. We hypothesized that participants would report more negative emotions after viewing images of very thin models.
African, Latina, or Asian). All participants received course credit for their participation. Measures and Materials Multidimensional Body-Self Relations QuestionnaireAppearance Scales. The Multidimensional Body-Self Relations Questionnaire-Appearance Scales (MBSRQ-AS; Cash, 2000) were used to assess initial body image. This questionnaire measured the degree to which participants were satisfied with their physical appearance (Appearance Evaluation; Cronbach’s ˛ in females = .88), invested in their own appearance (Appearance Orientation; ˛ = .85), were preoccupied with being overweight (Overweight Preoccupation; ˛ = .76), satisfied with most areas of their body (Body Areas Satisfaction; ˛ = .73), and how they classified their own weight at the time of study (Self-Classified Weight; ˛ = .89). In completing this questionnaire participants indicated their agreement with statements such as, “I constantly worry about being or becoming fat” using a 5-point Likert scale. Rosenberg Self-Esteem Scale. The Rosenberg Self-Esteem Scale (RSES) was used to measure participants’ initial self-esteem (Rosenberg, 1965). The scale consists of 10 items that assess both internal and external self-esteem. Participants responded to statements such as, “I feel that I am a person of worth, at least on an equal plane with others” using a 5-point Likert scale. Internal consistency for the RSES has been reported to range from .85 to .88 in college-age groups. The RSES has convergent validity (.69) with other self-esteem scales such as the Single-Item Self-Esteem Scale (Robins, Hendin, & Trzesniewski, 2001). Hospital Anxiety and Depression Scale. The Hospital Anxiety and Depression Scale (HADS) was used to assess the level of baseline anxiety and depression in participants at the beginning of the study. Participants were asked to respond to statements such as “I still enjoy the things I used to enjoy” as quickly as possible by circling a number from 1 to 4. Half of the questions evaluated depression whereas the other half evaluated anxiety. The HADS has been shown to be a reliable measure of anxiety and depression (˛ = .80 and .76 respectively; Mykletun, Stordal, & Dahl, 2001). Validity correlations between the HADS and other similar questionnaires range between .49 and .83 (Bjelland, Dahl, Haug, & Neckelmann, 2002).
Participants
Visual Analog Scale. The Visual Analog Scale (VAS) was selected to measure differences in anxiety after viewing each set of images (very thin and healthy weight). Participants were asked to indicate their responses by checking one of eleven boxes ranging from 0 (Not at all) to 100 (Extremely). Given the need to measure emotions at multiple time points within-subject, the VAS was selected for reportedly low test sensitization (Thompson, 2004). In addition to anxiety, VAS measures of sadness, frustration, anger, happiness, and relaxedness were also reported. The VAS showed high correlations with other similar scales (r = .70–.72) and the test–retest reliability correlation was .87 (de Boer et al., 2004).
Participants were 44 female college students (M = 20.2 years; SD = 1.3) recruited from a Psychology research participation pool at the University of Massachusetts, Amherst. All participants reported having normal cognitive functioning, and no history of an eating disorder, mental illness, neurological disease or injury. Moreover, participants reported they were not taking any medication known to affect cognitive functioning, had normal or corrected-to-normal vision, and spoke English as a first language. While race and ethnicity were not formally surveyed, it is estimated that participants’ race and ethnicity matched that of the University as a whole (∼20%
Body Image Assessment Software. The Body Image Assessment Software (BIAS) was used to measure participants’ subjective ideal female body after viewing each set of images and has high internal consistency (˛ = .92; Ferrer-Garcia & GutierrezMaldonado, 2008; Letosa-Porta, Ferrer-Garcia, & GutierrezMaldonado, 2005). The BIAS allows participants to alter the body size and shape of a virtual model by adjusting independently the head, arms, breasts, waist, hips, and legs. The program then converts the adjusted virtual model into a percentage of the participant’s actual body mass, which is calculated from the height
Method
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and weight entered by the experimenter. For example, a participant who alters the virtual model so that it is smaller than her own BMI would have a percentage less than 100, indicating that what she believes is the ideal female body is smaller than her current body size. Similarly, a participant who adjusts the virtual model to be bigger than her own BMI would be a percent more than 100, indicating that what she believes is the ideal female body is larger than her current body size. Participants adjusted the virtual model from a front and a side view. Subscales for each view as well as a total score were generated as previously described (Letosa-Porta, Ferrer-Garcia, & Gutierrez-Maldonado, 2005). Height and weight. Weight was measured using a Tanita HD357 Digital Scale. A standard measuring tape fixed to a wall throughout the experiment was used to measure participants’ height. BMI was automatically calculated by the BIAS software (following the formula BMI = weight (in kg)/height2 (in m)). Experimental stimuli. Stimuli consisted of slideshows of 20 images of either models clearly depicting the current media standard ideal of very thin female body size and shape (i.e., estimated BMI of below 18.5) or of models clearly depicting a body size and shape above that of the current media standard but within a healthy BMI range (i.e., estimated BMI between 18.5 and 24.9). All images were collected from clothing websites (geared to a range of body types) and edited so that all models appeared to be wearing a plain blue bathing suit. Models in each set of images were matched for body posture and bathing suit shape. No model was wearing any jewelry and all images showed the model’s body from the neckline to the mid thighs (Fig. 1). Images were uniform in size so that each model was proportional to the others. In an attempt to quantify the difference between the images of very thin models and healthy weight models, models in the images were equated in height and, subsequently, waist size was measured on the 2dimensional images (given that body position was matched across image sets). The difference in the waist sizes of the images of very thin models and healthy weight models used in the slideshow was significant, F(1, 38) = 8.83, p = .005, 2p = .19, indicating that very thin models had waist sizes significantly smaller than the images of healthy weight models. Procedure All procedures were approved by University of Massachusetts, Amherst Institutional Review Board and all participants were treated in accordance with APA ethical guidelines. Accordingly, prior to initiating the experiment, a description of the procedures was provided and written informed consent was obtained. Following informed consent procedures, participants completed the MBSRQ-AS, the HADS, and the RSES. When completed, the participants were brought to a separate room where the experimenter measured and recorded their height and weight. For these measurements all participants removed their shoes and jackets. Participants were then shown one of two slideshows (healthy weight or thin). Within the slideshows, images were displayed in a random order for 5 s. Each image was presented approximately five times during a slideshow. At the end of the slideshow the experimenter entered participants’ weight and height into the BIAS program. Participants completed the BIAS desired body assessment after being directed by the experimenter to adjust the head, arms, breasts, waist, hips and legs of a virtual model on the screen by following the directions on the screen until the model looked like how the participant thought the ideal female body would look like. Lastly, participants completed the VAS. Consistent with the within-subjects design, between 11 and 15 days after participants completed the first session they returned for
Fig. 1. Samples of very thin models (left column) and healthy weight models (right column). Stimuli consisted of 20 total images of each model type. Very thin models had an estimated body mass index (BMI) of <18.5 and healthy weight models had an estimated BMI of 18.5–24.9. The difference in the waist sizes of the images of very thin models and healthy weight models was significant, F(1, 38) = 8.83, p = .005, 2p = .19.
a second session. The order of thin and healthy weight viewing was counterbalanced across participants. Following the slideshow all participants again completed the BIAS program. The experimenter reminded them to adjust the body parts of the virtual models to look like what they thought the ideal female body looked like. Participants then filled out the VAS again and, lastly, were debriefed. Data Analyses Paired samples t-tests were used to compare body ideals (i.e., BIAS scores) and VAS rated measures of anxiety for the two sessions. Post hoc analyses included a bivariate correlation between the difference in body ideals after viewing images of very thin models and after viewing images of healthy weight models (measured with the BIAS) and participants’ baseline anxiety scores (measured with the HADS). A median split was then performed based on participants’ baseline anxiety. Additionally, intersession differences in positive (composite of VAS happiness and relaxedness scores) and negative (composite of VAS anxiety, sadness, anger, and frustration scores) affect were considered. Internal consistencies, reported with composite scores means, were determined using Cronbach’s ˛. Results Overall, participants were all within normal range (18.5–24.9) for BMI (M = 23.54, SD = 3.73). Participants were also within the normal range (<8) on measures of depression (HADS depression: M = 2.89, SD = 2.13, Cronbach’s ˛ = .696) and anxiety (HADS anxiety:
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Fig. 2. Mean total scores on the Body Image Assessment Software (BIAS) reflecting subjective body ideals after viewing images of very thin models and healthy weight models. Error bars represent standard error.
M = 7.46, SD = 3.62, Cronbach’s ˛ = .772). Normal range for the RSES measure of self-esteem is 15–25 and participants were within this range (M = 23.06, SD = 4.10, Cronbach’s ˛ = .881). MSBRQ scores also approximated normative data in female participants with good internal consistency for subscales Appearance Evaluation (M = 3.46, SD = 0.74; Cronbach’s ˛ = .871), Appearance Orientation (M = 3.54, SD = 0.55; Cronbach’s ˛ = .826), Body Areas Satisfaction (M = 3.41, SD = 0.71; Cronbach’s ˛ = .844), Overweight Preoccupation (M = 2.49, SD = 0.92; Cronbach’s ˛ = .824), and Self-Classified Weight (M = 3.26, SD = 0.58; Cronbach’s ˛ = .841). Norms for these subscales in females are 3.36 (SD = 0.87), 3.91 (SD = 0.60), 3.23 (SD = 0.74), 3.03 (SD = 0.96), and 3.57 (SD = 0.73) respectively (Cash, 2000). A paired samples t-test comparing BIAS scores across sessions revealed that BIAS scores were significantly lower following the viewing of very thin models (M = 100.4, SD = 6.6) compared to scores following viewing of the healthy weight models (M = 102.2, SD = 7.1; t(43) = 2.97, p = .005, Cohen’s d = 0.272; Fig. 2). The areas of the body most affected by viewing the different sets of images were front breast, side head, side breast, and side hip (Table 1). A one-way ANOVA with the order of presentation of the slideshows as a factor was performed and it was found that there was not a significant order effect on BIAS scores, F(1, 42) = .588, p = .447, 2p = .17. To test the hypothesis that anxiety would be higher following viewing of thin relative to healthy weight models, a paired samples t-test was performed on VAS anxiety levels after viewing the different sets of images. However, anxiety levels did not differ, t(43) = .724, p = .473, Cohen’s d = 0.110. Next, we examined whether baseline anxiety moderated the change in body image after the viewing healthy weight relative to thin models. When level of baseline anxiety (measured by the HADS) was correlated with the difference between BIAS scores after viewing each slideshow (thin model slideshow minus healthy weight model), a significant positive correlation was observed (r = .304, p = .045). Participants with low levels of baseline anxiety had small differences between their BIAS scores across conditions, whereas participants with higher levels of baseline anxiety had larger differences between their BIAS scores. To further confirm the relationship between baseline anxiety and the difference in BIAS scores for the two conditions, a median split was then performed based on baseline anxiety. Participants with a HADS anxiety score below 8 (n = 23) were considered to have low baseline anxiety, participants with a HADS anxiety score of 8
Fig. 3. A median split was performed based on participants’ baseline anxiety scores. Participants with high baseline anxiety had smaller body ideals (based on BIAS total scores) after viewing images of very thin models (M = 97.9) and larger body ideals after viewing images of healthy weight models (M = 101.3). Participants with low baseline anxiety did not have a significant change in body ideals between conditions; the mean after viewing images of very thin models was 102.6 whereas the mean after viewing images of healthy weight models was 103.1.
or above (n = 21) were considered to have high baseline anxiety. Participants with high baseline anxiety had significantly smaller body ideals after viewing images of very thin models and significantly larger body ideals after viewing images of healthy weight models, t(20) = −3.33, p = .003, Cohen’s d = −0.749. Participants with low baseline anxiety, however, did not have a significant change in body ideals after viewing either set of images, t(22) = −7.4, p = .47, Cohen’s d = −0.156 (Fig. 3). Given that VAS measures of positive and negative affect were also probed, we explored the relationship of general changes in positive and negative affect across conditions. The difference in positive affect for the two conditions (Cronbach’s ˛ = .722 after viewing thin; Cronbach’s ˛ = .770 after viewing healthy weight models) significantly correlated with baseline anxiety (r = .505, p < .001) such that those with high baseline anxiety had greater positive affect following viewing of the healthy weight models compared to affect after viewing thin models. This was supported by a median split analysis in which those with high baseline anxiety had a significant change in positive affect across sessions while those with low baseline anxiety did not (F(1, 42) = 9.757, p = .003, 2p = .19). A similar analysis using a composite measure of negative affect (Cronbach’s ˛ = .841 after viewing thin; Cronbach’s ˛ = .859 after viewing healthy weight models) was not significant (F(1, 42) = 1.496, p = .228, 2p = .03). Discussion We sought to test the hypothesis that viewing images of healthy weight models increases the size of participants’ ideal female body relative to ideals chosen after viewing the media standard, thin models. Supporting this hypothesis, participants’ self-adjusted body ideal was significantly larger following viewing of healthy weight models than that reported following viewing thin models. This effect was greatest in those individuals with the high levels of baseline anxiety. These individuals also had significantly more positive affect after viewing healthy weight models than after viewing thin models. Consistent with the present results, a corpus of studies have reported that exposure to media images of very thin female models is correlated with a drop in female body satisfaction and an increase
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Table 1 Body Image Assessment Software (BIAS) scores, reflecting subjective body ideal, for a sample of college-age women (n = 44). After viewing very thin models
Front head Front arm Front breasta Front waist Front hip Front legs Side heada Side breasta Side waist Side hipa Side legs Total frontal Total sidea Totala
M
SD
102.6 105.0 93.6 100.7 103.3 110.3 98.5 96.7 96.6 97.2 99.7 102.6 97.7 100.4
6.9 13.6 8.0 8.9 9.2 15.6 6.0 6.8 7.8 7.3 7.9 8.8 6.2 6.6
After viewing healthy weight models ˛
M
SD
.898 .919 .910
102.3 105.6 103.5 100.6 103.7 110.3 100.2 98.9 97.6 99.0 101.2 104.3 99.4 102.1
6.6 14.2 7.5 8.4 8.3 15.6 5.0 7.1 6.7 6.5 7.0 8.5 5.0 6.1
t
p
d
0.371 −0.413 −2.98 0.109 −0.427 −0.022 −2.28 −2.22 −1.11 −2.25 −1.33 −1.71 −3.04 2.97
.71 .68 .01 .91 .67 .98 .03 .03 .27 .03 .19 .10 .00 .01
0.057 −0.063 −0.439 0.011 −0.043 −0.003 −0.365 −0.341 −0.162 −0.337 −0.210 −0.257 −0.473 −0.438
˛
.876 .832 .877
Note. The Body Image Assessment Software (BIAS) was developed by Letosa-Porta, Ferrer-Garcia, & Gutierrez-Maldonado, 2005. ˛ = Cronbach’s ˛ for composite measures; d = Cohen’s d. a Difference between mean score after viewing images of very thin models and mean score after viewing images of healthy weight models was significant (mean score difference was calculated by subtracting scores collected after viewing images of very thin models from scores collected after viewing healthy weight models).
in body image related anxiety (Anschutz, Engels, et al., 2008; Bell et al., 2007; Fister & Smith, 2004; Groesz et al., 2002; Hawkins et al., 2004; Quigg & Want, 2011; Swami et al., 2010; Tucci & Peters, 2008). Contributing to these findings, the present results suggest that viewing images of very thin female models promotes a smaller body ideal than promoted by viewing healthy weight models. Individuals with high baseline anxiety were most susceptible to the negative impact of viewing thin models. Traditionally, individuals with high anxiety have been shown to have a selective attentional bias toward threat (Pacheco-Unguetti, Acosta, Lupianez, Roman, & Derakshan, 2011). Because images of very thin models are a threat to individuals’ self-esteem and body satisfaction, individuals with higher anxiety may pay increased attention to these images. This may underlie the larger decrease in female body ideals after viewing images of very thin models in high anxiety participants. Harper and Tiggemann (2008) reported an increase in negative mood when viewing advertisements with thin models relative to advertisements without people. By comparing ads with people in both conditions but that varied in weight, we report no significant change in negative affect but rather an increase in positive affect when viewing healthy weight models relative to thin models in anxious individuals. Positive affect is associated with activation of the reward system (Ashby, Isen, & Turken, 1999). Thus, participants may have a sense of reward from viewing a healthy weight, likebodied woman that is not experienced when viewing thin models. No such reward difference would be expected for advertisements with thin models relative to advertisements without people. Given that positive and negative affect are independently regulated states (Khalfa, Schon, Anton, & Liegeois-Chauvel, 2005) that can co-exist, it is important to consider positive and negative affect independently in future research. Collectively, our results suggest that viewing healthy weight models instead of very thin models is beneficial to women’s body ideals. While limited research has been done on the impact of viewing healthy weight models, the studies that have been published concur with our findings. Fister and Smith (2004) found women at risk for eating disorders to be less likely to act on diet urges after viewing images of healthy weight models. Likewise, studies in which female participants viewed images of overweight models found a significant increase in body satisfaction, though this could indicate a persisting belief that being thinner than overweight models is preferable (Brown & Dittmar, 2005; Groesz et al., 2002; Papies & Nicolaije, 2012; Posavac et al., 1998; Quigg & Want, 2011; Yamamiya et al., 2005).
Although baseline anxiety moderated the reported effects, notably, contrary to previous studies (Anschutz, Engels, et al., 2008; Bell et al., 2007; Fister & Smith, 2004; Groesz et al., 2002; Hawkins et al., 2004; Quigg & Want, 2011; Swami et al., 2010; Tucci & Peters, 2008), we did not find an increase in anxiety following viewing of thin relative to healthy weight models as measured by the VAS. This scale has low test sensitization (Thompson, 2004), which was advantageous for the present design. While this questionnaire has been used in a number of similar studies (Anschutz, Engels, et al., 2008; Anschutz, van Strien, & Engels, 2008; Tucci & Peters, 2008), it leaves limited room for variability. A more detailed questionnaire or a physiological measure such as a cortisol or skin conductance response may have provided clearer insight. Alternatively, the images we showed to participants may not have been significantly anxiety provoking. It is also possible that participants habituated to seeing very thin models and so they did not report feeling significant anxiety. Further studies are needed in order to confirm this result. It is also worth considering whether our sample size reduced the ability to detect an effect of condition (thin versus healthy weight models) on anxiety levels or other measures of mood. The decision to cap our participants at 44 was primarily based on similar studies in which the number of subjects was quite small (Friederich et al., 2007; Wood-Barcalow, Tylka, & Augustus-Horvath, 2010). The present study also benefited from a within-subject design, increasing the power of the present findings. In fact, primary effects had medium to large effect sizes suggesting that the study had sufficient power. Nonetheless, the small sample size was not sufficient to detect whether effects differed across racial, ethnic, or socioeconomic groups in our sample as have previously been reported (Paeratakul, White, Williamson, Ryan, & Bray, 2002). Thus, future research must consider whether body image differs in response to thin and healthy weight models across these groups. Additionally, one might explore whether men respond to images of very thin versus healthy weight female models in the same way as women, and likewise how men react to viewing images of thin and healthy weight male models. At this time, the BIAS is only available for a female form. In conclusion, these results suggest that a movement toward healthy weight models in popular media may provide a substantial benefit to mental health. The Dove Campaign for Real Beauty is a corporate advertising campaign that aimed to use ‘real’ women in their advertising. However, ‘real’ models ranged from full-figured (often overweight) models to underweight models that had freckles. Nonetheless this campaign and a recent pact by editors of Vogue
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magazine to use healthy models (BBC, 2012), demonstrates that the media is willing to reconsider the body ideal that they portray. A healthy BMI for models may not only be optimal for the models themselves but for the viewers’ mental health as well. Acknowledgements This project was funded by a research grant from the Commonwealth Honors College at the University of Massachusetts, Amherst. The authors thank Dr. Maureen Perry-Jenkins for her helpful feedback on this work and Bengi Baran for her assistance and advice on data analysis. References Anschutz, D. J., Engels, R. C., & Becker, E. S. (2008). The bold and the beautiful. Influence of body size of televised media models on body dissatisfaction and actual food intake. Appetite, 51, 530–537. Anschutz, D. J., van Strien, T., & Engels, R. C. (2008). Exposure to slim images in mass media: Television commercials as reminders of restriction in restrained eater. Health Psychology, 27, 401–408. Ashby, F. G., Isen, A. M., & Turken, A. U. (1999). A neuropsychological theory of positive affect and its influence on cognition. Psychological Review, 106, 529–555. BBC. (2012). Vogue magazine editors pledge to use ‘healthy’ models. http://www.bbc.co.uk/news/world-us-canada-17949035 Bell, B. T., Lawton, R., & Dittmar, H. (2007). The impact of thin models in music videos on adolescent girls’ body dissatisfaction. Body Image, 4, 137–145. Berrington de Gonzalez, A., Hartge, P., & Cerhan, J. R. (2010). Body-mass index and mortality among 1.46 million white adults. New England Journal Medicine, 363, 2211–2219. Bjelland, I., Dahl, A. A., & Haug, T. T. (2002). The validity of the Hospital Anxiety and Depression Scale. An updated literature review. Journal of Psychosomatic Research, 52, 69–77. Bonafini, B. A., & Pozzilli, P. (2010). Body weight and beauty: The changing face of the ideal female body weight. Obesity Reviews, 12, 62–65. Brown, A., & Dittmar, H. (2005). Think thin and feel bad: The role of appearance schema activation, attention level, and thin-ideal internalization for young women’s responses to ultra-thin media images. Journal of Social and Clinical Psychology, 24, 1088–1113. Cash, T. F. (2000). Users’ manual for the Multidimensional Body-Self Relations Questionnaire. www.body-images.com de Boer, A. G., van Lanschot, J. J., & Stalmeier, P. F. (2004). Is a single-item visual analogue scale as valid, reliable and responsive as multi-item scales in measuring quality of life? Quality of Life Research, 13, 311–320. Ferrer-Garcia, M., & Gutierrez-Maldonado, J. (2008). Body Image Assessment Software: Psychometric data. Behavioral Research Methods, 40, 394–407. Fister, S. M., & Smith, G. T. (2004). Media effects on expectancies: Exposure to realistic female images as a protective factor. Psychology of Addictive Behaviors, 18, 394–397. Friederich, H. C., Uher, R., & Brooks, S. (2007). I’m not as slim as that girl: Neural bases of body shape self-comparison to media images. Neuroimage, 37, 674–681. Groesz, L. M., Levine, M. P., & Murnen, S. K. (2002). The effect of experimental presentation of thin media images on body satisfaction: A meta-analytic review. International Journal of Eating Disorders, 31, 1–16.
Harper, B., & Tiggemann, M. (2008). The effect of thin ideal media images on women’s self-objectification, mood, and body image. Sex Roles, 58, 649– 657. Hawkins, N., Richards, P. S., & Granley, H. M. (2004). The impact of exposure to the thin-ideal media image on women. Eating Disorders, 12, 35–50. Jarry, J. L., & Kossert, A. L. (2007). Self-esteem threat combined with exposure to thin media images leads to body image compensatory self-enhancement. Body Image, 4, 39–50. Khalfa, S., Schon, D., & Anton, J. L. (2005). Brain regions involved in the recognition of happiness and sadness in music. Neuroreport, 16, 1981–1984. Letosa-Porta, A., Ferrer-Garcia, M., & Gutierrez-Maldonado, J. (2005). A program for assessing body image disturbance using adjustable partial image distortion. Behavioral Research Methods, 37, 638–643. Martin, J. B. (2010). The development of ideal body image perceptions in the United States. Nutrition Today, 24, 98–110. Mykletun, A., Stordal, E., & Dahl, A. A. (2001). Hospital Anxiety and Depression (HAD) Scale: Factor structure, item analyses and internal consistency in a large population. British Journal of Psychiatry, 179, 540–544. Pacheco-Unguetti, A. P., Acosta, A., & Lupianez, J. (2011). Response inhibition and attentional control in anxiety. Quarterly Journal of Experimental Psychology, 65, 646–660. Paeratakul, S., White, M. A., & Williamson, D. A. (2002). Sex, race/ethnicity, socioeconomic status, and BMI in relation to self-perception of overweight. Obesity Research, 10, 345–350. Papies, E. K., & Nicolaije, K. A. (2012). Inspiration or deflation? Feeling similar or dissimilar to slim and plus-size models affects self-evaluation of restrained eaters. Body Image, 9, 76–85. Posavac, H. D., Posavac, S. S., & Posavac, E. J. (1998). Exposure to media images of female attractiveness and concern with body weight among young women. Sex Roles, 38, 187–201. Quigg, S. L., & Want, S. C. (2011). Highlighting media modifications: Can a television commercial mitigate the effects of music videos on female appearance satisfaction? Body Image, 8, 135–142. Robins, R. W., Hendin, H. M., & Trzesniewski, K. H. (2001). Measuring global selfesteem: Construct validation of a single-item measure and the Rosenberg SelfEsteem Scale. Personality and Social Psychology Bulletin, 27, 151–161. Rosenberg, M. (1965). Society and the adolescent self-image. Princeton, NJ: Princeton University Press. Stokes, R., & Frederick-Recascino, C. (2003). Women’s perceived body image: Relations with personal happiness. Journal of Women and Aging, 15, 17–29. Swami, V., Frederick, D. A., & Aavik, T. (2010). The attractive female body weight and female body dissatisfaction in 26 countries across 10 world regions: Results of the international body project I. Personality and Social Psychology Bulletin, 36, 309–325. Sypeck, M. F., Gray, J. J., & Ahrens, A. H. (2004). No longer just a pretty face: Fashion magazines’ depictions of ideal female beauty from 1959 to 1999. International Journal of Eating Disorders, 36, 342–347. Thompson, J. K. (2004). The (mis)measurement of body image. Body Image, 1, 7–14. Tucci, S., & Peters, J. (2008). Media influences on body satisfaction in female students. Psicothema, 20, 521–524. Uher, R., Murphy, T., & Friederich, H. C. (2005). Functional neuroanatomy of body shape perception in healthy and eating-disordered women. Biological Psychiatry, 58, 990–997. Wood-Barcalow, N. L., Tylka, T. L., & Augustus-Horvath, C. L. (2010). “But I Like My Body”: Positive body image characteristics and a holistic model for young–adult women. Body Image, 7, 106–116. Yamamiya, Y., Cash, T. F., & Melnyk, S. E. (2005). Women’s exposure to thin-andbeautiful media images: Body image effects of media-ideal internalization and impact-reduction interventions. Body Image, 2, 74–80.
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Body Image journal homepage: www.elsevier.com/locate/bodyimage
Body ideals in women after viewing images of typical and healthy weight models Rebecca Owen a , Rebecca M.C. Spencer a,b,∗ a b
Department of Psychology, University of Massachusetts Amherst, Amherst, MA 01003, USA Neuroscience and Behavior Program, University of Massachusetts Amherst, Amherst, MA 01003, USA
a r t i c l e
i n f o
a b s t r a c t
Article history: Received 1 August 2012 Received in revised form 16 April 2013 Accepted 16 April 2013 Keywords: Body ideal Body image Body satisfaction Anxiety Media Healthy weight
Viewing thin models, pervasive in popular culture, is correlated with body dissatisfaction and anxiety in women. Whether or not the same is true when viewing healthy weight models is unknown. In this study we tested whether viewing healthy weight models increases the ideal female body size. Body image, anxiety, happiness and depression were measured in 44 female participants following viewing of images of thin or healthy weight models (within-subject separated by two weeks). We found that after viewing images of healthy weight models, women’s body ideals (as measured by a participant-adjusted virtual model) were significantly larger than when the same women viewed images of very thin models. This effect was greatest in those women with the highest levels of baseline anxiety (as measured by the Hospital Anxiety and Depression Scale). These results suggest that viewing healthy weight models results in more healthy body ideals than those typically promoted through media. © 2013 Elsevier Ltd. All rights reserved.
Introduction Throughout history body ideals, culturally determined preferred body shapes and sizes, have been promoted through art and publicly available media. These provide a historical record of how body ideals have changed over time. Until the early twentieth century, Western painters depicted the ideal female body as having a body mass index (BMI) between 27 and 30 (Bonafini & Pozzilli, 2010). By the mid-twentieth century, however, according to Western culture’s art, the ideal female body had shrunk to a BMI of around 19. Currently, the range of BMIs in which women are considered to be at a healthy weight is between 18.5 and 24.9 (Berrington de Gonzalez et al., 2010). However, the majority of idealized bodies have a body weight 15% less than the healthy weight (Martin, 2010). As such, one can conclude that the current idealized female body portrayed in the media is an unhealthy body weight for most women based on the recommended BMI for healthy women. Concurrent with the shift in female body ideals has been an increase in disordered eating and body dissatisfaction among women, particularly in Western cultures (Sypeck, Gray, & Ahrens, 2004). Moreover, exposure to media in which a very thin ideal female body (that is, a woman with a BMI under 18.5) is portrayed
∗ Corresponding author at: Department of Psychology, 419 Tobin Hall, 135 Hicks Way, Amherst, MA 01003, USA. Tel.: +1 413 545 5987. E-mail address: [email protected] (R.M.C. Spencer). 1740-1445/$ – see front matter © 2013 Elsevier Ltd. All rights reserved. http://dx.doi.org/10.1016/j.bodyim.2013.04.005
in a positive light is correlated with a drop in female body satisfaction and an increase in body image related anxiety (Anschutz, Engels, Becker, & van Strien, 2008; Bell, Lawton, & Dittmar, 2007; Fister & Smith, 2004; Groesz, Levine, & Murnen, 2002; Hawkins, Richards, Granley, & Stein, 2004; Quigg & Want, 2011; Swami et al., 2010; Tucci & Peters, 2008). Jarry and Kossert (2007) found that being exposed to the current ideal body size and shape encouraged healthy women with low self-esteem to judge their own worth by their appearance, creating a desire in participants to enhance self-esteem by lowering their BMI. Not surprisingly, viewing thin models is correlated with negative mood. Harper and Tiggemann (2008) found that looking at images of very thin models was correlated with negative mood in female participants. Similarly, women whose bodies were close to the cultural body ideal reported feeling happier than women whose bodies were further from the cultural body ideal (Stokes & Frederick-Recascino, 2003). Subjective negative affect in response to viewing images of thin models is supported by objective measures of the neurophysiological response to such stimuli. Friederich et al. (2007) used functional neuroimaging to measure brain responses of healthy young women viewing images of slim idealized bodies and comparing their own bodies to those displayed. While comparing their own bodies to images of slim idealized bodies, female participants showed brain activation in the fusiform gyrus, the right inferior parietal lobule, the right lateral prefrontal cortex and the left anterior cingulate, areas that Uher et al. (2005) proposed compose the body shape processing network. More importantly,
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participants report higher levels of anxiety while viewing images of slim models and this anxiety is positively associated with activation in the fear network (including the amygdala, dorsal anterior cingulate, rostral prefrontal cortex and the inferior lateral prefrontal cortex). Friederich and colleagues thus concluded that because fear network activation occurred during the period in which participants were processing body shapes of slim idealized bodies, their findings confirm previous hypotheses that body dissatisfaction exists at a neurobiological level. The fear response (e.g., fear of gaining weight) when viewing thin models may underlie body dissatisfaction that, in turn, may lead to eating disorders. As a result of evidence that viewing very thin models can be detrimental to female viewers’ body satisfaction and anxiety, research has begun to explore mechanisms to reduce this detrimental effect, such as viewing healthy weight models instead of very thin models. Fister and Smith (2004) found that women at risk for eating disorders were less likely to act on urges to diet after viewing images of healthy weight models than after viewing images of very thin models. Likewise, Tucci and Peters (2008) found that when female students were shown images of models from magazines, they experienced decreased body satisfaction after viewing images of very thin models and increased body satisfaction after viewing overweight models (a BMI of 25–29.9). Many studies have confirmed that viewing overweight models increases female viewers’ body satisfaction based on an array of body satisfaction measures (Brown & Dittmar, 2005; Groesz et al., 2002; Papies & Nicolaije, 2012; Posavac, Posavac, & Posavac, 1998; Quigg & Want, 2011; Yamamiya, Cash, Melnyk, Posavac, & Posavac, 2005). However, it is possible that viewing overweight models may have a negative impact in spite of increasing satisfaction; if average weight individuals consider their own body more preferable to that of someone further from a small body ideal, then they are still upholding the belief that positive body satisfaction comes from being thin. Viewing healthy weight models (a BMI between 18.5 and 24.9) rather than overweight models may present an optimal alternative. Using healthy weight models in media (e.g., the Dove Campaign for Real Beauty) may be a means to increase body satisfaction without promoting a small body ideal. However, body ideal and emotional responses to normal body weight models have not been investigated. In this study, we tested the hypothesis that viewing a slideshow of images of healthy weight models would increase the size of participants’ body ideal relative to body ideals reported after viewing a slideshow of images of very thin models. We also investigated whether this shift in body ideal would vary more for those with high baseline anxiety relative to those with low baseline anxiety. Finally, we tested whether participants would have significant differences in positive and negative affect after viewing each set of images. We hypothesized that participants would report more negative emotions after viewing images of very thin models.
African, Latina, or Asian). All participants received course credit for their participation. Measures and Materials Multidimensional Body-Self Relations QuestionnaireAppearance Scales. The Multidimensional Body-Self Relations Questionnaire-Appearance Scales (MBSRQ-AS; Cash, 2000) were used to assess initial body image. This questionnaire measured the degree to which participants were satisfied with their physical appearance (Appearance Evaluation; Cronbach’s ˛ in females = .88), invested in their own appearance (Appearance Orientation; ˛ = .85), were preoccupied with being overweight (Overweight Preoccupation; ˛ = .76), satisfied with most areas of their body (Body Areas Satisfaction; ˛ = .73), and how they classified their own weight at the time of study (Self-Classified Weight; ˛ = .89). In completing this questionnaire participants indicated their agreement with statements such as, “I constantly worry about being or becoming fat” using a 5-point Likert scale. Rosenberg Self-Esteem Scale. The Rosenberg Self-Esteem Scale (RSES) was used to measure participants’ initial self-esteem (Rosenberg, 1965). The scale consists of 10 items that assess both internal and external self-esteem. Participants responded to statements such as, “I feel that I am a person of worth, at least on an equal plane with others” using a 5-point Likert scale. Internal consistency for the RSES has been reported to range from .85 to .88 in college-age groups. The RSES has convergent validity (.69) with other self-esteem scales such as the Single-Item Self-Esteem Scale (Robins, Hendin, & Trzesniewski, 2001). Hospital Anxiety and Depression Scale. The Hospital Anxiety and Depression Scale (HADS) was used to assess the level of baseline anxiety and depression in participants at the beginning of the study. Participants were asked to respond to statements such as “I still enjoy the things I used to enjoy” as quickly as possible by circling a number from 1 to 4. Half of the questions evaluated depression whereas the other half evaluated anxiety. The HADS has been shown to be a reliable measure of anxiety and depression (˛ = .80 and .76 respectively; Mykletun, Stordal, & Dahl, 2001). Validity correlations between the HADS and other similar questionnaires range between .49 and .83 (Bjelland, Dahl, Haug, & Neckelmann, 2002).
Participants
Visual Analog Scale. The Visual Analog Scale (VAS) was selected to measure differences in anxiety after viewing each set of images (very thin and healthy weight). Participants were asked to indicate their responses by checking one of eleven boxes ranging from 0 (Not at all) to 100 (Extremely). Given the need to measure emotions at multiple time points within-subject, the VAS was selected for reportedly low test sensitization (Thompson, 2004). In addition to anxiety, VAS measures of sadness, frustration, anger, happiness, and relaxedness were also reported. The VAS showed high correlations with other similar scales (r = .70–.72) and the test–retest reliability correlation was .87 (de Boer et al., 2004).
Participants were 44 female college students (M = 20.2 years; SD = 1.3) recruited from a Psychology research participation pool at the University of Massachusetts, Amherst. All participants reported having normal cognitive functioning, and no history of an eating disorder, mental illness, neurological disease or injury. Moreover, participants reported they were not taking any medication known to affect cognitive functioning, had normal or corrected-to-normal vision, and spoke English as a first language. While race and ethnicity were not formally surveyed, it is estimated that participants’ race and ethnicity matched that of the University as a whole (∼20%
Body Image Assessment Software. The Body Image Assessment Software (BIAS) was used to measure participants’ subjective ideal female body after viewing each set of images and has high internal consistency (˛ = .92; Ferrer-Garcia & GutierrezMaldonado, 2008; Letosa-Porta, Ferrer-Garcia, & GutierrezMaldonado, 2005). The BIAS allows participants to alter the body size and shape of a virtual model by adjusting independently the head, arms, breasts, waist, hips, and legs. The program then converts the adjusted virtual model into a percentage of the participant’s actual body mass, which is calculated from the height
Method
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and weight entered by the experimenter. For example, a participant who alters the virtual model so that it is smaller than her own BMI would have a percentage less than 100, indicating that what she believes is the ideal female body is smaller than her current body size. Similarly, a participant who adjusts the virtual model to be bigger than her own BMI would be a percent more than 100, indicating that what she believes is the ideal female body is larger than her current body size. Participants adjusted the virtual model from a front and a side view. Subscales for each view as well as a total score were generated as previously described (Letosa-Porta, Ferrer-Garcia, & Gutierrez-Maldonado, 2005). Height and weight. Weight was measured using a Tanita HD357 Digital Scale. A standard measuring tape fixed to a wall throughout the experiment was used to measure participants’ height. BMI was automatically calculated by the BIAS software (following the formula BMI = weight (in kg)/height2 (in m)). Experimental stimuli. Stimuli consisted of slideshows of 20 images of either models clearly depicting the current media standard ideal of very thin female body size and shape (i.e., estimated BMI of below 18.5) or of models clearly depicting a body size and shape above that of the current media standard but within a healthy BMI range (i.e., estimated BMI between 18.5 and 24.9). All images were collected from clothing websites (geared to a range of body types) and edited so that all models appeared to be wearing a plain blue bathing suit. Models in each set of images were matched for body posture and bathing suit shape. No model was wearing any jewelry and all images showed the model’s body from the neckline to the mid thighs (Fig. 1). Images were uniform in size so that each model was proportional to the others. In an attempt to quantify the difference between the images of very thin models and healthy weight models, models in the images were equated in height and, subsequently, waist size was measured on the 2dimensional images (given that body position was matched across image sets). The difference in the waist sizes of the images of very thin models and healthy weight models used in the slideshow was significant, F(1, 38) = 8.83, p = .005, 2p = .19, indicating that very thin models had waist sizes significantly smaller than the images of healthy weight models. Procedure All procedures were approved by University of Massachusetts, Amherst Institutional Review Board and all participants were treated in accordance with APA ethical guidelines. Accordingly, prior to initiating the experiment, a description of the procedures was provided and written informed consent was obtained. Following informed consent procedures, participants completed the MBSRQ-AS, the HADS, and the RSES. When completed, the participants were brought to a separate room where the experimenter measured and recorded their height and weight. For these measurements all participants removed their shoes and jackets. Participants were then shown one of two slideshows (healthy weight or thin). Within the slideshows, images were displayed in a random order for 5 s. Each image was presented approximately five times during a slideshow. At the end of the slideshow the experimenter entered participants’ weight and height into the BIAS program. Participants completed the BIAS desired body assessment after being directed by the experimenter to adjust the head, arms, breasts, waist, hips and legs of a virtual model on the screen by following the directions on the screen until the model looked like how the participant thought the ideal female body would look like. Lastly, participants completed the VAS. Consistent with the within-subjects design, between 11 and 15 days after participants completed the first session they returned for
Fig. 1. Samples of very thin models (left column) and healthy weight models (right column). Stimuli consisted of 20 total images of each model type. Very thin models had an estimated body mass index (BMI) of <18.5 and healthy weight models had an estimated BMI of 18.5–24.9. The difference in the waist sizes of the images of very thin models and healthy weight models was significant, F(1, 38) = 8.83, p = .005, 2p = .19.
a second session. The order of thin and healthy weight viewing was counterbalanced across participants. Following the slideshow all participants again completed the BIAS program. The experimenter reminded them to adjust the body parts of the virtual models to look like what they thought the ideal female body looked like. Participants then filled out the VAS again and, lastly, were debriefed. Data Analyses Paired samples t-tests were used to compare body ideals (i.e., BIAS scores) and VAS rated measures of anxiety for the two sessions. Post hoc analyses included a bivariate correlation between the difference in body ideals after viewing images of very thin models and after viewing images of healthy weight models (measured with the BIAS) and participants’ baseline anxiety scores (measured with the HADS). A median split was then performed based on participants’ baseline anxiety. Additionally, intersession differences in positive (composite of VAS happiness and relaxedness scores) and negative (composite of VAS anxiety, sadness, anger, and frustration scores) affect were considered. Internal consistencies, reported with composite scores means, were determined using Cronbach’s ˛. Results Overall, participants were all within normal range (18.5–24.9) for BMI (M = 23.54, SD = 3.73). Participants were also within the normal range (<8) on measures of depression (HADS depression: M = 2.89, SD = 2.13, Cronbach’s ˛ = .696) and anxiety (HADS anxiety:
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Fig. 2. Mean total scores on the Body Image Assessment Software (BIAS) reflecting subjective body ideals after viewing images of very thin models and healthy weight models. Error bars represent standard error.
M = 7.46, SD = 3.62, Cronbach’s ˛ = .772). Normal range for the RSES measure of self-esteem is 15–25 and participants were within this range (M = 23.06, SD = 4.10, Cronbach’s ˛ = .881). MSBRQ scores also approximated normative data in female participants with good internal consistency for subscales Appearance Evaluation (M = 3.46, SD = 0.74; Cronbach’s ˛ = .871), Appearance Orientation (M = 3.54, SD = 0.55; Cronbach’s ˛ = .826), Body Areas Satisfaction (M = 3.41, SD = 0.71; Cronbach’s ˛ = .844), Overweight Preoccupation (M = 2.49, SD = 0.92; Cronbach’s ˛ = .824), and Self-Classified Weight (M = 3.26, SD = 0.58; Cronbach’s ˛ = .841). Norms for these subscales in females are 3.36 (SD = 0.87), 3.91 (SD = 0.60), 3.23 (SD = 0.74), 3.03 (SD = 0.96), and 3.57 (SD = 0.73) respectively (Cash, 2000). A paired samples t-test comparing BIAS scores across sessions revealed that BIAS scores were significantly lower following the viewing of very thin models (M = 100.4, SD = 6.6) compared to scores following viewing of the healthy weight models (M = 102.2, SD = 7.1; t(43) = 2.97, p = .005, Cohen’s d = 0.272; Fig. 2). The areas of the body most affected by viewing the different sets of images were front breast, side head, side breast, and side hip (Table 1). A one-way ANOVA with the order of presentation of the slideshows as a factor was performed and it was found that there was not a significant order effect on BIAS scores, F(1, 42) = .588, p = .447, 2p = .17. To test the hypothesis that anxiety would be higher following viewing of thin relative to healthy weight models, a paired samples t-test was performed on VAS anxiety levels after viewing the different sets of images. However, anxiety levels did not differ, t(43) = .724, p = .473, Cohen’s d = 0.110. Next, we examined whether baseline anxiety moderated the change in body image after the viewing healthy weight relative to thin models. When level of baseline anxiety (measured by the HADS) was correlated with the difference between BIAS scores after viewing each slideshow (thin model slideshow minus healthy weight model), a significant positive correlation was observed (r = .304, p = .045). Participants with low levels of baseline anxiety had small differences between their BIAS scores across conditions, whereas participants with higher levels of baseline anxiety had larger differences between their BIAS scores. To further confirm the relationship between baseline anxiety and the difference in BIAS scores for the two conditions, a median split was then performed based on baseline anxiety. Participants with a HADS anxiety score below 8 (n = 23) were considered to have low baseline anxiety, participants with a HADS anxiety score of 8
Fig. 3. A median split was performed based on participants’ baseline anxiety scores. Participants with high baseline anxiety had smaller body ideals (based on BIAS total scores) after viewing images of very thin models (M = 97.9) and larger body ideals after viewing images of healthy weight models (M = 101.3). Participants with low baseline anxiety did not have a significant change in body ideals between conditions; the mean after viewing images of very thin models was 102.6 whereas the mean after viewing images of healthy weight models was 103.1.
or above (n = 21) were considered to have high baseline anxiety. Participants with high baseline anxiety had significantly smaller body ideals after viewing images of very thin models and significantly larger body ideals after viewing images of healthy weight models, t(20) = −3.33, p = .003, Cohen’s d = −0.749. Participants with low baseline anxiety, however, did not have a significant change in body ideals after viewing either set of images, t(22) = −7.4, p = .47, Cohen’s d = −0.156 (Fig. 3). Given that VAS measures of positive and negative affect were also probed, we explored the relationship of general changes in positive and negative affect across conditions. The difference in positive affect for the two conditions (Cronbach’s ˛ = .722 after viewing thin; Cronbach’s ˛ = .770 after viewing healthy weight models) significantly correlated with baseline anxiety (r = .505, p < .001) such that those with high baseline anxiety had greater positive affect following viewing of the healthy weight models compared to affect after viewing thin models. This was supported by a median split analysis in which those with high baseline anxiety had a significant change in positive affect across sessions while those with low baseline anxiety did not (F(1, 42) = 9.757, p = .003, 2p = .19). A similar analysis using a composite measure of negative affect (Cronbach’s ˛ = .841 after viewing thin; Cronbach’s ˛ = .859 after viewing healthy weight models) was not significant (F(1, 42) = 1.496, p = .228, 2p = .03). Discussion We sought to test the hypothesis that viewing images of healthy weight models increases the size of participants’ ideal female body relative to ideals chosen after viewing the media standard, thin models. Supporting this hypothesis, participants’ self-adjusted body ideal was significantly larger following viewing of healthy weight models than that reported following viewing thin models. This effect was greatest in those individuals with the high levels of baseline anxiety. These individuals also had significantly more positive affect after viewing healthy weight models than after viewing thin models. Consistent with the present results, a corpus of studies have reported that exposure to media images of very thin female models is correlated with a drop in female body satisfaction and an increase
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Table 1 Body Image Assessment Software (BIAS) scores, reflecting subjective body ideal, for a sample of college-age women (n = 44). After viewing very thin models
Front head Front arm Front breasta Front waist Front hip Front legs Side heada Side breasta Side waist Side hipa Side legs Total frontal Total sidea Totala
M
SD
102.6 105.0 93.6 100.7 103.3 110.3 98.5 96.7 96.6 97.2 99.7 102.6 97.7 100.4
6.9 13.6 8.0 8.9 9.2 15.6 6.0 6.8 7.8 7.3 7.9 8.8 6.2 6.6
After viewing healthy weight models ˛
M
SD
.898 .919 .910
102.3 105.6 103.5 100.6 103.7 110.3 100.2 98.9 97.6 99.0 101.2 104.3 99.4 102.1
6.6 14.2 7.5 8.4 8.3 15.6 5.0 7.1 6.7 6.5 7.0 8.5 5.0 6.1
t
p
d
0.371 −0.413 −2.98 0.109 −0.427 −0.022 −2.28 −2.22 −1.11 −2.25 −1.33 −1.71 −3.04 2.97
.71 .68 .01 .91 .67 .98 .03 .03 .27 .03 .19 .10 .00 .01
0.057 −0.063 −0.439 0.011 −0.043 −0.003 −0.365 −0.341 −0.162 −0.337 −0.210 −0.257 −0.473 −0.438
˛
.876 .832 .877
Note. The Body Image Assessment Software (BIAS) was developed by Letosa-Porta, Ferrer-Garcia, & Gutierrez-Maldonado, 2005. ˛ = Cronbach’s ˛ for composite measures; d = Cohen’s d. a Difference between mean score after viewing images of very thin models and mean score after viewing images of healthy weight models was significant (mean score difference was calculated by subtracting scores collected after viewing images of very thin models from scores collected after viewing healthy weight models).
in body image related anxiety (Anschutz, Engels, et al., 2008; Bell et al., 2007; Fister & Smith, 2004; Groesz et al., 2002; Hawkins et al., 2004; Quigg & Want, 2011; Swami et al., 2010; Tucci & Peters, 2008). Contributing to these findings, the present results suggest that viewing images of very thin female models promotes a smaller body ideal than promoted by viewing healthy weight models. Individuals with high baseline anxiety were most susceptible to the negative impact of viewing thin models. Traditionally, individuals with high anxiety have been shown to have a selective attentional bias toward threat (Pacheco-Unguetti, Acosta, Lupianez, Roman, & Derakshan, 2011). Because images of very thin models are a threat to individuals’ self-esteem and body satisfaction, individuals with higher anxiety may pay increased attention to these images. This may underlie the larger decrease in female body ideals after viewing images of very thin models in high anxiety participants. Harper and Tiggemann (2008) reported an increase in negative mood when viewing advertisements with thin models relative to advertisements without people. By comparing ads with people in both conditions but that varied in weight, we report no significant change in negative affect but rather an increase in positive affect when viewing healthy weight models relative to thin models in anxious individuals. Positive affect is associated with activation of the reward system (Ashby, Isen, & Turken, 1999). Thus, participants may have a sense of reward from viewing a healthy weight, likebodied woman that is not experienced when viewing thin models. No such reward difference would be expected for advertisements with thin models relative to advertisements without people. Given that positive and negative affect are independently regulated states (Khalfa, Schon, Anton, & Liegeois-Chauvel, 2005) that can co-exist, it is important to consider positive and negative affect independently in future research. Collectively, our results suggest that viewing healthy weight models instead of very thin models is beneficial to women’s body ideals. While limited research has been done on the impact of viewing healthy weight models, the studies that have been published concur with our findings. Fister and Smith (2004) found women at risk for eating disorders to be less likely to act on diet urges after viewing images of healthy weight models. Likewise, studies in which female participants viewed images of overweight models found a significant increase in body satisfaction, though this could indicate a persisting belief that being thinner than overweight models is preferable (Brown & Dittmar, 2005; Groesz et al., 2002; Papies & Nicolaije, 2012; Posavac et al., 1998; Quigg & Want, 2011; Yamamiya et al., 2005).
Although baseline anxiety moderated the reported effects, notably, contrary to previous studies (Anschutz, Engels, et al., 2008; Bell et al., 2007; Fister & Smith, 2004; Groesz et al., 2002; Hawkins et al., 2004; Quigg & Want, 2011; Swami et al., 2010; Tucci & Peters, 2008), we did not find an increase in anxiety following viewing of thin relative to healthy weight models as measured by the VAS. This scale has low test sensitization (Thompson, 2004), which was advantageous for the present design. While this questionnaire has been used in a number of similar studies (Anschutz, Engels, et al., 2008; Anschutz, van Strien, & Engels, 2008; Tucci & Peters, 2008), it leaves limited room for variability. A more detailed questionnaire or a physiological measure such as a cortisol or skin conductance response may have provided clearer insight. Alternatively, the images we showed to participants may not have been significantly anxiety provoking. It is also possible that participants habituated to seeing very thin models and so they did not report feeling significant anxiety. Further studies are needed in order to confirm this result. It is also worth considering whether our sample size reduced the ability to detect an effect of condition (thin versus healthy weight models) on anxiety levels or other measures of mood. The decision to cap our participants at 44 was primarily based on similar studies in which the number of subjects was quite small (Friederich et al., 2007; Wood-Barcalow, Tylka, & Augustus-Horvath, 2010). The present study also benefited from a within-subject design, increasing the power of the present findings. In fact, primary effects had medium to large effect sizes suggesting that the study had sufficient power. Nonetheless, the small sample size was not sufficient to detect whether effects differed across racial, ethnic, or socioeconomic groups in our sample as have previously been reported (Paeratakul, White, Williamson, Ryan, & Bray, 2002). Thus, future research must consider whether body image differs in response to thin and healthy weight models across these groups. Additionally, one might explore whether men respond to images of very thin versus healthy weight female models in the same way as women, and likewise how men react to viewing images of thin and healthy weight male models. At this time, the BIAS is only available for a female form. In conclusion, these results suggest that a movement toward healthy weight models in popular media may provide a substantial benefit to mental health. The Dove Campaign for Real Beauty is a corporate advertising campaign that aimed to use ‘real’ women in their advertising. However, ‘real’ models ranged from full-figured (often overweight) models to underweight models that had freckles. Nonetheless this campaign and a recent pact by editors of Vogue
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