Body Image and Gender

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J. Tanner

Body Image and Gender Body image refers to perceptions, thoughts, and feelings about physical appearance. Although most people are relatively satisfied with their bodies, evaluative measures of body image indicate that many individuals, both men and women, from young to old, 1282

are dissatisfied and wish they could change some aspect of their bodies. On average, women are more dissatisfied with their bodies than men. This article reviews the measurement of body image, the factors that influence its development, and gender differences in which aspects of physical appearance are the strongest determinants of body image.

1. Assessment of Body Image The assessment of body image is based either on perceptual estimation or on affective reactions to selfevaluation. Unfortunately, the two measures are poorly related to each other. Perceptual estimations refer to the accuracy of judgments about the relative size of various body components whereas subjective evaluations refer to how people feel about those judgments.

1.1 Perceptual Estimates Are Not Reliable Perceptual techniques are used to assess the accuracy of judgments about physical size. For example, researchers distort physical images (e.g., photographs, silhouettes, or mirror images) and then have subjects select their actual image from among the distortions. The difference between perceived and actual body size is used as an indicator of body image. Unfortunately, perceptual distortions of body image are common and occur with equal frequency across many diverse populations. Moreover, the perceptual distortions are unrelated to body image satisfaction and do not indicate any pathological condition. Relatively little research has found these measures to have adequate reliability or validity, and therefore they cannot be recommended at this time (Polivy et al. 1990).

1.2 Subjecti
e E
aluations Reflect Satisfaction With One’s Body Body image is also assessed through subjective evaluation, such as asking people to rate satisfaction or dissatisfaction with their bodies or parts of their bodies. Common techniques include the following: self-ratings of physical attractiveness; self-ratings of specific body part satisfaction (e.g., hips, thighs, nose, and chest); self-ratings of weight, size, or shape satisfaction; and self-reports of affective reactions (such as anxiety or dysphoria) to thoughts about the body. People’s feelings about their bodies are often unrelated to objective reality—many young girls who are objectively underweight feel that they are fat and are actively trying to lose weight. Most people are also typically happy with some of their physical features while being unhappy with others. Although people who dislike many of their body parts tend to have

Body Image and Gender more negative body image, how the various parts contribute to the whole has yet to be precisely determined. 1.3 Excessi
e Concerns About Body Image May Reflect Psychopathology Some individuals are so preoccupied with trivial or imagined defects in their appearance that it interferes with normal psychological functioning. Body dysmorphic disorder is a pathological disturbance in body image in which individuals feel extreme distress about minor flaws in some part of the body, such as the size or shape of the ears, eyebrows, mouth, hands, feet, fingers, or buttocks. These thoughts can be so intrusive that individuals avoid work and public places, going out only at night when they cannot be seen. Those who have body dysmorphic disorder often undergo cosmetic surgery, but unfortunately for some, the surgery fails to alleviate body image dissatisfaction. Indeed, in some cases it increases their concerns as a doctors’ willingness to provide surgery validates their views of abnormality, which may give rise to intensified or new preoccupations.

2. De
elopment and Components of Body Image Many different physical characteristics affect body image, including skin color, nose and ear size, hair loss, facial acne, pregnancy, wrinkles, varicose veins, straightness of teeth, and so on. Indeed, nearly every body part could influence overall body image, especially for those who perceive that body part to be unusual in some desirable or undesirable way. The features most closely associated with body image change over the course of lifespan development and differ as a function of gender. 2.1 Body Image De
elops Early Facially attractive infants receive more positive attention (e.g., increased smiling, eye contact, greater expectations of intelligence) than unattractive infants. For instance, mothers of attractive babies are more affectionate than are mothers of unattractive babies (Langlois et al. 1995). This differential treatment continues throughout childhood. School teachers, nurses, and parents rate attractive children as having better personalities, greater academic ability, and being more likely to be successful than unattractive children. These ratings are likely to have a strong impact on the self-esteem and body image of unattractive or overweight children. The children of parents whom themselves are preoccupied with bodyweight issues or dieting or who have symptoms of disordered eating are at greater risk of developing body image dissatisfaction.

2.2 Adolescence is a Critical Period Adolescence is a time of increased self-reflection and self-attention, and teenagers are especially concerned with how they are viewed by their peers (see Adolescent De
elopment, Theories of). The physical changes that accompany adolescence, such as secondary sexual characteristics, oily complexion and acne, and tremendous individual variation in rate of growth lead most adolescents to be particularly conscious of physical appearance. Many girls become obsessed with body image issues, and by age 16 nearly all female adolescents report having at some point dieted in an attempt to lose weight. At the same time, boys are often concerned with being too short or not sufficiently muscular, especially when compared with popular male peers. Negative comments from peers, particularly in the form of teasing, are important predictors of body image dissatisfaction (Grilo et al. 1994). Unattractive and obese adolescents are liked less, excluded from social events, and viewed by their peers as possessing more negative traits (e.g., lazy, sloppy) than their slimmer and more attractive peers. This social exclusion may promote a self-fulfilling prophecy, in that ostracized adolescents have fewer opportunities to acquire social skills (because of their limited social opportunities) and, in turn, their diminished social skills reinforce people’s avoidance of them. In general, body image is at its most negative during adolescence.

2.3 Adulthood to Aging: Satisfaction to Dissatisfaction As individuals mature into adulthood and focus on family and career issues, most individuals experience a reduction in body image concerns. However, individuals who gain large amounts of weight during adulthood experience increased body dissatisfaction, which may motivate efforts to improve a healthful lifestyle or lead to unhealthful dieting practices and weight cycling. Changes in appearance and physical stamina that accompany old age may have a negative influence on body image. Older men may feel a decline in their body satisfaction because of their declining physical abilities, whereas women may be more concerned about excess weight as well as their wrinkling skin and hair loss. Both men and women may also be concerned about being too thin, since being frail may indicate poor or failing health.

3. Gender Across the lifespan, women tend to have lower body image satisfaction than men. Women are more likely than men to evaluate specific body features negatively, 1283

Body Image and Gender to attempt weight loss, to report anxiety about the evaluation of their physical appearance, and to have cosmetic surgery. 3.1 Women Are Especially Concerned With Body Weight Body image dissatisfaction among women is usually related to self-perceptions of overweight. More than three-quarters of women would like to lose weight and almost none would like to gain weight. Believing oneself to be overweight, whether one is or not, is closely related to body image dissatisfaction. Beginning in early adolescence, women compare their body shape and weight with their beliefs about cultural ideals. A discrepancy from the cultural ideal often motivates people to undertake dieting in order to achieve a more attractive body size. Dieting is rarely successful, with fewer than 1 percent of individuals able to maintain weight loss over five years. Repeated dietary failures may exacerbate body image dissatisfaction and feelings of low self-esteem (Heatherton and Polivy 1992). Perfectionistic and low self-esteem women are particularly affected by body dissatisfaction, such that these personality traits in combination have been linked to increased bulimic symptoms ( Vohs et al. 1999). Black women are much less likely to consider themselves obese and are much more satisfied with their weight than are white women, despite the fact that black women are twice as likely to be obese. Black women also rate large black body shapes much more positively than do white women rating large white body shapes. 3.2 Men are Concerned with Size and Strength Men are more likely than women to view their bodies as instruments of action (Franzoi 1995). Men who are physically large are viewed as more powerful than men who are physically slight, and many men try to increase their physical size. Very thin men are likely to experience body image dissatisfaction. Many men have a desire to be taller and tend to exaggerate their height. This is not surprising given the well-documented link between men’s height and positive social outcomes. Many short men report dissatisfaction with their stature and some evidence suggests that they are more likely to experience decreased self-esteem and more negative body image relative to their taller male counterparts. 3.3 Physical Attracti
eness Cues Vary by Gender The specific attributes that are found attractive differ by gender. Facial features that indicate youthfulness (e.g., large eyes, small nose, big lips) and body features that are petite and thin (e.g., long legs, flat stomach) tend to be desirable for women. For men, facial 1284

features that imply maturity (e.g., square jaw, visible cheekbones) and body features that indicate mass and largeness (e.g., height, mesomorph build) tend to be desirable. There is only a modest association between objectively rated physical attractiveness and body image. However, subjective ratings of physical attractiveness (i.e., personal beliefs) are closely linked to body image satisfaction.

4. Culture Throughout history, cultural influences have played significant roles in determining body image: the Greeks revered the male body, the Romans valued thinness, and people from the Middle Ages showed a preference for larger, rounder female body types. Thus, the determinants of body image change over time as a function of cultural and societal influences (Fallon 1990). 4.1 There is Variation Across Cultures A limited number of physical attributes have defined attractiveness over time (e.g., fleshiness rather than flabbiness, cleanliness, and symmetry in one’s body); the rest are defined within cultures. For instance, the stigma of obesity varies greatly across cultures: Fijians, Kenyans, Samoans, Mexicans and Israelis stigmatize obesity less than do Americans, Canadians, and the British. Individuals often conform their bodies to match local norms and standards. Extreme examples of this include the Burmese tradition of women affixing brass rings around their necks in order to stretch their necks to lengths of up to 40 cm, the East Indies tradition of filing teeth down to the gums, the South American (Abipone) tradition of inflicting deep wounds on the face, breasts, and arms, and the proliferation of Americans piercing and tattooing various body parts. 4.2 There is Variation within Cultures O
er Time Within a single culture, mandates for what is beautiful and desirable also undergo substantial variation across time, particularly for women. For instance, during the 1820s some women drank vinegar to lose weight and stayed up all night to look pale and fragile; in the midnineteenth century, a big, voluptuous figure was in vogue and women often worried about appearing too thin; in the early twentieth century a more slender but very sturdy physique was desirable. Although the preference for body size has fluctuated during the twentieth century, Western societies have been obsessed with thinness since at least 1970. Thus, body image is determined to a great extent by current societal norms and expectations. See also: Adolescent Health and Health Behaviors; Body: Anthropological Aspects; Body, History of;

Borderline Personality Disorder Cerebellum: Cognitive Functions; Culture as a Determinant of Mental Health; Eating Disorders: Anorexia Nervosa, Bulimia Nervosa, and Binge Eating Disorder; Obesity and Eating Disorders: Psychiatric

Bibliography Fallon A 1990 Culture in the mirror: sociocultural determinants of body image. In: Cash T F, Pruzinsky T (eds.) Body Images: De
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iance, and Change. Guilford, New York, pp. 80–109 Franzoi S L 1995 The body-as-object versus body-as-process: gender differences and gender considerations. Sex Roles 33: 417–37 Grilo C M, Wilfley D E, Brownell K D, Rodin J 1994 Teasing, body image, and self-esteem in a clinical sample of obese women. Addicti
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iors 19: 443–50 Heatherton T F, Polivy J 1992 Chronic dieting and eating disorders: a spiral model. In: Crowther J H, Hobfall S E, Stephens M A P, Tennenbaum D L (eds.) The Etiology of Bulimia Ner
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elopmental Psychology 31: 464–72 Polivy J, Herman C P, Pliner P 1990 Perception and evaluation of body image: the meaning of body size and shape. In: Olson J M, Zanna M P (eds.) Self-inference Processes. L Erlbaum Associates, Hillsdale, NJ, pp. 87–114 Vohs K D, Bardone A M, Joiner T E, Abramson L Y, Heatherton T F 1999 Perfectionism, perceived weight status, and self-esteem interact to predict bulimic symptoms: a model of bulimic symptom development. Journal of Abnormal Psychology 108: 695–700

T. F. Heatherton Copyright # 2001 Elsevier Science Ltd. All rights reserved.

Borderline Personality Disorder The term borderline personality is used in two main ways: (a) Borderline personality disorder, one of the personality disorders described in the classification system of DSM-IV (American Psychiatric Association 1994), that is, a circumscribed constellation of pathological personality traits that constitutes approximately 15 percent of all diagnosed personality disorders, and, at least in the USA, probably around 15 percent of all patients in psychiatric hospitals. (b) Borderline personality organization, that is, the psychostructural features that together characterize all severe personality disorders, and that differentiate them from less severe personality disorders (that is, from patients presenting neurotic personality organization). Borderline personality organization includes the borderline personality disorder as one dominant constellation of pathological personality traits among others.

This terminological issue has practical implications: Borderline personality disorder, with its circumscribed symptomatology, has been subject to research regarding specific treatment approaches. The present trend is to treat these patients with a supportive psychotherapeutic approach, based either on psychoanalytic principles or on cognitive behavioral ones, plus a psychopharmacological approach to certain target symptoms. Dialectic behavior therapy (DBT) is one form of cognitive behavioral therapy that has proven effective in reducing suicidal and parasuicidal behavior in borderline patients (Linehan et al. 1991), and psychodynamic psychotherapy has proven effective in treating borderline patients in a day hospital setting (Bateman and Fonagy 1999). Low dose neuroleptics are effective in reducing severe anxiety and cognitive disorganization characteristic of borderline patients, and antidepressive medication, particularly the use of SSRI medication, has been effective in palliating their symptomatic depression (Soloff 1998).

1. The Characteristics of Borderline Personality Disorder The DSM-IV description of borderline personality disorder defines it as a pervasive pattern of instability of interpersonal relationships, self-image, and affects, with marked impulsivity beginning by early adulthood and present in a variety of contexts. It is indicated by five (or more) of the following: (a) Frantic efforts to avoid real or imagined abandonment. (b) A pattern of unstable and intense interpersonal relationships alternating between extremes of idealization and devaluation. (c) Identity disturbance: persistent and markedly disturbed, distorted, or unstable self-image and\or sense of self. (d) Impulsivity in at least two areas that are potentially self-damaging, (e.g., spending, sex, substance use, reckless driving, binge eating). (e) Recurrent suicidal threats, gestures, or behavior, or self-mutilating behavior. (f) Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety, usually lasting a few hours and only rarely more than a few days). (g) Chronic feelings of emptiness. (h) Inappropriate, intense anger or lack of control of anger ( e.g., frequent displays of temper, constant anger, recurrent physical fights). (i) Transient, stress-related paranoid ideation, or severe dissociative symptoms. This personality disorder has substantial comorbidity or overlap with other severe personality disorders, particularly the histrionic, avoidant, dependent, paranoid, and narcissistic personality disorders. 1285

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