Search Search Button Menu Button Menu Button Menu Button Menu Button

About This Page

The Body Project was developed by the Women’s Studies Program of Bradley University in cooperation with the University’s Center for Wellness and Department of Sociology. We invite you to use this site

  • To challenge the way you think about current standards of beauty and fitness;
  • To locate books and videos, facilities and programs, activities, and courses to help you on your way to body acceptance;
  • To expand your understanding of the links between current body ideals and the political, economic and cultural force that shape them;
  • To get information and assistance with balanced nutrition and eating disorders;
  • To have your say on issues of body image and standards of beauty and fitness;
  • And to start down the path to a positive body image.

The Body Project is for women and men of all ages, in the Bradley community and beyond. Join us in increasing awareness and acceptance of the human body in all its shapes and sizes.

Many people think the topic of body image only applies to women and girls. But while researchers differ when defining body image, there is no question that body image is an issue that affects anyone, regardless of sex, ethnicity, or age.

Body image can be a tough topic. Lots of people struggle with theirs. The Body Project recognizes this problem and seeks to challenge the ideal body form and bring awareness to its negative consequences in our society. We do this by providing information to our campus to help individuals understand how widespread unrealistic body image is and overcome personal unhealthy body image.

Understanding body image in order to tackle these issues doesn’t have to be difficult. Essentially, body image is just how we think and feel about our bodies. Researchers investigate whether or not we are content with our bodies, and how that level of contentment affects our behavior (e.g. are we comfortable, do we diet, do we exercise, do we engage in negative body talk, do we develop deeper psychological issues).

Still, the individual definitions of body image from different researchers can be interesting and help reveal deeper meaning. Some stand-outs:

  • Ridgeway and Tylka (2005) define body image as how we internally represent our outer appearances to ourselves.
  • Leone et al. (2011) add that, while body image is constructed, it nonetheless has a powerful impact on the quality of our lives and is an integral part of the structure of identity.
  • Other researchers inform us that body image is made up of two parts: evaluation, which is how satisfied or dissatisfied we are with our bodies; and body image investment, which is how much stake we put into how we look (Brennan, Lalonde, and Bain 2010, and Hargreaves and Tiggemann 2006).

As these samples show, issues of body image are not limited by gender, race, or age. All of us can be affected by unrealistic or unhealthy body image.

Throughout our website, you’ll find pages discussing causes and effects of unhealthy body image in both men and women, juxtaposing body image with gender studies, shedding light on how bodies are perceived from cultural and racial standpoints, and ultimately highlighting some of the most severe consequences of body image problems, including eating disorders and varied psychological disorders. Since we want to equip individuals with the ability to fight back against unrealistic body image, we also have information about ways to alter our attitudes toward body image and to find healthy ways of achieving healthy bodies.

Eating Disorders

In many affluent industrialized nations, eating disorders have reached near epidemic proportions. According to the National Eating Disorder Association (NEDA), 20 million women and 10 million men in the US will have an eating disorder at some point in their lifetime. An estimated 24 million people currently suffer from an eating disorder, with some groups, such as adolescent and college-age women, suffering in alarming numbers. In 2006, the National Eating Disorder Association reported that 1 in 5 college women suffers from an eating disorder. Yet these disorders often go undiagnosed and untreated. It is estimated that only about 10% of people with eating disorders seek treatment.

This page is designed to provide readers with both basic eating disorder “warning signs” and more detailed clinical information. If you have concerns about yourself or others, we encourage you to complete an online screening and/or visit your local health care professional.

Bradley students may access an online screening service at Mental Health Screening. (Keyword: Bradley University).

Only a health care professional can provide a comprehensive and accurate assessment of your health. However, you might want to consider these broad guidelines.

Normal body-image and eating concerns

  • Interest in improving physical appearance, health, and overall wellness
  • Enthusiasm about a new fitness or healthy eating plan
  • Focus on body image, while maintaining a reasonable level of self-acceptance
  • Pursuit of a challenging physical training program that incorporates good nutrition and balance

Problematic body-image and eating concerns

  • Singular focus on weight loss or obsession with restrictive (yo-yo) dieting
  • Punitive approach to body image which includes self-denigrating comments and/or excessive exercise or purging after eating
  • Working out to lose weight without regard for health and nutritional needs
  • Self-worth based entirely on body image
  • Compulsive, rigid or inflexible approach to a diet/exercise routine

There is no single cause of eating disorders but rather they result from multiple influences—social, psychological, developmental, biological, and genetic.

Genetic factors

  • Twin Studies look at Heritability (a percentage representing how much genes contribute to the development of an eating disorder in a particular group of people):
  • Bulimia = 54%. Bullik et al (2001) found evidence of bulimia susceptibility on chromosome 10
  • Anorexia = 58%. Thornton et al (2011); Grice et al (2002) found evidence of anorexia susceptibility on chromosome 1
  • Binge-Eating =  41%.  (Striegel-Moore & Bulik, 2007)
  • Evidence suggests that eating disorders are likely the result of the combined influence of many genes, not just a single gene.
  • Family studies examine the prevalence of eating disorders within groups of genetically related individuals. They have found that:
  • Biological relatives of individuals with Anorexia and Bulimia are 7 to 12 times more likely to have an eating disorder than the general population.
  • Family members of an individual with an eating disorder are 2 to 3.5 times more likely to suffer from bipolar or unipolar depression.
  • Family members of an individual with bulimia have a 3-4 times higher risk for substance abuse.

Psychological, behavioral, physiological and cultural factors

Keel (2005) and Striegel-Moore & Bulik (2007) describe a range of psychological, behavioral, physiological and cultural factors associated with the development of eating disorders:

  • Personality
  • Anorexia: high levels of perfectionism and constraint, higher levels of negative emotion (i.e. depression and anxiety)
  • Bulimia: high levels of impulsiveness and poor emotional regulation, higher levels of negative emotion (i.e. depression and anxiety)
  • Behavior
  • Dieting behavior and initial weight loss is positively reinforced through compliments and attention; increasing value and using foods as rewards can reinforce binges.
  • The experience of eating can become a punishing experience, due to physical discomfort, anxiety, shame over eating, and shame over one’s body/shape.
  • Cognition
  • Those with anorexia or bulimia pay more attention to information about food and body weight/shape than those without an eating disorder.
  • Dichotomous thinking (or black-and-white thinking) – foods get classified as good/bad; losing weight = good, gaining weight = bad.
  • Cognitive rigidity – individuals continue with a specific course of action, without reevaluating it consequences.
  • These cognitions may reflect a consequence of an eating disorders and don’t necessarily predate the onset of an eating disorder.
  • Physiology
  • Low or abnormal Serotonin (5-HT)
  • Serotonin plays a role in eating and weight regulation.
  • Even after recovery some functioning of serotonin is still abnormal, suggesting that a serotonin abnormality may predispose certain individuals to the development of an eating disorder.
  • Culture/Society
  • Western culture’s emphasis on thinness is internalized leading to body dissatisfaction, dieting, and restriction which then leads to over-eating in some individuals.
  • For females: widespread objectification of the female body teaches girls and women that they are valued only for their looks.

Many individuals with eating disorders never receive any form of treatment. Why is this?

Treatment is more likely when an individual has more severe symptoms, impaired psychosocial functioning (i.e. problems at school, home, or job) or a personality disorder or mood disorder (Keel, 2005).

Treatment options for an eating disorder is dependent upon the individual, their symptoms, as well as other factors such as other psychological disorders, but anyone suffering with disordered thoughts should have the ability to seek treatment and find it beneficial.

Inpatient Treatment

  • Spend 24 hours per day in treatment
  • Controlled environment, close monitoring, intensive therapy
  • Patients are often either underweight or purging frequently or suicidal, but very often treatment centers encourage patients to begin treatment as inpatients in order to break their cycle.

Outpatient Treatment

  • Day programs, evening programs, or intensive group and individual therapy that occurs weekly, biweekly, or monthly
  • Day programs involve 2 or 3 monitored meals and snacks and group therapy, but there is less medical monitoring and patients spend evenings and nights at home. 

Cognitive-Behavioral Treatment

  • An empirically supported directive therapy that is organized around the theory that disorders are composed of reinforced behaviors to which there are healthier alternatives and irrational beliefs that need to be elicited, challenged, and replaced
  • Preliminary studies show individuals with anorexia treated with CBT saw 60% good outcomes out of the sample of patients (Murphy 2010). 
  • Shown to be particularly effective with bulimia and binge-eating disorder,
  • In 30-50% of Bulimia cases it eliminates binge-eating and purging
  • Over 50% of Binge Eating Disorder individuals recover with this treatment

Medication

  • Antidepressants and mood stabilizers have been used to treat Anorexia, Bulimia, and Binge Eating Disorder, particularly when used to address simultaneous disorders such as depression, bipolar disorder, and anxiety disorders.

Anorexia Nervosa (Detailed Diagnostic Criteria)

  • Deliberate self-starvation with weight loss
  • Intense, persistent fear of gaining weight
  • Refusal to eat or highly restrictive eating
  • Continuous dieting
  • Excessive facial/body hair because of inadequate protein in the diet
  • Compulsive exercise
  • Abnormal weight loss
  • Sensitive to cold
  • Absent or irregular menstruation
  • Dry, brittle, thinning hair, or hair loss

Bulimia Nervosa (Detailed Diagnostic Criteria)

  • Preoccupation with food
  • Binge eating, usually in secret
  • Vomiting after bingeing
  • Abuse of laxatives, diuretics, diet pills
  • Denial of hunger or drugs to induce vomiting
  • Compulsive exercise
  • Swollen salivary glands
  • Calloused knuckles
  • Broken blood vessels in the eyes

Binge-Eating Disorder (Detailed Diagnostic Criteria)

  • Recurrent episodes of binge eating, defined as
  • Eating much more rapidly than normal
  • Eating until feeling uncomfortably full
  • Eating large amounts of food when not feeling physically hungry
  • Eating alone because of being embarrassed by how much one is eating
  • Feeling disgusted with oneself, depressed, or feeling very guilty after overeating
  • A sense of lack of control over eating during binging episodes
  • Marked psychological distress regarding binge eating

Orthorexia Nervosa

Criterion A.

  • Obsessive focus on “healthy” heating, as defined by a dietary theory or set of beliefs whose specific details may vary;
  • Marked by exaggerated emotional distress in relationship
     to food choices perceived as unhealthy;
  • Weight loss may ensue as a result of dietary choices, but this is not the primary goal.

As evidenced by the following:

  • Compulsive behavior and/or mental preoccupation regarding affirmative and restrictive dietary practices believed by the individual to promote optimum health.
  • Violation of self-imposed dietary rules causes exaggerated fear of disease, sense of personal impurity and/or negative physical sensations, accompanied by anxiety and shame.
  • Dietary restrictions escalate over time, and may come to include elimination of entire food groups and involve progressively more frequent and/or severe “cleanses” (partial fasts) regarded as purifying or detoxifying. This escalation commonly leads to weight loss, but the desire to lose weight is absent, hidden or subordinated to ideation about healthy eating.

Criterion B.

The compulsive behavior and mental preoccupation become clinically impairing by any of the following:

  • Malnutrition, severe weight loss or other medical complications from restricted
     diet.
  • Intrapersonal distress or impairment of social, academic, or vocational functioning secondary to beliefs or behaviors about healthy
     diet.
  • Positive body image, self-worth, identity and/or satisfaction excessively dependent on compliance with self-defined “healthy” eating behavior.

Eating Disorder Not Otherwise Specified

Some disordered eating does not fit neatly into the categories described above. Individuals may suffer from a variety of symptoms, but not meet the diagnostic criteria for any specific eating disorder. Such individuals may be diagnosed with an Eating Disorder Not Otherwise Specified (ED-NOS). Examples include the following:

  • For females, all of the criteria for anorexia nervosa are met except that the individual has regular periods.
  • All of the criteria for anorexia nervosa are met, however, despite significant weight loss the individual’s current weight is in the normal range.
  • All of the criteria for bulimia nervosa are met except that the binge eating and inappropriate compensatory mechanisms (eg. purging, laxative abuse, excessive exercise, etc.) occur less than 2 times a week or for less than 3 months.
  • The regular use of inappropriate compensatory behavior by an individual of normal body weight after eating small amounts of food
  • Repeatedly chewing and spitting out, but not swallowing, large amounts of food. 

Men and Eating Disorders

Although eating disorders are commonly considered women’s disorders, men account for approximately 10% of those diagnosed with anorexia or bulimia. In addition, there is a growing awareness of Muscle Dysmorphia (one form of Body Dysmorphic Disorder), a body image disturbance suffered primarily by men. It is characterized by the following:

  • Viewing one’s body as puny despite efforts and success at body building.
  • Having a distorted body perception that leads to extreme efforts to increase lean muscle mass and overall body size.
  • Taking extreme measures to increase muscle mass, including excessive exercise, dietary manipulation and high protein intake, use of anabolic steroids.

Last update: 18 March 2021

Name

Detailed Diagnostic Criteria

Prevalence

Typical Course

Anorexia Nervosa (AN)

Detailed diagnostic criteria are taken from the Diagnostic Statistical Manual, 5th edition (DSM-V).

  1. Restriction of energy intake relative to requirements, leading to a significant low body weight in the context of age, sex, developmental trajectory, and physical health (less than minimally normal/expected).
  2. Intense fear of gaining weight or becoming fat or persistent behavior that interferes with weight gain.
  3. Disturbance in the way in which one’s body weight, size, or shape is experienced (i.e. body image disturbance); denial of the seriousness of the current low body weight.
  4. Subtypes:
    • Restricting Type: During the last 3 months, the person has not regularly engaged in binge-eating or purging behavior (i.e., self-induced vomiting or the misuse of laxatives, diuretics, or enemas)
    • Binge-Eating/Purging Type: During the last 3 months, the person has regularly engaged in binge-eating or purging behavior (i.e., self-induced vomiting or the misuse of laxatives, diuretics, or enemas). 

According to Keel (2005) and Wilson, Grilo & Vitousek (2007), the prevalence of eating disorders is as follows: 

  • The female-to-male ratio is 10:1
  • The percentage of women who have had anorexia at some point in their lifetime (lifetime prevalence) is 0.5%

Keel (2005), Steinhausen (2002) and Wilson, Grilo & Vitousek (2007) describe the typical onset and course of eating disorders; Leigh (2019) provides recovery statistics:

  • Onset: usually early to late adolescence
  • Approximately 21% make a full recovery (an absence of all clinical symptoms).
  • 75 % improve but remain symptomatic
  • 20% the illness becomes chronic and remitting
  • 5% of those diagnosed eventually die – this is the highest mortality of any psychiatric disorder.
  • The leading cause of death is medical complications.
  • The second most common cause is suicide.
  • 51% of patients hospitalized eventually require a second hospitalization
  • 10-50% of individuals with anorexia cross over to bulimia

Bulimia Nervosa

Detailed diagnostic criteria are taken from the Diagnostic Statistical Manual, 5th edition (DSM-V).

  1. Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following: (1) Eating, in a discrete period of time a large amount of food (2) A sense of lack of control over eating during the episode
  2. Recurrent inappropriate compensatory behavior (sometimes called “purging”) in order to prevent weight gain, such as self-induced vomiting; misuse of laxatives, diuretics, enemas or other medications; fasting or excessive exercise.
  3. The binge eating and inappropriate compensatory behaviors occur, on average, at least once a week for 3 months.
  4. Self-evaluation is unduly influenced by body shape and weight.
  5. The disturbance does not occur exclusively during episodes of anorexia nervosa.

According to Keel (2005) and Wilson, Grilo & Vitousek (2007), the prevalence of eating disorders is as follows:

  • The lifetime prevalence for women is between 1-3%
  • The lifetime prevalence for men is between 0.1-0.3%

Keel (2005), Steinhausen (2002) and Wilson, Grilo & Vitousek (2007) describe the typical onset and course of eating disorders:

  • Onset: late adolescence to early adulthood
  • 50% of individuals recover and maintain recovery
  • 30% improve but remain symptomatic
  • 10% of individuals continue to meet full criteria for bulimia (Cowden, 2020).
  • The rate of relapse is 31-44% (Wilkerson, 2019), 
  • Cross-over rates to either anorexia or binge-eating are very low, because those with bulimia are more likely to continue to suffer from bulimia

Binge-Eating Disorder


Detailed diagnostic criteria are taken from the Diagnostic Statistical Manual, 5th edition (DSM-V).

  1. Recurrent episodes of binge eating. An episode of binge eating is characterized by both (1) Eating, in a discrete period of time, a large amount of food that is larger than most people would eat in a similar period of time and circumstance and (2) A sense of lack of control over eating during the episode
  2. The binge eating episodes are associated with at least three of the following:
    1. Eating much more rapidly than normal
    2. Eating until feeling uncomfortably full
    3. Eating large amounts of food when not feeling physically hungry
    4. Eating alone because of being embarrassed by how much one is eating
    5. Feeling disgusted with oneself, depressed, or feeling very guilty after overeating
  3. Marked distress regarding binge eating.
  4. Binge eating occurs at least 1 day a week for 3 months 
  5. The binge eating is not associated with the regular use of inappropriate compensatory behaviors (eg, purging, fasting, excessive exercise) and does not occur exclusively during the course of anorexia nervosa or bulimia nervosa.

According to Keel (2005) and Wilson, Grilo & Vitousek (2007), the prevalence of eating disorders is as follows:

  • 3 % of adults
  • Higher in obese persons

Keel (2005), Steinhausen (2002) and Wilson, Grilo & Vitousek (2007) describe the typical onset and course of eating disorders:

  • Onset: usually either childhood or late adolescence/early adulthood
  • Individuals who seek treatment are typically older than anorexia or bulimia patients
  • Individuals tend to be significantly overweight and obese

Otherwise Specified Feeding or Eating Disorder

Detailed diagnostic criteria are taken from the Diagnostic Statistical Manual, 5th edition (DSM-V).
Includes disorders of eating that do not meet the criteria for any specific eating disorder. Examples include:

  1. For females, all of the criteria for anorexia nervosa are met except that the individual has regular periods.
  2. All of the criteria for anorexia nervosa are met, however, despite significant weight loss the individual’s current weight is in the normal range.
  3. All of the criteria for bulimia nervosa are met except that the binge eating and inappropriate compensatory mechanisms occur less than 2 times a week or for less than 3 months.
  4. The regular use of inappropriate compensatory behavior by an individual of normal body weight after eating small amounts of food
  5. Repeatedly chewing and spitting out, but not swallowing, large amounts of food.
  6. Frequent night eating either by waking up from sleeping to eat or by consuming excessive amounts of food after having an evening meal.

Background Information
Otherwise Specified Feeding or Eating Disorder (OSFED) replaced Eating Disorder Not Otherwise Specified (EDNOS) in the DSM-V.  It is the most common eating disorder diagnosis. Approximately 32-53% of people with eating disorders fit under this umbrella (Muhlheim 2020). This category helps diagnose eating disorders in individuals who do not  meet all the criteria for one specific disorder such as anorexia or bulimia. Individuals suffering from OSFED may have tendencies that fit within all the branches of eating disorders.

Orthorexia

What is Orthorexia Nervosa?

The term “orthorexia nervosa” (ON) was first used by Steven Bratman in 1997 to describe a pathological fixation on the consumption of appropriate and healthy food. “Orthos” means “accurate, straight, right, valid or correct” and “orexis” means “hunger or appetite” (Brytek-Matera, 2012). A person with ON initially wants to improve his/her own health, treat a disease or lose weight, but eventually their diet becomes the most important part of their life. They become extremely selective about their food choices regarding the food’s purity, origin, presence of artificial ingredients and additives, preservatives, etc. (Chaki et al., 2013).

How Prevalent is Orthorexia Nervosa?

Very few studies have been conducted to determine the worldwide presence of ON. Studies that have examined prevalence are inconclusive.

  • In the general population, 57.5% were diagnosed with ON using a self-administered questionnaire called the ORTO-15. Most were females (Ramacciotti et al., 2011).
  • The overall prevalence of ON was 6.9% in Italy with higher rates among males compared to females (Donini et al., 2004).
  • Athletes are at a higher risk of ON because they exert a high degree of control over their diets to maximize athletic performance. The prevalence of ON is 31% in female athletes and 41% in male athletes (Farooq & Bradbury, 2016).
  • Nutrition students in Germany show higher levels of dietary restraint, but disinhibition and orthorexia nervosa
     did not differ between nutrition students and students in other fields of study (Korinth et al., 2009).
  • Among dietitians in Austria, 12.8% showed four or more symptoms of orthorexia nervosa (Kinzl et al.,2005).
  • Among performance artists, the highest prevalence is among opera singers (81.8%), ballet dancers (32.1%), and symphony orchestra musicians (36.4%) (Aksoydan & Camci, 2009).

What are the Risk Factors for Orthorexia Nervosa?

What begins as exuberant interest in healthy food eventually turns into an eating disorder in susceptible individuals. Individuals who present with the following are at higher risk for ON.

  • Adoption of a highly restrictive dietary theory
  • Parents assign extreme importance to food
  • Childhood illness involving diet and/or digestive issues
  • Medical problems that can’t be addressed by medical science
  • Traits such as OCD, perfectionism, and extremism
  • Fear of disease  (Bratman, 2016)

What are the Diagnostic Criteria for Orthorexia Nervosa?

ON has not been officially recognized as a disorder by the Diagnostic and Statistical Manual of Mental Disorders – V (DSM-V), so valid diagnostic criteria is controversial (Chaki et al., 2013). Aspects of ON overlap with anorexia nervosa and bulimia nervosa, such as food and eating preoccupation, restrictive eating, health-related consequences, and cognitive distortions (Brytek-Matera et al., 2015). However, there are significant similarities between ON and obsessive-compulsive disorder (OCD), such as obsessional anxiety that leads to ritualistic behaviors with meal planning and preparation. It has been shown that individuals with higher OCD tendencies have higher ON tendencies (Poyraz et al., 2015). Because ON does not involve low self-esteem, poor body image, preoccupation with weight loss, or the quantity of food consumed like other eating disorders, it is questioned if ON should be classified as OCD rather than an eating disorder (Brytek-Matera, 2012).

Scarff (2017) has proposed the most recent diagnostic criteria for orthorexia nervosa:

Criterion A. Obsessive focus on “healthy” heating, as defined by a dietary theory or set of beliefs whose specific details may vary; marked by exaggerated emotional distress in relation to food choices perceived as unhealthy; weight loss may ensue as a result of dietary choices, but this is not the primary goal. As evidenced by the following:

  1. Compulsive behavior and/or mental preoccupation regarding affirmative and restrictive dietary practices believed by the individual to promote optimum health.
  2. Violation of self-imposed dietary rules causes exaggerated fear of disease, sense of personal impurity and/or negative physical sensations, accompanied by anxiety and shame.
  3. Dietary restrictions escalate over time, and may come to include elimination of entire food groups and involve progressively more frequent and/or severe “cleanses” (partial fasts) regarded as purifying or detoxifying. This escalation commonly leads to weight loss, but the desire to lose weight is absent, hidden or subordinated to ideation about healthy eating.

Criterion B. The compulsive behavior and mental preoccupation become clinically impairing by any of the following:

  1. Malnutrition, severe weight loss or other medical complications from a restricted diet.
  2. Intrapersonal distress or impairment of social, academic, or vocational functioning secondary to beliefs or behaviors about healthy diet.
  3. Positive body image, self-worth, identity and/or satisfaction excessively dependent on compliance with self-defined “healthy” eating behavior.

What are the Treatment Options for Orthorexia Nervosa?

Treatment options are similar to those offered for other eating disorders and addictive behaviors in general. This may include cognitive behavior therapy that teaches the person how to replace obsessive thoughts with healthier alternatives, and/or gradual-exposure therapy reintroducing “forbidden” foods one by one. Treatment involves a multi-disciplinary treatment team of professionals that may include a physician, therapist, and dietitian (Haupt, 2011).

Ask Yourself…

What is your definition of “health” and “healthy eating,” and where does your definition derive from?

How do you think society and the media has shaped your idea of what foods or eating patterns are considered “healthy?”

Is society’s focus on “clean eating,” “detoxing,” and “natural foods” problematic? Why or why not?

For this page note that in our research ‘women’ and ‘ethnic minority women’ refer to cisgender women. The research gave no indication of the sexual orientation or gender identity of any subjects, only regarding to them as male or female. To stay consistent with the research, the gendered pronouns, “she” and “her” will be used.

Eating disorders are complex mental and physical illnesses. The negative stigma attached to eating disorders can deter people suffering from seeking out potentially life-saving help (Rodgers, Watts, Austin, Haines, & Neumark-Sztainer, 2017). In the United States, mainstream culture places great emphasis on appearance. Women are preferred to be thin, large busted, long legs, and lighter-skinned (Claudat, White, & Warren, 2016). For most women, especially minority women this “ideal” is unattainable. These women, regardless of race, have the possibility to develop eating disorders. The 2020 Minority Diversity Report says minorities account for about 40% of the United States population, but only 26.6% of minorities acquired leading roles in films that year (Wolf, 2020). While this is only one part of the media, the message is clear, minorities are still not as welcome in mainstream media as white people are.

All women can be affected by eating disorders. Yet, it should be noted any research that exists on African American women, Asian American women, and Latin American women is sparse and research on ethnicities besides those three is almost non-existent. Women of different nationalities are not necessarily protected from eating disorders by their cultures, customs, and beliefs (Aviña & Day, 2016; Rodgers et. al., 2017; Small, 2016; Smart & Tsong, 2014; Talleyrand, 2010). While it may be true for some, the belief that all women of minority status are protected is wrong and can be dangerous.

Shifting the Focus

The focus of eating disorder studies has typically been on young white women. It can be argued that young white women are the “face” of eating disorders. But the “face” of eating disorders needs to be revised and ethnic minorities must be a part of that revision. Minority women experience similar but also drastically different lives compared to white women in the United States. They can face racism and bigotry, which can attribute to something called acculturative stress. Acculturative stress is stress that occurs in someone who is trying to adjust and/or fit into the society they live in (Claudat, White, & Warren, 2016). While it is unfair to say every minority in America deals with acculturation and the possible stress behind it, it does appear to have some influence on possible eating disorder development.

The misconception that women who are also ethnic minorities are protected from eating disorders stems from the belief that minorities do not buy into American ideas put in place by the predominantly white media. The underrepresentation of minorities in the media can contribute to unhealthy body image in minority women (Javier & Belgrave, 2015; Kroon Van Diest, Tartakovsky, & Stachon, 2014; Pettit & Perez, 2014; Smart & Tsong, 2014; Talleyrand, 2010). While for some women, this may be true, media influence is not the only way someone can develop an eating disorder. Eating disorders can develop out of many different circumstances.

Stereotypes do not Always Equal Truth

African American women can sometimes subscribe to different, larger body shapes. That is why people believe all African American women are immune to eating disorders (Aviña & Day, 2016; Kroon Van Diest et. al., 2014; Rodgers et. al., 2017; Shuttlesworth & Zotter, 2011; Small, 2016; Talleyrand, 2010). That is not true. Latin American women are stereotyped as preferring both larger body types, as well as smaller ones, which just shows how little research there is in this field (Aviña & Day, 2016; Rodgers et. al., 2017). Just because some Asian American women are very perfectionistic and come from stricter family units does not mean they are more likely to develop eating disorders (Chang, Yu, & Lin, 2014; Javier & Belgrave, 2015; Smart & Tsong, 2014). These beliefs stem from stereotypes and while they are sometimes based in truth, it is wrong to say that minorities all believe in the same things simply because they are of the same or similar ethnicity.

Information about eating disorders and how they affect minorities is minimal. There is not a lot of research about how minorities are affected. To understand how and why minorities develop eating disorders, more research is needed. With research comes understanding, and with understanding comes help for those in need.

African American Women and Eating Disorders

Based on existing research, African American women are a minority group commonly thought to be protected from developing eating disorders (Aviña & Day, 2016; Kroon Van Diest et. al., 2014; Rodgers et. al., 2017; Shuttlesworth & Zotter, 2011; Small, 2016; Talleyrand, 2010). This is because African American women are believed to be more accepting of women with larger body types. By larger, it means being larger than the American ideal female body which is tall and thin. While this may ring true for some African American women, or even women of other ethnicities, it does not mean they are immune to eating disorders.

Asian American Women and Eating Disorders

Asian American women are affected by eating disorders. Unfortunately, research about how eating disorders affect Asian Americans and what factors can predict them is very limited (Chang, Yu, & Lin, 2014; Claudat, White, & Warren, 2016; Javier & Belgrave, 2015; Kroon Van Diest et. al., 2014; Smart & Tsong, 2014). Research that has been done on Asian American women and eating disorders acknowledge the stereotypes that may put Asian American women at risk of developing an eating disorder. The stereotype that Asian Americans are perfectionistic and put a lot of pressure on themselves can contribute to the development of eating disorders (Chang et. al., 2014; Smart & Tsong, 2014). In general, perfectionism has served as a predictor of eating disorder pathology in all women (Chang et. al, 2014; Smart & Tsong, 2014). That does not mean every Asian American woman is this way or believes these things.

Acculturation and acculturative stress can play a role in Asian American women’s development of eating disorders (Claudat, White, & Warren, 2016; Kroon Van Diest et. al., 2014). Based on the research done so far, it is inconclusive as to whether Asian American women experience eating disorder symptoms are similar or different rates than white women (Kroon Van Diest et. al., 2014). This makes it difficult to draw conclusions about what could possibly exacerbate eating disorders in Asian American women and if there are specific eating disorder(s) that occur in Asian American women at higher rates.

Latin American Women and Eating Disorders

Latin American women experience eating disorders. The research on Latin American women and eating disorders is sparse. Just like other minorities, there is a need for more research to understand what, if anything is different when Latin American women and the development of eating disorders. Multiple studies suggest that acculturation and acculturative stress may have some influence in Latin American women’s development of eating disorders or at least the development of feelings of low self-esteem about their bodies (Aviña & Day, 2016; Claudat, White, & Warren, 2016; Kroon Van Diest et. al., 2014; Rodgers et. al., 2017).

Body & Beauty Standards

With images of ideal beauty bombarding us daily, it is easy to forget that standards of beauty are arbitrary and they vary greatly both from one culture to another and over time.

Such variations in ideals of beauty often reflect the roles women and men are expected to fulfill in a given society. For instance, in contexts where women are valued mainly for their fertility—their ability to bear and nurture children—often full-bodied women with broad hips and ample breasts are considered the most beautiful. In societies such as Fiji, large bodies are a symbol of one’s status and power. It is not surprising, therefore, that individuals who would be classified as obese in the US are considered the most attractive and desirable members of this culture.

But as social conditions and gender roles change, so do ideas about beauty. Consider some recent changes in the US. In the 1960s and 70s, beauty ideals for women shifted from the mature curvaceous body of stars such as Marilyn Monroe to the stick-thin, flat-chested figure epitomized by supermodels such as Twiggy or Kate Moss.The compelling fact here is that just as women started to make dramatic gains in the areas of education, employment and politics, the ideal female body began to look like a malnourished preadolescent girl, weak, emaciated and non-threatening. Women may have been gaining in freedom and power, but they were increasingly encouraged to discipline their bodies through diet and exercise to conform to ideals that were almost impossible to achieve.

Now, however, we see the beauty standard for women becoming curvier in some areas such as the bust and butt, and staying thin, toned, and tucked in other areas such as the waist and the thighs. According to Hoff (2019), in a recent survey of 1,000 Americans, the “perfect” woman was described as 5’5”, 128 pounds, with a 26-inch waist. It would be almost impossible to achieve the proportions of this body ideal without using extremely unhealthy means.

Ask yourself…

Why is the American body ideal for women so unrealistic and unattainable?

Is the body ideal for men any more realistic or attainable than the ideal for women?

Does this tell us anything about the roles we expect men and women to fulfill

Can you think of any plus-size celebrities today? How are they portrayed and how has the movement changed within the last 5 years or so?

A multi-billion dollar economy is built on our insecurities about the size, shape and appearance of our bodies. The leading Beauty Industries–fashion, cosmetics, weight loss and cosmetic surgery–realize greater profits the more dissatisfied we are with our appearance. It is hardly surprising then that these industries spend millions of dollars promoting beauty ideals that are almost impossible to achieve. Our continued failure to live up to such ideals virtually guarantees that we will continue to invest our money (and our hopes) on the latest miracle diet, “slimming” garments, or “age-defying” creams and potions.

Ask Yourself

Why is it okay for women to dress in mensware-style suits, but utterly unacceptable for men to dress in skirts, lace or anything considered “feminine”?

Which is more oppressive to women? Victorian era corsets, full skirts, bonnets and gloves OR the pressure to wear low-cut form-fitting shirts and tight ultra-low-rise jeans?

How much time do you spend each day on your clothing and makeup? Compare this with the amount of time you spend on significant social issues such as poverty or prejudice.

Have you ever noticed how many women’s cosmetics these days are made to look and smell like food? Women are encouraged to “nourish” our bodies with products such as vanilla sugar facial scrubs, chocolate mousse moisturizers, and coconut body butters. At the same time, women are encouraged to carefully limit our actual consumption of things like sugar, chocolate and butter. Is there a connection between these trends?

What are some arguments for and against cosmetic surgery?

Corsets, bustles, push-up-bras, control-top pantyhose: each designed to discipline and “perfect” the female body. Of course, clothing fashions change along with changing standards of female beauty. While corsets and bustles emphasized impossibly small waists, broad hips and large posteriors, today’s fashions often emphasize large breasts and flat, toned mid-sections. But what does fashion have to do with the way we feel about our bodies? What can a critical analysis of fashion tell us?

Fashion Trends Can Tell Us About Gender Relations In A Given Society At A Particular Time

For instance, women’s fashions shifted from the restrictive full-length skirts and tight bodices of the 19th century to the shorter split-skirts advocated by women’s rights campaigners at the turn of the century to the skin-baring “flapper” dresses of the 1920s. We can see that as some of the social, economic and legal restrictions on women began to ease, women’s fashions became less restrictive. It is worth considering, however, whether at some point more revealing and more form-fitting fashions for women become almost as oppressive to women as the corsets and bustles of earlier eras.

Fashion And Fashion Advertising Can Shape The Way We Feel About Our Bodies

When fashions are designed to suit the tall, thin frames of supermodels, it is unlikely that the majority of women will be able to live up to the ideals they see on the catwalks and in the pages of fashion magazines. Some studies have even found that women and girls who are more frequent readers of fashion magazines have poorer body image (Harrison & Cantor 1997). Another study found that employees working in the beauty and fashion industry have a higher risk of developing an eating disorder or an eating disorder-patterned behavior (Lukács-Márton et al 2008). With this growing awareness of the ways the fashion industry contributes to the lowered self-esteem of girls and women, in 2006 the organizers of the Madrid fashion week banned overly thin models from participating. While spokespeople for the Madrid event said that they simply wanted to avoid promoting the unhealthy, anorexic or “heroine chic” look, representatives of top modeling agencies in America expressed outrage over the move, which would exclude many of their top earners from the event. France followed suit in 2017 when they banned overly thin models from modeling any type of clothing or fashion item and required any photoshopped photo to be labeled as such under (“France” 2017). More recently, the trend has been less about banning overly thin models and more toward including a range of body types. For instance, a 2020 article previewing Spring Fashion Month 2021 announce that size-inclusive fashion lines would be featured by many leading designers (Naer 2020)

We Spend More Time Worrying About Fashion Than About More Significant Political, Social And Even Moral And Emotional Issues

It is not a coincidence that in America an emphasis on female thinness developed in the 1920s, just as women won the right to vote and started to make their way into previously forbidden territory—like university classrooms, professions and elective office. Perhaps because many in the culture felt threatened by women’s new freedoms, new standards of bodily beauty developed, standards which encouraged women to spend more time on their wardrobes, makeup and body shape and less on education, career and political activism.

Likewise, the cosmetics industry promotes impossible standards of flawless beauty while suggesting that natural features such as “fine lines and wrinkles,” freckles and even pores are unsightly. This fuels self-doubt and self-loathing among consumers, making us more willing spend our hard-earned cash on products to hide our countless “flaws.”

Back in 1990, Naomi Wolf pointed out, people in the US spent $20 billion dollars a year on cosmetics (1990: 113). That was enough to pay for

  • 2,000 women’s health clinics;
  • 33,000 battered women’s shelters;
  • 400,000 four-year university scholarships;
  • 200,000 vans for safe nighttime transport;
  • 1 million highly paid child care workers; or
  • 1 million home health aids for the elderly.

This trend seems to be getting worse. The cosmetic skincare market in the US alone made $39.2 billion in revenue in 2020. Other countries such as China, Japan, and Canada aren’t far behind and are projected to grow tremendously in the 2020-2027 period. For example, Japan is expected to increase revenue by 1% over the next seven years and Canada by 2.7% (Markets 2020). That’s a lot of money that could be spent on more pressing issues or benefitting ourselves in more healthful ways such as improving the health, safety, education, career opportunities and security of women across the nation. It’s no surprise that the US isn’t alone in this issue either as our messages about beauty have reached nations across the globe.

Fashion, Cosmetics And Men

Since the beginning of modern advertising, the fashion, cosmetics, plastic surgery and weight loss industries have primarily targeted women. In recent years, however, these industries have set their sights on men as well. Many cosmetics companies now carry men’s lines consisting mainly of skin and hair care products but also “fragrances” and assorted “grooming aids.” (Of course, they can’t call these things perfume and makeup!) At the same time, men’s fashions are more aggressively marketed with images of muscular male models with chiseled abs, often in sexually suggestive poses.

Is the selling of unrealistic bodily standards for men in some ways a positive development for women? Does it suggest that women and men are finally equal? Jean Kilbourne in Killing Us Softly 3 says “No.” This is not a positive development for either men or women. Rather, we can see this as an attempt by the Beauty Industries to boost profits by instilling insecurities in men as well. But Kilbourne notes that the beauty industries may not be as harmful to men as they are to women, because our society tends to judge men more on their achievements than on their appearance.

These days our society seems to suffer from makeover mania. Countless television shows and magazine stories focus on transforming individuals from the outside in. Weight loss and “toning,” hair cuts, hair color and makeup, wardrobe changes, and even plastic surgery have become the staples of today’s mass mediated makeovers. Such stories and the accompanying “before” and “after” photos provide the audience with powerful messages. They imply that

  • Anyone can dramatically change and improve their appearance if they have enough willpower.
  • Such transformations will be more successful with professional help. We need to purchase the services of personal trainers, diet gurus, plastic surgeons and other beauty professionals.
  • And, perhaps most importantly, makeovers do not simply change a person’s appearance: they change one’s outlook and one’s self-image. The implied promise is that a makeover will make you happier and more confident, and lead you toward greater professional, financial and personal success.

This promise—this idea that a thinner, more toned, more beautiful body is just a purchase away—is the lifeblood of the weight loss and cosmetic surgery industries.

Americans now spend more than $40 billion dollars a year on weight loss products and programs. 90 percent of American women consider themselves overweight, and almost half of them are dieting (Naomi Wolf 1990: 185).

Ironically, contrary to the diet industry’s promises, the majority of people who diet will gain back any weight they lost within 1-5 years, and will actually gain additional pounds as well. Researchers suggest that crash diets and chronic on-again-off-again dieting cause our bodies to adjust to these self-imposed periods of “famine” by slowing down our metabolism and more efficiently storing fat. In a sense then, dieting can actually lead us to gain weight, thus making us more likely to diet again, gain more weight, and diet yet again. While this is good for the profit margins of the weight loss industry, it can take a serious toll on our health. Extreme weight loss regimens can lead to side effects ranging from bad breath to organ damage and, in the most severe cases, even death. While diet gurus seem to suggest that thinner is always healthier, recent research suggests that overweight people have a slightly lower risk of death than those who are underweight when compared to normal BMI patients (Mozes 2014).

According to the American Society of Plastic Surgeons, Americans have spent over $16.5 billion each year since 2018 on cosmetic surgery. And the number of patients and procedures is rising dramatically. From 2018-2019, the number of liposuction procedures has increased 3%; eyelid surgery has increased by 2%; and Botox injections have increased by 4% (American Society of Plastic Surgeons 2019). In addition to the more well-known “face lift,” “nose job” or breast enlargement, patients can now undergo vaginal or labial “rejuvenation” procedures or even acquire fake bullet scars to give them street cred.

In Beauty Junkies (2006), Kuczynski points out that the cosmetics surgery industry in the United States is only loosely regulated, and because it is so lucrative it can attract unscrupulous and under-qualified practitioners. Under current federal regulations, anyone with an MD can perform cosmetic surgical procedures—whether or not they have been trained and board certified on any particular set of skills. There are different qualifications to become a “cosmetic” versus “plastic” surgeon and the differences are quite extreme. A board-certified plastic surgeon requires at least six years of residency training whereas a board-certified cosmetic surgeon solely requires one year of training (American Society of Plastic Surgeons 2017). And the results can be devastating—disfigured bodies, paralysis, chronic pain, infections, and even death.

Even for those who do not get such procedures themselves, cosmetic surgery can have pernicious psychological effects. That is, as increasing numbers of celebrities, models and public figures undergo such procedures, the beauty standards shift even further away from the natural body toward more artificial, more unattainable norms.

With images of ideal beauty bombarding us daily, it is easy to forget that standards of beauty are arbitrary and they vary greatly both from one culture to another and over time.

Such variations in ideals of beauty often reflect the roles women and men are expected to fulfill in a given society. For instance, in contexts where women are valued mainly for their fertility—their ability to bear and nurture children—often full-bodied women with broad hips and ample breasts are considered the most beautiful. In societies such as Fiji, large bodies are a symbol of one’s status and power. It is not surprising, therefore, that individuals who would be classified as obese in the US are considered the most attractive and desirable members of this culture.

But as social conditions and gender roles change, so do ideas about beauty. Consider some recent changes in the US. In the 1960s and 70s, beauty ideals for women shifted from the mature curvaceous body of stars such as Marilyn Monroe to the stick-thin, flat-chested figure epitomized by supermodels such as Twiggy or Kate Moss.The compelling fact here is that just as women started to make dramatic gains in the areas of education, employment and politics, the ideal female body began to look like a malnourished preadolescent girl, weak, emaciated and non-threatening. Women may have been gaining in freedom and power, but they were increasingly encouraged to discipline their bodies through diet and exercise to conform to ideals that were almost impossible to achieve.

Now, however, we see the beauty standard for women becoming curvier in some areas such as the bust and butt, and staying thin, toned, and tucked in other areas such as the waist and the thighs. According to Hoff (2019), in a recent survey of 1,000 Americans, the “perfect” woman was described as 5’5”, 128 pounds, with a 26-inch waist. It would be almost impossible to achieve the proportions of this body ideal without using extremely unhealthy means.

It is not surprising that most women and many men feel they cannot live up to the body ideals they see in the media. With recent photo manipulation technologies already-thin women are made to look even thinner. In 2006, it was revealed that CBS doctored a publicity photo of news anchor Katie Couric to make her appear younger and thinner. [Original and retouched photos below.] Such practices contribute to widespread body dissatisfaction among American women, who in real life will never live up to these digitally manipulated ideals.

“For an understanding of the extreme manipulation of images of beauty, view the short film “Evolution,” produced by Dove Films.

The Media

Where do we get our ideas about bodies and beauty? The list is seemingly endless. We inherit such ideas from our parents, our peers, our teachers and mentors, from our places of worship, our schools, and increasingly from the mass media. In high-tech societies such as ours, there are few settings into which the mass media do not intrude. And even if we are beyond the reach of tvs, iPhones and laptops, we still carry in our minds media messages about appearance and desirability.

It would be overly simplistic to argue that media consumers always accept such messages completely and uncritically. Nor is it reasonable to suggest that the media alone are responsible for eating disorders and body image disturbances. However, systematic research on the topic, especially during the last two decades, suggests that the mass media powerfully influence our perceptions of beauty, our attitudes toward others, and our own self-image.

According to a 2018 article published by NEDA (National Eating Disorders Association), Myers & Biocca (1992) and Irving (1990,1998) have found that exposure to media depictions of thin female models lead women and girls to overestimate their own body size, experience greater dissatisfaction with their own bodies, and report lower self-esteem. NEDA also reports that In a study conducted among elementary school girls who read magazines, 69% are influenced by the body ideal and 47% were convinced by these messages to lose weight (Martin, 2010). Among men, such exposure is correlated with a drive toward muscularity and still promotes body dissatisfaction. It has been proven that those who watch Black-oriented television shows generally have a better relationship with themselves and their body (“Media” 2018).

Ask Yourself

The next time you read a fashion magazine or watch a trendy television show, try monitoring how you feel. What kinds of “self talk” do you engage in? (eg. “I wish I could have thighs like that,” “I’ll never lose that last 5 pounds.”)

If reading or watching makes you feel bad about your appearance, why do you think you continue to do so?

Next time you are tempted to read or watch such media, what could you do instead?

It is always difficult to conclusively prove what effect the media have on people. This is because the media are just one among many influences in our lives. When someone commits a gruesome crime, people often assume that the criminal act was the result of watching violent movies, playing violent video games or listening to certain kinds of music. But such explanations are much too simplistic. The perpetrator may have been getting certain messages from these media, but messages were also coming from family, friends, teachers and others. And, of course, millions of people watched, played or listened to such media forms without committing acts of violence. So we must always be cautious about assuming simplistic cause-and-effect relationships between media messages and people’s attitudes and actions.

Nonetheless, several compelling recent studies demonstrate what a powerful force media messages can be in shaping attitudes about bodies and beauty.

In 1999, Anne Becker and Rebecca Burwell of the Harvard Eating Disorders Center found that media exposure dramatically increased the incidence of eating disorders in the island nation of Fiji. The researchers chose to study Fiji both before and after the introduction of Western television programming to the nation. Before Western TV arrived, most Fijians subscribed to traditional ideas of beauty: larger bodies, bodies that would be classified as obese in the West, were considered the most attractive. Large bodies were seen as evidence of a person’s health and high status; slim bodies were thought to look sickly, and were seen as indications that the person suffered from a lack of food and/or a lack of friends and loved ones to support them. Only three years after the introduction of Western (mainly US, UK and Australian) TV programs, the number of girls and women who reported vomiting to control their weight increased five-fold. 74% of girls reported feeling “too fat,” and 62% reported dieting in the last month. And furthermore, girls who watched more television were more likely to evaluate their bodies negatively. Interviews with the girls and young women demonstrated that they were attempting to emulate the thin Western actresses they saw on television.

Other researchers, including Myers & Biocca (1992) and Irving (1990, 1998) have found that exposure to media depictions of thin female models lead women and girls to overestimate their own body size, experience greater dissatisfaction with their own bodies, and report lower self-esteem. In addition, Harrison and Cantor (1997) tested the effects of media exposure on the development of disordered eating among college students. They found that among women, exposure to media that depicted and promoted thinness “appears to be associated with a subsequent increase in eating disorder symptomatology.” Among men, such exposure is correlated with a drive toward personal thinness as well as favorable attitudes toward female thinness.

So while the media alone don’t create harmful body attitudes and practices, they promote images that can seriously harm our self-esteem and tempt us to engage in expensive, unhealthy and ultimately futile, attempts to live up to mass mediated beauty ideals.

As well as purveying unrealistic beauty ideals, the mass media send us a slew of contradictory messages as if to confound us further. It is common for a single magazine cover to promote both the latest miracle crash diet and a quick and easy recipe for Double Fudge Overload Brownies. That same magazine might pair an image of a scantily dressed woman in a sexually provocative pose with an article on The Rewards of Abstinence. The contradictions are obvious: restraint and indulgence, seduction and chastity, “good” girls and “bad” girls. How can we possibly live up to such mixed messages?

Of course, the answer is we can’t. Such contradictory messages ensure that we will always feel inadequate and insecure. And our insecurity is good for those who want to sell us quick-fixes in the form of such things as diet plans, exercise videos, anti-cellulite lotions and steel-reinforced undergarments.

There are some perspectives, contrary to popular belief, which we can take to become critical viewers of the media and its messages and to protect ourselves against the unrealistic and unattainable body ideal.

  • Understand that the content that is being put out does not reflect reality whatsoever. There are certain images and messages being sent out for specific, destructive reasons.
  • Advertisers are displaying what they want you to see and they want to sell you a service. If that is a shared understanding of all consumers, the emotional response will not be as effective as the creators would have hoped. Therefore, the effectiveness of the ad will decrease.
  • Choose to view the media with a filter that protects your body-image and self esteem. We are the only ones who can control this and the media should not get to decide this for us. (NEDA 2018)

It is clear from the research that the media present powerful messages about ideal body types for men and women, and that such messages can shape our attitudes and behaviors. But images of ideal bodies also carry meanings about the kinds of roles and traits that are desirable for men and women. There is a growing awareness of the ways media representations of masculinity and femininity contribute to patterns of violence in the United States today.

Jackson Katz, in his films Tough Guise: Violence, Media and the Crisis of Masculinity(2000) and Wrestling with Manhood: Boys, Bullying and Battering (2002) and his book The Macho Paradox (2006), argues that the mass media in the US construct violent masculinity as the norm. Through exposure to the media, he suggests, boys learn that “real” men are physically dominant, tough, aggressive, and willing to use violence to achieve their goals. He notes that violence is one of the nation’s most serious epidemics, and most of that violence is committed by men. In 2006, Katz reported that 85% of murders are committed by men; 90% of physical assaults, 95% of domestic assaults, and 99% of rapes are committed by men. More recent statistics show that by 2012 88.7% of murders are committed by men; 77.1% of aggravated assaults, 72.3% of other assaults, and 99.1% of rapes are committed by men (FBI 2012). Katz reminds us that pointing out such statistics is not anti-male. After all, most victims of male violence—76% of victims—are other men. So trying to break the association between masculinity and violence promises to benefit both men and women.

Media depictions of large, heavily muscled male bodies emphasize male power and dominance. Although little systematic research has been conducted to test the effect of such media representations on the body image, it has been proven that it is in fact harmful for males to be bombarded with such body ideals. Men, after watching television advertisements promoting the muscular and ripped body ideal, have increased levels of depression as well as increased body dissatisfaction. This unrealistic ideal is becoming more and more extreme as time goes on and is one of the causes for the increase in use of steroids and excessive exercise (Halliwell et al., 2007).

While the mass media all too often present us with oppressive images of ideal beauty and ideal bodies, some media forms are designed to challenge such unrealistic representations. One recent example of this is the Dove Campaign for Real Beauty, that uses the images of women of a variety of ages, ethnicities and body shapes to advertise its products.

Body positivity has been quite a movement that surfaced in the United States around 2012 and promoted the message that “all bodies are beautiful”, combating the idea that has bombarded consumers for decades on end that one’s body must be stick thin, flawless, and essentially inhuman. With the plethora of media, including social media platforms, many companies, well-known individuals, and everyday people started to post more about the reality of the body ideal and how it is unattainable for anyone.

One company that has taken this movement quite seriously is Aerie. As a clothing, activewear, and intimate brand under American Eagle, Aerie decided to display their products via an extremely diverse group of models. Since 2014, Aerie’s media does not include any airbrushing to mask any “imperfections” once deemed unacceptable by the body ideal.

However, the most pressing question is does this actually work? Do women who view ads like Aerie’s feel more comfortable with themselves and their bodies? In a 2019 study, the effectiveness of this campaign was assessed by 35 women. The consensus was clear in that the women felt more positively both about Aerie and their bodies compared to other companies’ campaigns that haven’t adopted the body positive mentality (Rodgers et al., 2019).

Documentaries like Jean Kilbourne’s Killing Us Softly are helping to challenge media representations of ideal beauty. However, there’s still a long way to go. Kilbourne’s career shows this: her first documentary was produced in 1979. Since then, she’s made three more updates that show the persistence of this problem — her most recent, Killing Us Softly 4, was released in 2010.

In Victorian America, women were discouraged from being physically active. The generally accepted belief of the day was that women were naturally frail. Too much physical (or intellectual) stimulation would upset the delicate balance of their bodies and lead to physical illness, infertility, “nervous” diseases, even insanity. Women who were judged by the society to be overly liberated or overly interested in physical or mental pursuits were sometimes subjected to the “rest cure.” They were confined to their beds for weeks at a time and not allowed to have visitors, read, sit up or use their hands. It was believed that this “cure” would calm women’s bodies and minds and make them acceptably compliant and pleasingly frail. Charlotte Perkins Gilman’s story The Yellow Wallpaper describes one woman’s experience of this treatment.

“Rich cultures value thin women, and poor cultures fat women, but all male-dominant cultures value weakness in women.” Gloria Steinem

Although our society no longer expects girls and women to refrain from strenuous physical activity, Colette Dowling in The Frailty Myth argues that girls in the U.S. are often discouraged from fully developing their muscles and sporting skills, and are rewarded for having small, weak, delicate bodies.

For example, according to Dowling’s research:

  • Studies show that parents routinely reward boys for active play, but reward girls for passive and quiet play; and schools encourage more large muscle skill development for boys than girls (Dowling 2000: 51-55).
  • Girls start playing organized sports an average of two years later than boys (Dowling 2000: 53) and drop out at 6 times the rate that boys do.
  • By age 4, boys perceive themselves as stronger than girls, and girls perceive themselves weaker than boys (Dowling 2000: 86).

When girls and women are discouraged from developing healthy, strong bodies, they lose out. Research shows that compared with girls who don’t play sports, girls who participate in organized sports as teens:

  • have higher grades and better self-concept,
  • do less drinking and smoking,
  • are less likely to experience teen pregnancy,
  • and have higher graduation rates and higher rates of college entry.

Later in life, physically active women have a lower incidence of osteoporosis and heart disease (Dowling 2000: 77-83).

But standards are changing! Girls’ and women’s participation in sports has increased dramatically since the 1970s. The development of professional leagues such as the WNBA (Women’s National Basketball Association) and the WUSA (Women’s United Soccer Association) have given girls and women new, strong and active female role models.

Ask Yourself

Why would a society encourage women to be physically weak, vulnerable and powerless?

Why are girls and women in our society encouraged to reduce their size of their bodies, while boys and men are encouraged to build up their bodies to be bigger and stronger?

Why are boys encouraged to play contact sports such as football and hockey, while women are encouraged to take up sports such as tennis, figure-skating or gymnastics?

Millions of children own them, millions of parents buy them, and most of us have played with them at one time or another. So why should we worry about the messages that toys such as Barbie or GI Joe convey about femininity, masculinity and the ideal bodies and behaviors for men and women?

Ask Yourself

Did you play with Barbie, GI Joe or other similar toys when you were growing up? Do you think this had any effect on your ideas about male and female bodies or male and female roles?

Action Figures

First, as most boys quickly remind you, GI Joes are not dolls. They are “action figures.” And this separate terminology reveals the very different meanings toys such as GI Joe and superhero figures convey. Typically, these toys are not designed to be dressed up and admired for their appearance. Product packaging shows them staging daring rescues and fighting battles. In stark contrast with Barbie, boys’ action figures seem to teach children that:

  • Boys and men are powerful and important.
  • Boys and men do great things and are recognized for their deeds.
  • Boys and men fight the bad guys, and protect the innocent and the weak.

And yet, recent decades have seen boys’ action figures become impossibly, even grotesquely muscular. Some recent dolls have biceps bigger than their heads—not a positive message about brain vs. brawn. Jackson Katz, in his documentary Tough Guise, observes that the GI Joe doll’s biceps have been steadily enlarged over the years to the point that the figure’s body proportions are virtually impossible for any real man to attain. What’s more, Katz points out that such toys are just one source of messages in our culture that associate masculinity with violence—heroic, morally justified violence in this case, but violence nonetheless. One current line of professional wrestling action figures is promoted as the “Ruthless Aggression” series. Thus, among the potential harmful messages conveyed by action figures, we might include the following:

  • Boys and men should have large, powerful bodies with sculpted muscles.
  • Boys and men should be willing and able to use their bodies to commit morally justified acts of violence.
  • The only real men are “tough guys.”

Again, the psychological and behavioral effects of being exposed to these messages are hard to gage. However, potential negative effects include

  • A negative body image for boys and men, especially those labeled as “fat” or “weak,” and the development of unhealthy practices to cope with feelings of frustration and shame 
  • The potentially life-threatening use of steroids to build muscle mass
  • The socialization of boys and men to violence and dominance.

Barbie

In the last three decades, the humble Barbie doll has come in for a lot of criticism. While many feminist researchers have suggested that Barbie represents an unattainable body ideal that damages girls’ self-esteem, the doll’s defenders have argued that Barbie is, after all, “just a toy” and is unlikely to create any lasting psychological effects.

What is indisputable, however, is that the Barbie’s body dimensions are very far outside the “normal” range. In a [2003] study, Urla and Swedlund calculated that if Barbie were full size, her measurements would be 32-17- 28, typical of a woman suffering from anorexia. Add to this anorexic frame her large gravity-defying breasts and you have a body ideal that is virtually impossible for a healthy, non-surgically altered woman to attain.

Although it is unlikely that children playing with Barbies consciously compare their own bodies to those of their dolls, it would be naïve to assume that they do not pick up on the powerful messages embodied by this cultural icon. Among these messages we might include the following:

  • The ideal female body is stick-thin and big-breasted.
  • The natural, healthy female body is unattractive.
  • To be attractive and popular, girls and women must have well-disciplined bodies, meticulously groomed hair and make-up, and a carefully coordinated and fully accessorized wardrobe. (Subtext:  Spend, spend spend! Diet, diet, diet! And live at the gym if you have to!)
  • And, perhaps the overriding message: Girls and women are judged more on how they look, than on what they do. Although Mattel has introduced some career-themed Barbies in recent years, the fashion-oriented dolls (along with the bride and princess) are the perennial best-sellers.

It is difficult to measure any negative psychological or behavioral effects that early and intense exposure to such messages may have. Such measurement is difficult primarily because such messages are so pervasive in our culture today. Summer (1996: 14) noted of fashion advertising, for instance, the prevalence of “concentration-camp-thin models with pasty complexions sporting blackened eyes, limp hair, and designer outfits.” However, with 80% of 10-year-old girls now dieting to control their weight, and most American women struggling daily to make their bodies conform to unrealistic ideals, few could argue that Barbie and her kind contribute to the development of positive body image among girls and women.

Mattel only took action when their sales plummeted 20% from 2012 to 2014. In 2016 Mattel released new petite, tall, and curvy Barbie dolls in addition to the original doll that has been sold for decades. With the rise of the body positivity movement and Barbie dolls just not making the cut among women anymore this was a long overdue release. There still exists some pushback and hesitancy from the general public. Some mothers are afraid they might hurt their child’s feelings if they give them a doll labeled “curvy” which just goes to show how much of an effect the body ideal has had on the general public. (Dockterman 2016).

Normalizing these realistic body types is essentially the long-term goal of this release. One day kids growing up will not see the “curvy” doll as slightly chubbier or the “petite” doll as slightly shorter but they will see them as normalized, beautiful bodies.

Male vs. Female Body Image

Researchers don’t make a distinction about what body image is to men and women. However, separate research is being done on the different ways each of the sexes handle body image. Most research has been conducted surrounding female body image, so male body image research, while becoming more popular, still lacks the depth and breadth of its counterpart.

How They’re Similar

So far, research has shown that male and female body images share many of the same features. Women and men, boys and girls, may share body image risk factors and consequences of negative body image, though studies do point toward males being affected a little less severely than females (Hargreaves & Tiggemann 2006). Brennan, Lalonde, and Bain (2010) conducted a comparative study of how male and female body image dissatisfaction is experienced in each of the sexes in which participants rated body image reactions to a series of statements. When responding to the statements, “When I am with attractive persons of the other sex,” “when the topic of conversation pertains to physical appearance,” and “during certain recreational activities,” both men and women reported experiencing negative emotions between sometimes and moderately often, This shows that men and women are equally insecure in their bodies when the idea of ‘the body’ is directly or indirectly confronted in social situations.

How They’re Different

However, male body image is distinguished from female body image in several ways:

  • Men seem to be more prone to ‘atypical’ eating disorders and substance abuse than women (Burlew & Shurts 2013).
  • Men tend to be quieter about their body negativity, seeking treatment less frequently or holding off on treatment longer than women due to shame (Brennan, Lalonde, & Bain 2010; Burlew & Shurts 2013). Women, however, internalize more, body shame more, and body surveillance more than men (Brennan, Lalonde, & Bain 2010).
  • Some researchers say men are typically more satisfied with their physical appearance and less likely than women to exhibit body-change behaviors (Muth & Cash 1997; see Doyle & Engeln 2014)
  • But other researchers insist that men still struggle with body image: They say men are caught “feeling either too thin or too heavy to meet the male ideal” (Doyle and Engeln 2014, 279).

Male body image also tends to be more misunderstood than female body image. Men are presumed to be mainly concerned with a “perceived lack of muscle,” when in fact male body image can be much more complex (See the first page of Male Body Image). On the other hand, the presumed concern for females is not as off the mark: weight.

It may seem unhealthy female body image is more prevalent than unhealthy male body image, but that may only be a perception: some researchers claim that women are simply exposed to more social situations that make them feel dissatisfied with their bodies, so the numbers reflect that women are more dissatisfied than men (Brennan, Lalonde, & Bain 2010). This clarifies why female body image is so prevalent whereas male body image is rarely recognized.

These differences of how the sexes relate to negative body image are important when it comes to recognizing it in males. It is critical we turn attention to male body image as much as we validate and seek to make it positive for women. For more information about how men develop unhealthy body image, check out Boys and Body Image to learn about the damaging outcomes of negative body image on males.

Why Should We Care About Male Body Image?

A massive “95% of college age men are dissatisfied with their bodies on some level” (Daniel & Bridges 2013). That’s a huge portion of each campus’s population! We need to pay more attention to male body image and the struggles men may face when coming to terms with their imperfect bodies. Just as today’s society expects women to become thinner with statuesque features, American men, and men all across Western cultures, feel pressure to pump up their bodies and slim down, creating a combination of lean, bulky muscle. However, unhealthy male body image extends beyond the average college man.

According to a study, over 90% of men struggle in some way with body dissatisfaction and negative affect (negative opinions of self), or negative emotions and thoughts towards one’s body (Castonguay et al. 2014). Research also shows that body image disorders may be more severe in both gay and heterosexual teenage-through-young-adult (post-college) males than men in other age categories (Burlew & Shurts 2013).

As a culture we know very little about the prevalence of this issue in men and boys since body image is traditionally considered a ‘female problem’. The fact is, men can suffer just as much body dissatisfaction as women, but we may pay less attention to male body image because men are quieter about these problems: Men tend to seek treatment, counseling, or positive solutions less frequently, or they hold off on doing so out of shame and embarrassment (Burlew & Shurts 2013).

We need to encourage men to be more open with their views on body image and give more attention to promoting healthy, realistic male body image as much as we do for females.

How do men struggle with body image?

The field studying male body image, unlike that of female body image, is fairly new; researchers are still grappling with what the real issues are that need to be addressed and studies. So, the majority of studies struggle to prove whether or not men are influenced by media, and the results are fairly split within the body of research and sometimes even within a single study. While research is rather inconclusive as to the effects of media on male body image, researchers do agree that the trend is for men to desire bigger muscles and leaner bodies. However, societal assumptions about male body image can be very misleading.

Assumption:

Inconclusive Research Says:

Sociocultural pressures shape body image.

That’s a minor thing; men are actually more concerned with attracting women and being healthy when it comes to body image.

Men only desire lean muscle and upper body development.

Men speak about a wide range of concerns beyond upper body mass, including other areas of the body, weight, and fitness and health.

Male body image concerns are focused on aspects they can change, mainly as muscle tone.

Men are equally concerned with things they can’t change, like body shape, balding, wrinkles, body hair, and height.

As a wide array of studies show, these assumptions are not accurate. The reality is, male body image is just as complex an issue as female body image, one that requires much more research as we begin to understand it. See sources: Ridgeway & Tylka 2005; McFarland & Petrie 2012; Burlew & Shurts 2013; Daniel & Bridges 2013; Barrow 2012; Schooler & Ward 2006.

Just like with female body image, male body image is driven by a number of factors, not just media pressure and the need to fit society’s ‘ideal body’. Once we as a society can understand that men are more than the bulk of their muscles—just as women are more than the circumference of their waists—we can begin to change the culture of ideal bodies toward more productive ends of health, body acceptance, and celebration of all body types. For men no less than women, the results of unhealthy body expectations are far-reaching, affecting how boys grow up viewing themselves, leading to the development of eating disorders or muscle dysmorphia, and ultimate making for an unhappy, unsatisfied lifestyle.

Ask Yourself

  • What do you think of today’s body image standards for men? How do they compare with those for women?
  • Why might men receive the same pressure as women to achieve the ‘perfect’ body?
  • According to a British study, one in three men would willingly give up a year of life in exchange for his ideal body. Why might this be, when this seems to be such an extreme desire? Would you be willing to do that? What would you do for your ideal body? Why?
  • Have you seen or experienced the effects of media’s pressure on men to have a certain body type? How might this affect men?

As adolescent boys reach puberty and experience the rage of hormones, they can sometimes be as susceptible to judgment about their bodies as much as girls can be through puberty. Just as in studying male body image, researchers are torn on the issue of the media’s effects on the way boys view their bodies. The following discussions are only examples of some research that support each side of the argument.

CLAIM: Media Affects Boys

  • Lini Kadaba (2009) says subliminal media messages do influence boys, especially in the available choices in popular Halloween costumes.
  • “Supersized” costume choices with padded abdominal, chest, and arm muscles are increasingly popular in a world of muscular superheroes and action figures.
  • Influence of a body ideal begins early, with padded costumes available for toddlers and infants, as well.
  • Kadaba argues this is due to the media’s pressure on males, even young boys and toddlers, to desire a sculpted body.

CLAIM: Media Does Not Affect Boys

  • Bodily development during puberty into the larger, more muscular male keeps boys from being too concerned with media messages (Pope, Phillips, & Olivardia 2000).
  • High metabolism (low fat gain), natural muscle development, growth spurts, and broadening of chest, shoulders, and jaw are all ideal features of adolescent males that match society’s male body ideal.
  • This is in opposition to men’s bodies that may have relaxed since puberty, and women and girls’ bodies that grow in size and shape, all of which are opposite of society’s ideals.

CLAIM: Media Affects Boys Indirectly
Some researchers, however, strike a balance between the two opinions to say that media does affect adolescent boys, but indirectly. They drew conclusions from directly interviewing adolescent boys to talk about body image and media.

Hargreaves & Tiggemann (2006)

  • In this focus group with boys 14-16, the researchers discovered that boys sought to fit in with their peers and be ‘cool’ much more than bulk up their bodies as researchers expected. They used media only to stay informed of ways to stay ‘cool,’ not to size up to standards of body.
  • The boys emphasized their belief, that males are not to express feelings or care about their looks—they need to be ‘tough guys’—beliefs ingrained through media exposure about the ideal male.
  • Though reluctant to reveal insecurities, the study participants did express their main concerns to be hair, fashion, weight, height, pimples, and not getting teased. Essentially, they just wanted to fit in. They didn’t seem very concerned about bulking up due to media standards. Most were content to stay as they were.

Lyles (2014)

  • Lyles also conducted interviews with 11-14-year-old boys in attempt to show media as a minor factor behind body image, or rather, an indirect influence.
  • Instead, Lyles concluded that media shapes their perceptions through the community around them, mainly the adults, or their peers, who are in turn influenced by parents, sports coaches, and healthcare providers, who are then in turn influenced by adult peers and media.
  • It seems the media may not reach boys as directly as girls when pressuring about body ideals.

Additional research is still needed to clarify the influences over adolescent boys’ body image and how to adjust those influences to help boys achieve and retain positive, healthy body images.

Boys and Weight

Despite puberty assisting them in fitting media’s ‘ideal body’ (see discussion of Pope et al. 2000, above) adolescent boys may struggle with their weight in a contemporary culture filled with unhealthy food and behaviors. Some boys wrestle with weight gain more than others. Under perfect conditions, this would be easily manageable, but Lyles (2014) lists a dozen factors prohibiting adolescent boys from maintaining a healthy weight.

Some factors can be controlled by the individual:

  • Self-Control
  • Motivation

Many, however, Lyles recognizes as being outside an adolescence’s influence:

  • Home environment
  • Lack of familial support to be healthy
  • Lack of education about healthy living
  • Lack of resources to provide or limited access to healthy food options and an active lifestyle
  • Deficient school or local programs not providing education about and access to healthy eating and activity

Out of all these factors, proper education about healthy eating and exercise habits seems to affect boys’ attitudes about their weight the most. Lyles writes:

[H]ealthy weight and underweight adolescents may overestimate their weight and in turn adopt unhealthy weight control behaviors and eating disorders . . . . Even though [some boys in the study] were categorized as about-right weight, they still had concerns about their bodies, body parts, and weight . . . . / Furthermore, those boys who were categorized as overweight, obese, or high BMI or underweight but indicated that they wanted to stay the same might also not recognize the need to make changes to their bodies. (561-62)

Without access to information about a healthy lifestyle to control excessive overweight, adolescent boys may not realize potential risks they incur, psychologically and physically.

It is just as prudent for us to be aware of body expectations for boys and the roles into which we groom them. Society is becoming more sensitive toward young girls’ body struggles—Now we need to set equal attention on adolescent boys. For more information about boys dealing with body image issues, check out the NEDA website and make sure to check this page for updated studies on boys and body image as they are released.

Ask Yourself

  • Do you think adolescent boys are affected by media’s ideal bodies as much as girls? Grown men? Women? What makes boys different?
  • Were you taught healthy habits as an adolescent? Where or by whom?
  • One boy in Hargreaves and Tiggemann’s focus group said, “I don’t really care if I get fat or anything . . . I eat what I want.” How do you respond? Of what do you think a belief such as this is a result?
  • How often do you unconsciously judge a boy for exposing his real feelings and emotions as a result of internalized prejudices from society?
  • Have you witnessed boys struggling with body image or with discussing it? Have you experienced it? What were the causal factors?

Cross-Cultural Perspectives

Although thin bodies are the ideal in America today, this is not always the case in other parts of the world. In some countries larger bodies are actually preferred because they are symbols of wealth, power, and fertility.

While Americans are obsessed with slimming down, in some societies where larger bodies are valued, people try to bulk up and maintain a high body weight.

Tahiti

  • In Tahiti, researchers in the 19th century observed chosen men and women engaging in a ritual process called ha’apori, or “fattening.”  Those selected to participate were usually young men and women from the upper echelons of society.  During the fattening process, they would reside in a special home where relatives fed and cared for them so they would grow large, healthy and attractive.
  • This ritual is no longer practiced today, but Tahitians still find large bodies attractive.

Nauru

  • In Nauru, large bodies were traditionally associated with beauty and fertility. Young women were fattened up in preparation for child bearing and young men were fattened in preparation for contests of strength.
  • Fattening rituals had both social and biological benefits. Feasting brought the community together and helped unite them; and the additional calories given to women of childbearing age increased the likelihood of conception and healthy birth and lactation.
  • Such fattening rituals ended in the 1920s.

Fiji

  • In Fiji, larger bodies are symbols of health and connectedness to the community. People who lose a lot of weight or are very thin are regarded with suspicion or pity.
  • In a 1998 study in Fiji, 54% of obese female respondents said they wanted to maintain their present weight, while 17% of obese women said they hoped to actually gain weight. Among overweight (although not obese) women, 72% said they did not wish to change their weight, while 8% of these women hoped to gain weight.
  • Both overweight and obese women expressed a high level of body satisfaction.

Jamaica

  • A 1993 study in Jamaica found that plump bodies are considered healthiest and most attractive among rural Jamaicans.
  • Fat is associated with fertility, kindness, happiness, vitality and social harmony.
  • Some Jamaican girls even buy pills designed to increase their appetite and help them gain weight.
  • Weight loss and thinness are considered signs of social neglect.

Changing Body Ideals

In recent times, even many societies that once favored larger bodies seem to be moving toward thinner bodies as the ideal. Why? One factor is that with globalization and the spread of Western media, people around the world are receiving the same message that we do in America: that thin bodies are the most attractive.

  • In a landmark 2002 study, researchers reported the effects of the Western mass media on body ideals in Fiji.
  • When researchers visited one region of Fiji in 1995 they found that broadcast television was not available and there was only one reported case of anorexia nervosa.
  • Just three years after the introduction of television, 69% of girls reported dieting to lose weight, and those whose families owned televisions were three times more likely to have eating attitudes associated with eating disorders.

Ask Yourself

Are thin bodies always healthier? Are larger bodies always unhealthy?

Why do Americans regard thin bodies as more attractive and healthier? How do such factors as the media, families, schools, the government or religious institutions affect the way we think about our bodies?

Is the spread of Western body ideals around the world problematic? Why or why not?

The Real Student Body

What is “real” beauty? In 2004, the Dove corporation launched its campaign for Real Beauty, with advertisements featuring women of all ages and body types. The campaign attempted to challenge the unrealistic beauty standards seen in the media today, and emphasized that true beauty comes in all shapes and sizes.

Inspired by Dove’s efforts, in 2008, Bradley University students launched their own “Real Student Body” project. Ten courageous young men and women volunteered to pose as models for a campus-wide poster campaign designed to promote the acceptance of the human body in all its forms.

While the posters certainly raised some eyebrows around campus, they also raised some important questions:

  • What is real beauty?
  • How can we feel good about our bodies when billions of dollars every year are invested in advertising designed to make us hate the way we look?
  • What can each of us do in our everyday lives to change unrealistic beauty standards and promote body acceptance?

Sex, Sexuality & Body Image

A complex range of cultural, experiential and biological factors shape the way we feel about our bodies. Among these, attitudes toward sex and sexuality are closely bound up with body image.

Although our society expects everyone to be unambiguously male or female, some people do not fit neatly into these categories. Some people (intersexuals) are born with some combination of male and female sexual anatomy. Some people, born as one sex, later undergo gender reassignment surgery to change their sex (transgender). Still others choose to dress, occasionally or permanently, as a member of the so-called opposite sex (gender variant). Such individuals are often stigmatized, even feared, by mainstream society for failing to conform to rigid ideas about gender and sexuality. Such societal rejection can have a negative impact on the ways such individuals feel about their bodies.

Society also often imposes negative judgments on children, especially girls, who mature physically at an early age, a phenomenon known as precocious puberty. Both adults and peers alike tend to respond to such early maturation with suspicion and innuendo, thereby dealing a heavy blow to the self-esteem of these early-bloomers. Likewise, those who later in life find themselves unable to have children may be regarded with suspicion or pity, leading them to view their own bodies with a sense of shame and inadequacy.

Early onset, or “precocious” puberty is becoming an increasingly common condition in industrialized societies. Although early physical maturation can occur in both sexes, girls are ten times more likely to undergo precocious puberty than boys. In such cases, children under 8 years of age must struggle with young bodies that begin to undergo significant physical changes well before they are emotionally and cognitively mature enough to deal with the implications of adolescence. Young girls, especially, are subject to psychological turmoil as a result of an early sexualized body and identity confusion, often resulting in lasting negative effects to their concepts of body image and self-worth.

Understanding Precocious Puberty

Puberty is the natural process of hormones signaling the growth of estrogen and female sexual characteristics in girls or testosterone and male sexual characteristics in boys. It usually begins between the ages of 10 and 14. However, “precocious puberty” is defined as the beginning of this physical transformation before the age of 8 (Chopack-Foss 2008).

Precocious puberty may be diagnosed in girls under 8 years old who experience menstruation, breast development, the growth of pubic or underarm hair, acne and/or a rapid growth in height. It may be the diagnosis in boys under 9 years old who experience the growth of pubic or underarm hair, enlargement of the genitalia, a deepening voice, acne and/or a rapid growth in height.

The precise causes of early physical maturation are still a matter of debate in the medical world. Most research has focused on changes in the brain and the endocrine system. Some of these changes may be triggered by environmental factors. Certainly research has shown that in populations with a higher caloric intake and fewer disease stressors, children tend to reach puberty earlier (Talpade, 2006; Tremblay, 2005).

Stigmatizing Early Bloomers

While both boys and girls can experience precocious puberty, the negative consequences tend to be more acute for girls who are “early bloomers.”

Girls who develop early face a difficult choice: whether to associate with their cognitive age group or with the age group that their bodies more closely resemble. An unexpected physical growth spurt into womanhood thrusts girls into a world in which their appearance is judged on a daily basis, often attracting sexual attention or unwanted advances. As Diamond (2009) reports and Weir (2016) confirms:

  • The shape of a woman’s body, such as large breasts and round hips, is explicitly sexualized in our society; and young girls are not mature enough to shoulder this societal burden.
  • Girls who develop physically faster are assumed to be more sexually active than their peers, and must struggle with that social stigma.
  • Adults tend to feel uncomfortable with precocious girls with shapely bodies, often associating them with social deviance.
  • Early developers are also more likely to engage in relationships of a sexual nature before they are emotionally prepared to do so.

The lasting impact of excessive body consciousness, as well as a premature exposure to sexual exploitation, affects precocious girls into their adolescence and adulthood. According to Diamond (2009) and Weir (2016):

  • Early exposure to excessive body-consciousness has a tendency to stick with premature developers, even years after their peers catch up with their physical development.
  • Early bloomers learn that they are agents of male erotic desire, which causes feelings of sexual exploitation and shame.
  • For early developers body esteem is often damaged well into adulthood. Some women actively cover their bodies in order to avoid attracting unwanted sexual attention.
  • Early bloomers face an increased likelihood of developing an eating disorder due to low body esteem.
  • Early developers are 2-3 times more likely to experience depression; depression begins in the middle of puberty.

Boys, on the other hand, appear to suffer fewer negative effects from precocious puberty (although this is an area that is under-researched in the medical and social scientific literature). This may be, in part, because the physical maturation of young males is considered a socially positive and rewarding endeavor, while the development of the mature female shape is associated with provocative or deviant behavior. Thus, a boy can look forward to the prospect of becoming more masculine, while a girl must prepare herself for the negative stigma attached to shapely, mature female bodies.

However, there is one aspect of precocious puberty that does appear to negatively affect the body image of precocious boys later in life: stunted height. While an early growth spurt may make precocious boys initially taller than their peers, their skeletons mature earlier and their bone growth stops earlier than average, often leaving them with a shorter-than-average height. In a society that attaches particular importance to male height, this may result in long-lasting feelings of inadequacy, fears that they are not masculine enough and a sense that they are not physically attractive.

Empowering Early Bloomers

Precocious puberty, or more precisely society’s reactions to early maturation, has the potential to harm the self-esteem and body image of girls and boys alike. Fortunately, researchers in the social sciences and medicine are helping to raise awareness of both the causes and the physical, emotional and social consequences of precocious puberty. For more information, consult the resources listed below:

Ask Yourself

In our society, why do we tend to regard girls’ early physical maturation as more problematic than boys’ early maturation?

Researchers have described an increasing tendency in our culture to sexualize young girls. (See Levin & Kilbourne’s So Sexy So Soon: The New Sexualized Childhood and What Parents Can Do to Protect Their Kids, 2009.) How might provocative images of children in the media affect the self-esteem and body image of young people—both early bloomers and those who develop at the average age?

According to the World Health Organization (WHO), in 2006 infertility affected 1 in 10 couples, or 80 million people internationally (Clarke, Martin-Matthews, & Matthews, 2006). In 2021, the WHO reported that rate had increased to 1 in 8 couples worldwide. In the US, infertility impacts 6.7 million people each year (“Infertility stats” 2021). The causes of infertility are multiple and complex (see Buck, et al., 1997; Covington & Burns, 2006; Fjällbrant, 1975; Herer & Holzapfel, 1993; Higgins, 1997; and Weiss, 1987). The social and emotional consequences of infertility are equally varied, but are generally quite negative.

The Social and Psychological Effects of Infertility

Infertility is often accompanied by “identity shock” with the painful realization that the failings of one’s body have led to a permanent change in one’s self-concept (Clarke, Martin-Matthews, & Matthews, 2006; Alamin et al, 2020). Therefore, frustration with the body’s perceived deficiency is the emotion expressed most often by both males and females around the world. However, experiences of infertility can differ quite substantially in more industrialized versus less developed nations.

Some researchers have reported, for instance, that infertile women in much of Africa can face not only divorce but social ostracism. They note that infertility tends to be a very public matter in such settings. In Botswana, for example, a woman’s fertility or infertility is announced by her own name. After the delivery her first child, a woman is addressed simply as “mother of such-and-such,” for instance, Mama Baruti, “mother of Baruti,” therefore providing a tangible reminder of her achieved motherhood/adulthood and higher social status. This leads infertile women to feel conspicuous, embarrassed and excluded when in the company of mothers (Mogobe, 2005). In an attempt to achieve social acceptance, infertile women may take desperate measures, such as risky sexual practices, that endanger their health (Samucidine, Barreto, Folgosa, Mondlane, & Bergström, 1999).

In Western developed nations, by contrast, infertility is a more private matter; and while infertile couples may not face social ostracism, they may experience intense feelings of inadequacy and personal failure. In addition, the reluctance to address fertility publicly may, in fact, leave couples feeling forgotten or unimportant (Afek, 1990; Greil, 1991).

Greil (1997) describes the experience of infertility as a “roller coaster of raised hopes followed by tragic disappointment.” Infertile women report feeling:

  • Powerless. They feel that they are no longer in control of their bodies, and they feel powerless when it comes to decisions about when they will become parents or when they will be intimate (Dunkel-Schetter & Lobel, 1991).
  • Broken or disabled. Some infertile women have reported feeling empty or broken, describing their bodies as “defective machines” (Clarke, Martin-Matthews, & Matthews, 2006). While this perception of the body can be painful enough when first diagnosed, infertility treatments tend to perpetuate and intensify this feeling. Women’s bodies are typically the focus of fertility treatments, and many women come to feel a sense of alienation from their own bodies, as the inner workings of what was once her private body are now described in medical terminology and exposed to unfamiliar, invasive procedures.
  • “Hollow” or incomplete.  63% of women interviewed in a study by Clarke, Martin-Matthews, and Matthews (2006) expressed the opinion that the ability to bear children is necessary for someone to be a “full-fledged woman,” and those who are infertile feel that it is not only their bodies that are incomplete, but also their sense of self.
  • Responsible.  Infertile women tend to hold the decision-making authority in regard to treatment, which adds a considerable amount of stress.  Women’s bodies are usually given more intensive medical treatments, often even when the man is the sole reason for the couple’s infertility.  Therefore, many couples claim that the decision to either continue or end treatment should be up to the woman, as it is her body that needs to be “fixed” (Clarke, Martin-Matthews, & Matthews, 2006). 

Although men often report many of the same reactions to infertility as women, they tend to specifically equate infertility with a defect in their masculinity (Davis, 1987). The societal construction of a masculine man requires that he be sexually potent enough to impregnate a woman. However, without this ability, the man is left to question his sexual identity and manhood (Clarke, Martin-Matthews, & Matthews, 2006). Also, just as women report feeling hollow, men report feelings of incompleteness, saying that they feel as if they are “shooting blanks” (Abbey, Andrews, & Halman, 1992).

Infertile individuals may feel the need to distance themselves from others. They may:

  • Isolate themselves from friends, family, or significant others as a result of feeling worthless or unattractive (Davis, 1987).
  • Avoid social gatherings that may remind one of infertility, such as baby showers, family gatherings where children are present, or even the infant or toy sections at department stores (Elson, 2004).
  • Hide their infertility from friends and family out of fear of disapproval.

Even when friends and family are aware of one’s infertility, communication can be exceptionally difficult or stressful. The mere knowledge that others know such personal details about one’s reproductive organs can cause infertile individuals to feel that their bodies are exposed or no longer private. Often a well-meaning relative will make an off-handed comment such as “Just relax, you’re trying too hard” to an infertile individual. Such a comment, while said with good intentions, may cause the individual to feel as though no one else understands what he or she is going through. It may also cause the individual to wonder if the infertility is actually due to a personal fault after all, or if there is something that could be done differently to improve the chances of becoming pregnant (Davis, 1987).

Infertility and Body Image

The damage to one’s body image and self-concept caused by infertility can be painful and life altering, but it certainly does not have to be hopeless. Many couples become parents through adoption, surrogacy or egg and sperm donation. Others choose to remain childless while devoting their time and energies to nieces, nephews and godchildren, to foster children or to any number of worthy and self-fulfilling pursuits.

More research is needed to determine how such choices affect the self-image of those who experience infertility. However, one study was conducted that determined out of a sample of women, 93.1% of the women had a higher body image score than the mean. It seems as if body image is not as much the issue compared to feelings of self-doubt and self-worth (Karamidehkordi 2014). Perhaps the more pressing question, however, is why fertility is so important to self-concept in our society and in others. Is parenthood a marker of full adulthood, maturity and higher status? Is motherhood still seen as a woman’s natural role and primary goal in life? Is the ability to father a child seen as the ultimate proof of manhood? And do we, as a society, need to adjust our ideas about gender, sexuality and reproduction to ensure that those who experience infertility are no longer stigmatized and traumatized?

Ask Yourself

In our society, how important is the ability to have children to our ideas about femininity (womanhood) and masculinity (manhood)? Do we need to change the ways we think about what makes us “real women” and “real men”?

Disability, Illness & Non-normative Bodies

In an age when the media barrage us with images of ideal beauty, and define only fit, healthy, active bodies as desirable, people with disabilities and serious illnesses are seldom portrayed as attractive, complex or even fully competent individuals. Disability and illness bring social stigma, leading some to fear or even reject people with certain physical conditions. Those labeled “not normal” by society on the basis of disability or illness can experience significant forms of discrimination and isolation. Such experiences often have negative effects on their self-esteem and body image.

All societies have notions about the “normal” (or normative) body, but these norms vary greatly across cultures. In some cultures, people are expected to modify their bodies through such practices as tattooing, neck elongation, earlobe elongation, scarification, tooth filing or body piercing. Such practices are often both an important part of initiation rituals, and a powerful expression of ethnic identity or spiritual commitment. Ear-piercing has long been a socially acceptable practice in the US, both other forms of body modification, such as tattooing, scarification, cosmetic surgery and extreme tanning, are becoming increasingly popular. While such practices can serve as a form of creative self-expression, they can also have some negative physical, psychological and social effects.

“Disability” has been defined as “the inability to perform one or more major life activities because of impairment,” either physical or mental (Miller and Sammons 1999: 26). More recently, that definition has been clarified: “Disability” is “any condition of the body or mind (impairment) that makes it more difficult for the person with the condition to do certain activities (activity limitation) and interact with the world around them (participation restrictions),” (CDC, 2020). In 2002, it was estimated that ten percent of the world’s population, or approximately 650 million people, and approximately 18 percent of the US population, lived with disabilities (Gerschick and Aldrich. 2008). Those estimates have increased: by 2011, it was estimated that 26 percent of the US population and 1 billion people worldwide — fifteen percent of the world’s population — lived with disabilities (The World Bank 2021).

While mental disabilities include both cognitive impairments and psychiatric disorders, physical disabilities include a broad range of impairments, from vision and hearing impairments to orthopedic, neuromuscular, cardiovascular and pulmonary disorders. The 1990 passage of The Americans with Disabilities Act helped ensure equal access to such things as education, employment, health care, housing and public facilities; subsequent updates have expanded ADA protections, especially focusing on access to transportation (ADA.gov). However, people with disabilities still face the daily challenges of being perceived as “different” and even inferior. Such experiences can have profoundly negative effects on self-esteem and body image.

Men with Physical Disabilities

Independence, dominance, strength, athleticism: these are just some of the traits associated with masculinity in our society. For men with physical disabilities, however, especially those who must rely upon devices such as wheelchairs, crutches, canes, and artificial limbs to obtain mobility, it is difficult to live up to such masculine ideals. This often damages the self-esteem of disabled men, leading them to question their masculinity, their desirability, and their very place in society.

In many cases, “not only are men with physical disabilities…perceived as undesirable, they are also perceived to be asexual” (Zola 1982). Disabled men may internalize such widespread perceptions. One 48-year-old man described his struggle with negative body image in an interview with researchers (Taleporos and McCabe 2002: 978):

“I’m different and I’m aware of my difference being what it is. And I see people who I find very attractive and I’m conscious that my chances of scoring with them are non-existent…I am conscious of my difference and I don’t have the confidence to go up to other people.” In a society that places a premium on men’s ability to attract sexual partners, to exert control over others, and operate without assistance from others, men with disabilities must struggle daily to be perceived as “real” men.

Women with Disabilities

Women who are disabled have to deal with not only that impairment but also the lower status that comes with being female in our society today. Disabled women often differ from narrow definitions of ideal feminine beauty displayed in the media, leading others to perceive them as unattractive, as not “real” women (Fine and Asch 1988). Annie Elainey is a young woman who has a disability that requires her to use a wheelchair. She describes her experience of not being a “real” woman:

“There were people who wouldn’t look at me. They would look at the person who was pushing me, but they wouldn’t look at me. And my self-esteem took a really hard hit.” (Leary, 2019)

Disabled women themselves may come to internalize such views, which may create barriers to forming intimate relationships. Women with disabilities are more likely than other women to remain single and less likely to become mothers. In Venus on Wheels, Diane, a 26-year-old student, described her childhood:

“I never heard the words, ‘Wait till you become a mother,’ or ‘Someday when you are married, you will understand.’ Even though my toys represented the perfect socialization of a little girl into wife and mother, they were probably given to me with the belief that they would be the closest I would ever get to the real thing. Neither of my parents ever felt I would someday become a sexually attractive female, let alone marry” (Frank 2000: 62). As Fine and Asch note, many women with disabilities “speak angrily of the unavailability of adequate counseling on sexuality, birth control, pregnancy, and childbirth from either gynecologists or rehabilitation professionals” (1988: 21). This is due to the fact that many clinicians make assumptions that women with disabilities cannot communicate at the level that is needed to understand, a completely false assumption (Silvers et al., 2016).

Disability and Body Acceptance

It is important to note that while many persons with disabilities may experience discrimination or have negative perceptions of themselves, they are not simply victims. They work actively to combat widespread misperceptions and negative stereotypes about people with disabilities. And, like all of us, they work daily to earn and maintain respect and acceptance from those around them.

By challenging widespread notions of ideal beauty and narrow conceptions of masculinity and femininity, people with disabilities are able to accept their bodies and achieve higher self-esteem. As Sue, a 39-year-old woman with Muscular Dystrophy, commented:

“I feel pretty comfortable with my body, probably even better than some of my able-bodied friends, who have worse feelings about their bodies than I do…I’d run around naked in front of anybody, I have a pretty healthy body image” (Taleporos and McCabe 2002: 977).

Ask Yourself

How does our society treat people with disabilities? Next time you are out in public, notice the countless barriers that people with disabilities must overcome just to go shopping, go out to dinner, or go to school. Steep curbs, cracked sidewalks, heavy doors or cramped restrooms may make it difficult for people with physical impairments to engage in ordinary, everyday activities.

How does the media portray people with disabilities? The next time you watch TV, note the number of disabled people who appear and how they are represented. How might such media practices affect the self-esteem of people with disabilities?

What can we do to change narrow conceptions of “normal” and “attractive” bodies (and restrictive ideas about femininity and masculinity) to allow for the full acceptance and participation of people with disabilities?

Although illness affects all of us at some point in our lives, it is a socially stigmatized condition, and those suffering from serious and chronic illnesses are often either marginalized, pitied, or even blamed for their ailments. The experience of illness itself may have a negative impact on people’s self-concept, as they experience such things as pain, discomfort, changes in appearance and a loss of control over their own bodies. Just as significantly, however, the social stigma that comes along with serious illnesses can deal a heavy blow to self-esteem and body image.

Bodily Changes and Body Image

For many people, many of the physical changes that occur with serious and chronic illnesses are psychologically devastating:

  • Rapid weight loss or weight gain (“bloating”)
  • Limited or lost mobility
  • Limited or lost control of bodily functions
  • Scarring or loss of body parts
  • Changes to the skin and nails
  • Hair loss

In a society that values fit, healthy bodies, physical beauty, and the importance of self control, such bodily changes can be experienced as a humiliating personal failure. In addition, they serve as constant reminders of one’s poor and possibly deteriorating health

Illness and Social Stigma

Such physical changes also attract a range of responses from others: pity, fear, avoidance, even anger. When faced with a cancer sufferer, for instance, some people are disturbed at the thought that this could happen to them or someone they love. Contact with the illness forces them to confront their own mortality.

With socially transmittable diseases, such as HIV/AIDS, the social stigma is even greater. One study reported that people with HIV/AIDS face “greater social rejection, economic discrimination, internalized shame, and social isolation” than people with other illnesses (Charmaz, 1991).

Illness and Body Image

Both the physical experience of illness and the social stigma attached to illness can have negative psychological effects. These may include:

  • Feelings of fear (of rejection, of loss of control over body and emotions, of exposure of formerly private things to public view)
  • Difficulties maintaining “normal” social interactions
  • Loss of self-esteem, with a sense of being different, deficient, or unattractive.

Nonetheless, as better information becomes available on serious and chronic disease, illness may eventually become less stigmatized. Fifty years ago, when many still feared that cancer was contagious, cancer patients battled both social isolation and a sense of shame. As our understandings of the disease have deepened, however, this is no longer the case.

Likewise, while HIV/AIDS was a highly stigmatized disease in the 1980s, leading sufferers to be shunned and ostracized, this stigma has decreased somewhat with a better understanding of the illness. High-profile HIV-positive sufferers, such as NBA superstar Magic Johnson, have helped to destigmatize the disease. His Magic Johnson Foundation helps educate people about the disease, and empowers young people to decrease their HIV risk factors.

Efforts such as these can lead to greater understanding of serious and chronic illnesses, and greater acceptance of those who suffer with such conditions. As society becomes more accepting, those with serious and chronic conditions may come to internalize such attitudes, leading them to a more positive relationship with their own bodies.

Ask Yourself

Why are people with serious and chronic illnesses stigmatized in our society?

How do you think people suffering from serious and chronic illnesses are affected by the behaviors and comments of the people around them?

Can you imagine a day when diseases such as HIV/AIDS are as destigmatized as the common cold? What would it take for that to happen?

We tend to think of human bodies as simply products of nature. In reality, however, our bodies are also the products of culture. That is, all cultures around the world modify and reshape human bodies. This is accomplished through a vast variety of techniques and for many different reasons, including:

  • To make the body conform to ideals of beauty
  • To mark membership in a group
  • To mark social status
  • To convey information about an individual’s personal qualities or accomplishments

Certain body modification practices, such as neck elongation or tooth filing, may strike Americans as strange and exotic, we must realize that we modify our own bodies in countless ways. Dieting, body-building, tanning, ear piercing and cosmetic surgery have long been common in the United States, and practices such as tattooing, body piercing and scarification are becoming increasingly popular.

People may seek to control, “correct” or “perfect” some aspect of their appearance, or to use their bodies as a canvas for creative self-expression. While some seek to improve their body-image, this is not necessarily a motivating factor for everyone who engages in body modification. Additionally, some attempts at body modification can also have unintended negative consequences that might ultimately damage self-esteem.

Historical and Global Contexts of Body Modification

Body modification occurs across the globe today in various forms and for many reasons (Barker & Barker, 2002, p. 92). Examples of body modifications from around the world include nose piercing associated with Hinduism, neck elongation in Thailand and Africa, henna tattooing in Southeast Asia and the Middle East, tooth filing in Bali, lip piercing and earlobe stretching in Africa, and female and male circumcision in many areas of the world (Larkin 2004; Barker & Barker 2002; Bendle 2004).

Two prominent historical examples of body modification are foot-binding and corseting. For hundreds of years, foot binding was commonly performed in China on girls, beginning between the ages of 3 and 7 and continuing throughout their lives. All toes but the big one were broken and folded under. The foot was then wrapped very tightly. The bandages were changed frequently, maintaining constant pressure. By the end of the process, women’s feet were usually only a few inches long (Hong 1997). Men reportedly found the tiny feet, swishy walk, and apparent frailty highly erotic. Although foot binding essentially crippled the women who underwent the process, parents continued the practice to improve their daughter’s chances of attracting a husband. When China was opened to the West, the process began to die out, and by the 1950s it was largely a relic of the past.

Other cultures have imposed similarly constrictive and debilitating body modifications on women’s bodies. In Western nations during the Victorian era, women were expected to wear stiff corsets in an attempt to obtain the ideal curvaceous feminine figure with broad hips and tiny waists, cinched as small as 12 inches (Riordan, 2007: 263). Such corseting was, in fact, a form of permanent body modification. With severely tight lacing, women’s bodies came to “literally incorporate the corset as the ribs and internal organs gradually adapt[ed] to its shape” (Riordan, 2007:263). This practice both reflected ideas about women’s natural frailty and contributed to such notions, as tight lacing left many short of breath and even unable to stand for long periods of time without support.

While such restrictive corsetry has gone out of fashion, Western women and girls are now encouraged to discipline and control their bodies with other practices such as extreme dieting and punishing exercise regimes. In addition, both women and men in the US today are increasingly modifying their bodies through practices such as cosmetic surgery, body piercing, tattooing and tanning.

Cosmetic Surgery

According to the American Society for Aesthetic Plastic Surgery (ASAPS), in 2008, Americans underwent 10.2 million cosmetic procedures, paying out just under $12 billion (Mann 2009). While the general economic downturn has led to a slight decrease in such procedures, cosmetic surgery has increased dramatically in the last decade. In fact, while the majority of procedures are performed on women, men’s use of cosmetic procedures has increased 20 percent since the year 2000 (Atkinson 2008).

Opinion is divided on the benefits of cosmetic surgery. Some suggest that cosmetic procedures can improve self-esteem and combat negative body image. Others see surgical interventions as a sad indictment of a culture with rigid and narrow ideas of beauty—a culture that values youth, sexuality and appearance more than experience, character and substance (Jeffreys 2000). Critics also note the potential risks associated with cosmetic surgery. In addition to the risk of post-operative infections and other surgical complications, one recent study revealed a correlation between plastic surgery, substance abuse and suicide (Lipworth, 2007).

Piercing, Tattoos and Scarification

Practices such as body piercing, tattooing and scarification, once only associated with more marginal or deviant social groups in the United States, have now become more mainstream.

Body piercing has become increasingly popular and socially acceptable in the US in recent years. One recent study of American college students found that 60 percent of women and 42 percent of men were pierced (Kaatz, Elsner & Bauer 2008). Common piercing sites include the ears, nose, tongue, eyebrow, lip, nipple, navel and genitals, with the ear being the most common site for both males and females (Larkin 2004). While some engage in piercing for the sake of fashion, researchers report that for others, it is a way to take control of their bodies, especially after being violated. As one rape victim reported:

“I’m getting pierced to reclaim my body. I’ve been used and abused. My body was taken by another without my consent. Now, by the ritual of piercing, I claim my body as my own. I heal my wounds” (Jeffreys 2000: 414). Tattooing has likewise grown in popularity over the last decade, with an estimated 10 percent of Americans sporting tattoos (Kaatz, Elsner & Bauser 2008). While once associated largely with criminality and deviance, today Americans are likely to see tattoos as a way of controlling their identities, expressing their creativity, and asserting their identity (Kang & Jones 2007). One recent study suggests that individuals who were moderately to heavily tattooed have “an increased sense of self-confidence after having pierced or tattooed their bodies” (Carroll & Anderson 2002: 628).

Tattoos may also act as a means of commemorating or moving on. It is not uncommon for trauma victims, those with disabilities or serious illnesses, or marginalized groups to tattoo as a way of claiming positive ownership of their own bodies, their own identities (Atkinson 2004). In this way, tattooing can serve to heal, to empowering, and to promote body acceptance and self-esteem. On the flipside, however, researchers have found that for some, tattoos serve as painful reminders of poor choices—rashness, intoxication, failed relationships, and other profound regrets (Houghton 1996). Some also report feeling embarrassment or discomfort about how others might view them because of their tattoos, feelings that can contribute to negative body-image and low self-esteem (Houghton 1996).

While not as common as piercing and tattooing, scarification is also an increasingly visible practice in the US today. Scarification, widely practiced as part of initiation and puberty rites in cultures throughout the world, involves the cutting (or sometimes burning) of the skin in ways designed to leave permanent scars. The scars often form intricate patterns across the skin.

Because scarification is a physically demanding (and painful) process, Jennings (2009) reports that in the US today it is often associated with sadomasochism and other subcultures that stress the experience itself as pleasurable, cleansing or transformative. If practiced as part of a group ritual, many participants report feeling a heightened sense of community, group membership and acceptance (Pitts 2000). Nonetheless, some practitioners also report feeling more vulnerable, even socially ostracized, by such permanent scarring (Pitts 2000).

Tanning

Ideas about physical beauty not only vary a great deal from culture to culture, but also change over time. American views of suntanned skin have changed dramatically over the past century. In Victorian America, pale skin was the ideal. Women wore hats and gloves and carried parasols to shield their skin from the sun. At a time when many people still earned a living by laboring out of doors, a pale complexion was an indication of affluence and indoor work and leisure. By the late twentieth century, however, most people were earning a living indoors. So tanned skin became an indication of affluence, a sign that one had the time and money to lounge by the pool, play golf or tennis, or travel to tropical destinations.

As the suntan became associated with both health and wealth, even those without access to swimming pools and tropical vacations increasingly aspired to the new physical ideal. And the indoor tanning industry was born. Tanning is now a $5 billion dollar a year industry with some 40,000 tanning outlets nationwide (Looking Fit Magazine 2009).

At least one recent study has suggests that some individuals become addicted to tanning, despite its well documented links to skin damage, severe wrinkling, and skin cancer (Warthan, Uchida & Wagner 2005). Others suggest that tanning addiction, what some have called “tanorexia,” may be linked to Body Dysmorphic Disorder (BDD). Excessive tanning may be stem from an obsession with perceived physical flaws and the compulsion to “correct” them. As health practitioners have observed:

Only by looking at the psychological factors that go into sun-tanning behavior can we understand the young woman who waits in line at a tanning salon, although she understands that tanning will age her skin and can cause cancer…Low self-esteem, body image distortion and undiagnosed depression and anxiety can drive some to act self-destructively in the pursuit of some idealized image of beauty (Deleo & Silvan, 2006).

Ask Yourself

How do you and those around you modify your bodies? What motivates you to do so? What are the potential benefits and risks (physical, emotional and social) of such body modification practices?

To what extent do rigid and unrealistic ideals of beauty encourage us to change our bodies? Should we try to conform to these ideals or try to change these ideals?

Fatism

Today in the U.S., millions of people who are larger than average will encounter significant discrimination, suffer unfair treatment and humiliation, and be denied equal opportunities in all areas of life.

Weight discrimination, sometimes called “fatism”, is a serious problem with devastating consequences both for the individuals who are discriminated against and for society as a whole. In America, 33% of the adult population is considered morbidly obese (Kristen, 2000: 60). That is 58 million people.

“A survey of college students found that they would prefer to marry an embezzler, drug user, shoplifter, or a blind person than someone who is fat” (Maine 2000:21).

In America, overweight women suffer the preponderance of weight-based discrimination. They are not viewed as “normal human being[s] with normal needs, desires, virtues and vices” (Goodman 1995: 2) but as failures, examples of what not to be—or become. They are continuously scrutinized, criticized, ostracized, and subjected to a constant stream of social prejudice, stereotypes, and double standards.

Numerous academic studies verify that heavy people in general, and heavy women in particular are discriminated against in employment. In one survey, 40% of heavy men and 60% of heavy women reported having experienced employment discrimination. (Kristen, 2000, p.63).

Barriers to Getting Hired

One study indicated that 16% of employers refuse to hire “obese women” no matter how qualified (Kristen 2000: 62).

And 44% of employers admitted they would use an applicant’s obesity as “conditional medical grounds” for not hiring– especially if the applicant was female (Kristen 2000: 62).

“Weightism affects people of all sizes who are plagued by fear of becoming fat and hence stigmatized” (Maine 2000: 18 ).

In another study, overweight job candidates were viewed by potential employers as “less competent, less productive, not industrious, disorganized, indecisive, inactive, and less successful”(Kristen 2000:63). Such negative stereotypes are pervasive in society today.

On the Job

Large size people are often denied jobs which require interaction with the public. When heavy workers do secure employment, they are kept in jobs which are beneath their abilities, are less likely to be promoted and are often demoted or fired because of weight prejudice (Kristen 2000: 64). Heavy workers are frequently subject to workplace harassment by employers and coworkers alike (Kristen 2000: 64).

Earnings

Studies show that among white women, heavy women earn significantly less than thin women. Those who were considered moderately obese earned 6% less while those who were considered to be highly obese earned 24% less than thin women. Not surprisingly, then, the household incomes of heavy women are $6,710 lower than women who are thin (Kristen 2000: 64). Heavy women have a 10% higher poverty rate. The earnings of heavy men are not significantly affected. This reflects the greater importance placed on women’s appearance in our society.

In most of America, weight is NOT a protected factor in fair-employment law. This means that legally, employers may deny job interviews to obese people or dismiss obese employees on grounds of weight alone. The only means by which an obese person may be afforded limited legal protection is through the Americans with Disabilities Act of 1990. This Act states that “it is illegal to discriminate against someone who has a physical or mental disability that substantially limits one or more…major life activities of the individual.” This Act rarely protects the obese.

There are two commonly held assumptions about fat. One is that it is unhealthy to be heavy. The other is that if they tried, heavy people could lose weight. These assumptions help to reinforce stereotypes of heavy people as being lazy, undisciplined, unhealthy and gluttonous.

In general, weight loss methods prove to be ineffective for most people, and may in fact pose serious health risks making the cure for obesity worse than the condition itself.

The Truth About Fat and Health

  • The New England Journal of Medicine reports that “the data linking fat with death and the data showing losing weight to be healthy are limited, fragmentary, and often ambiguous” (Kristen 2000: 67).        
  • Chronic dieting causes weight gain and may eventually make weight loss a physical impossibility.
  • Studies have found an association between weight loss and weight fluctuations and an increased risk of death from cardiovascular disease.
  • Significant health problems and fatalities sometimes result from weight loss surgeries.
  • Many obesity “cures” have been found to cause harm.
  • Studies have found that when heavy people were fit, their death rates were nearly the same as people who were considered lean and fit.
  • Risks of diabetes and heart disease were reduced for heavy people who engaged in regular exercise and practiced sound eating EVEN IF THEY DID NOT LOSE WEIGHT.
  • Studies have identified over 100 genes that contribute to the etiology of obesity (Kristen 2000: 69).

Another inaccurate assumption that is commonly made about heavy people is that they must have poor dietary habits and do not engage in physical activity. People who are thin are not automatically healthy because they are thin. Nor is their thinness an automatic indication of good nutrition and adequate exercise. Moreover, with good nutrition and exercise one may be heavy and still be fit and enjoy good health. A growing number of scientists agree that weight is not the determining factor for poor health, poor nutrition and lack of physical activity are. This is true whether an individual is heavy or thin. Nevertheless, health insurance is denied to many large people because of their size. If health coverage is granted, they are often forced to pay higher premiums compared to those of average weight.

Weight Prejudice and Medical Practice

Many heavy patients report distressing experiences with health care providers. (http://www.fwhc.org/health/fatfem.htm) Physicians and health care providers frequently focus solely on an individual’s body size rather than their actual health problem.

  • Heavy patients are commonly advised to lose weight regardless of their state of health. And while a thin person is given medication or other appropriate treatments, a heavy person with the same symptoms may simply be told to lose weight.
  • Even though the U.S. Department of Health and the World Health Organization agree that dieting and weight lose surgery can be dangerous to human health, patients healthfulness continues to be determined by their body mass index regardless of the lack of scientific evidence supporting its use.
  • Current medical technology has only a 10% success rate in treating obesity.

Fat acceptance advocates work toward goals which promote size diversity. After all, humans come in all shapes and sizes! Part of this acceptance is the preferred use of the term “fat”. Activists hope that this word can be de-stigmatized and embraced in our culture.

Activists propose that the concept of an “ideal” body size or weight be abandoned entirely. Height and weight tables delineating “ideal” body proportions are based on Caucasian body types. The genetically distinct body types of people of color are not considered in the formulation of “ideal proportions”.

Fat acceptance means that large people love and accept themselves the way they are. Advances in the fat acceptance movement has meant the creation of support groups, magazines, exercise classes and regional conferences which empower large people and give them strength to be who they are in a society that isn’t nearly large enough for them. The sense of self-confidence, well-being, and better health that comes from loving and accepting their bodies frees them to live and enjoy life to the full. In the words of fat acceptance advocate Monica Persson, “when we reclaim the right to eat, focus on our lives, and stop giving our money to the diet industry, anything is possible.”