SOCIAL BEHAVIOR AND PERSONALITY, 2003, 31(1), 81-90

Society for Personality Research

DOI 10.2224/sbp.2003.31.1.81

INTERNALIZATION OF THE THIN IDEAL,

WEIGHT AND BODY IMAGE CONCERNS

KATHRYN GRAFF LOW, SWITA CHARANASOMBOON, CLAIRE BROWN,

GWEN HILTUNEN, KATHERINE LONG, AND KATHERINE REINHALTER
Bates College, ME, USA
HANNAH JONES
Wheaton College, MA, USA

Weight and shape concerns in college women are epidemic. Understanding the role of the
thin ideal in the development of such concerns is critical for designing prevention programs.
This study examines the association between the Sociocultural Attitudes Towards Appearance
Questionnaire (SATAQ; Heinberg, Thompson, & Stormer, 1995), a measure of internalization
and awareness of the thin ideal, and eating and body image concerns in college women.
70 undergraduates completed questionnaires on eating symptomatology, body image,
and demographics. In general, internalization, but not awareness, of the thin ideal was associated
with eating and weight concerns. In a two-way analysis of body mass and dichotomized
SATAQ internalization scores, body mass moderated the effects of internalization, with over-
weight women high in internalization having the most body image concerns. Prospectively,
SATAQ-internalization scores predicted increasing drive for thinness over the school year in
a subsample of women. Future research should explore the moderating effects of weight on
outcomes related to internalization of the thin ideal.
Keywords: weight, body shape, women, body image, Sociocultural Attitudes Towards Appearance
Questionnaire.

The prevalence of body image concerns and eating disturbances in college

women is well documented (Hart & Kenny, 1997; Posavac, Posavac & Posavac,
1998; Snyder, 1997). Recent research has explored the internalization of the thin
ideal, transmitted through popular media and strengthened through social
reinforcement, as a potential risk factor for eating and body image concerns
(Cusumano & Thompson, 1997; Heinberg, Thompson, & Stormer, 1995; Thompson
& Stice, 2001). In theory, subscription to these unrealistic ideals may result in
increased body dissatisfaction, dieting, or eating pathology.

Kathryn Graff Low, PhD, Swita Charanasomboon; Claire Brown; Gwen Hiltunen, Katherine Long; and
Katherine Reinhalter, Bates College, ME, USA; and Hannah Jones, Wheaton College, MA, USA.
Appreciation is due to anonymous reviewers.
Please address correspondence and reprint requests to: Kathryn Graff Low, PhD, Department of
Psychology, Bates College, Lewiston, Maine 04240. Phone: 207-786-6186; Fax: 207-786-8338;
Email: klow@bates.edu
81
82 WEIGHT AND THE THIN IDEAL

Several studies support the importance of the thin ideal in both the development
and treatment of eating disturbances (Thompson & Stice, 2001). In a community
sample of grade school girls, the thin ideal was associated with both body
dissatisfaction and the self-described ideal (Dunkley, Wertheim, & Paxton, 2001). In
addition, short- and long-term exposure to thin models has been associated with
increased body image concerns and negative effect in college students (Stice,
Schupak-Neuberg, Shaw, & Stein, 1994; Stice & Shaw, 1994; Stice, Spangler, &
Agras, 2001). In prospective research, internalization of the thin ideal has been
associated with the onset of dieting (Stice, Mazotti, Krebs, & Martin, 1998) and
with increased bulimic symptomatology in adolescent women (Stice & Agras, 1998).
Finally, in several intervention studies with college women, decreases in the
internalization of the thin ideal have been associated with positive outcomes
(Stice & Ragan, 2002; Stice, Spangler, & Agras, 2001). Accumulating evidence
suggests that the effects of the thin ideal may be important for understanding both
the etiology and treatment of eating and body image concerns.
Despite the evidence that internalization of the thin ideal and body image
disturbance are correlated, there has been relatively little research on potential
moderators of the internalization-body dissatisfaction relationship (Stice,
Mazotti, Krebs, & Martin, 1998). Weight gain associated with puberty has long
been associated with the onset of eating issues (Levine, Smolak, Moodey,
Shuman, & Hessen, 1994), as have actual-ideal body image discrepancies
(Snyder, 1997), suggesting the need to explore the relationship between body
mass, the thin ideal, and body dissatisfaction. Similarly, a variety of psychosocial
variables related to social support may have an impact on risk, including dating
(Levine et al., 1994), peer relationships, and family interaction (Leon, Fulkerson,
Perry, & Early-Zald, 1995). In first-year students who have only recently arrived
at college, factors related to social support may be particularly important.
The present study explored the relationship between the internalization of the thin
ideal as assessed by the Sociocultural Attitudes Towards Appearance Questionnaire
(SATAQ; Heinberg, Thompson, & Stormer, 1995), and its relation to body mass and
subclinical eating and body image disturbances in a sample of undergraduates. In
addition, the association between SATAQ scores and changes in self-reported
weight and body image over the first six months of the school year were assessed
in a subsample of women.

METHOD

PARTICIPANTS
Participants were 72 first- and second-year students at a small liberal arts college
 WEIGHT AND THE THIN IDEAL 83
in the northeast of the United States of America recruited for a larger eating
disorders prevention study. Women with a history of an eating disorder or who
were currently purging were ineligible for the study. At baseline, women gave
informed consent, were administered a variety of questionnaires, and were
randomized to four conditions: three treatment conditions (n = 19, 18, 18) and a
control group (n = 16). Follow-up data collection on 70 of the original participants
occurred six months later. Data from the 16 women assigned to the control condition
were used to examine changes in eating and body image over the six-
month period, and their association with the SATAQ scales.

MEASURES
Demographic data, including Body Mass Index, were collected after obtaining
informed consent. In addition, the Weight and Shape Concerns Scale (WSC;
Killen, Taylor, Hayward, Haydel, & Wilson, 1994), the Eating Disorders Inventory
(EDI; Garner & Olmsted, 1984), a single item self-report measure of
social support, and the Stunkard Figure Rating Scale (Stunkard, Sorensen, &
Schulsinger, 1983) were administered, along with the SATAQ (Heinberg,
Thompson, &Stormer, 1995).All the measures have acceptable reliability and
validity in female college student samples. Both the WSC and the EDI were
readministered at six month follow-up.

RESULTS

Participants were first- (48.6%) or second-year (51.4%) undergraduate women

between the ages of 18 and 21. The sample was 7% minority, with an African
American and Hispanic participant, two Asian-American participants, and one
participant who endorsed other. The Weight and Shape Concerns Scale, self-
reported symptoms (purging), and previous treatment for eating disorders were
used to screen participants with a history of clinical eating concerns. In addition,
recruiting materials specified that women with a history of eating disorders were
ineligible for the study.
Preliminary correlations suggested that, as predicted, the three EDI scales
assessing body image and eating issues, Drive for Thinness, Bulimia, and Body
Dissatisfaction, were all highly correlated with the SATAQ Internalization scale
(SATAQ-I), but not with the Thin Ideal Awareness scale (SATAQ-A, see Table
1). Further, the Weight and Shape Concerns scale was strongly associated with
SATAQ-Internalization scores (r = .53, p < .001). There was also a positive
correlation between Body Mass Index (BMI) and SATAQ-Awareness (r = .27, p =
.04), suggesting that weight and awareness of the thin ideal may be linked, perhaps
because those who are overweight may be more aware of cultural mandates to
be thin. These analyses support Thompsons contention that Internalization and
84 WEIGHT AND THE THIN IDEAL

Awareness of the thin ideal may be independent, and that internalization rather
than awareness of the thin ideal is associated with eating and weight and shape
concerns (Thompson & Stice, 2001).

TABLE 1
CORRELATIONS

Variable Int-SATAQ Aw-SATAQ

EDI Subscales
Drive for Thinness .53** .14
Bulimia .34* .19
Body Dissatisfaction .44** .26*
Ineffectiveness .27* .20
Perfectionism -.02 .14
Distrust .14 .06
Interoceptive Awareness .33** .16
Maturity Fears .28* .27*

Other Variables
Weight and Shape Concerns .53** .10
Body Mass Index .07 .27*
Social Support .05 -.21
Stunkard .11 .24*

*p < .05, **p < .01

Two-way multivariate analysis of variance (MANOVA) was employed to explore

the potentially synergistic effects of body mass and internalization of the thin
ideal at
baseline (n = 70, see Table 2). It was hypothesized that women higher in body
mass who had also adopted the thin ideal would report the most eating and body
image concerns. For the MANOVA, SATAQ internalization scores were
dichotomized using a median split. Because of the relatively truncated range of
Body Mass, upper and lower quartiles of BMI were used in the analyses.
Dependent variables were Drive for Thinness (DT), Body Dissatisfaction (BD),
and Weight and Shape Concerns (WSC). MANOVA resulted in a significant
main effect for BMI (Hotellings T = .27, F = 3.7 (3, 41), p = .02), with heavier
women reporting more eating and body image concerns. Similarly, there was a
significant effect of internalization of the thin ideal, with women high in
internalization also reporting more symptoms (Hotellings T = .67, F = 8.9(3,41),
p. = 001). Finally there was a marginal interaction between BMI and SATAQ
internalization scores, in the direction of women high in both body mass and
internalization reporting the most weight and shape concerns. The interaction reached
significance in univariate analyses only for body dissatisfaction (F = 4.1 (1, 43),
p = .05).
 WEIGHT AND THE THIN IDEAL 85
TABLE 2
BODY MASS, INTERNALIZATION OF THE THIN IDEAL, AND EATING AND BODY SHAPE CONCERNS

Mean (SD)

Drive for Thinness

Low BMI
Low Int .78 (1.9)
High Int 6.8(6.5)*
High BMI
Low Int 1.5 (2.1)
High Int 7.4(6.4)*
Body Dissatisfaction
Low BMIa
Low Int 5.6 (3.9)
High Int 7.2 (4.6)
High BMIa
Low Int 7.0 (4.5)
High Int 15.5(7.8)*
Weight and Shape Concerns
Low BMIb
Low Int 23.6 (18.2)
High Int 48.7(15.9)*
High BMIb
Low Int 26.8 (15.7)
High Int 54.0(17.3)*

Note: a = significantly different from each other; b=significantly different from each other; *p < .05 for
simple effects.

Parallel analyses were carried out for internalization scores and a

dichotomized Stunkard Figure Scale score, an assessment of body image, to predict
the composite body concern variables (DT, BD, WSC). Again, there was a
main effect for internalization of the thin ideal in the expected direction.
Similarly, the higher the Stunkard score, the more self-reported body image
concerns across the dependent variables (Hotellings T = .18, F = 3.9 (3,67), p =
.012). The interaction between internalization and body image as assessed by
the Stunkard Scale was also significant (Hotellings T = .13, F = 2.7 (3,67), p =
.05), with high Stunkard scores in combination with high internalization scores
resulting in the most self-reported body image concerns. Univariate analyses were
significant for the internalization by body image interaction for body dissatisfaction
(F = 6.6 (1,69), p = .01), and were marginal for drive for thinness (F = 3.7 (1,69),
p = .06).
To examine more complex models, two multiple regressions were run in which
BMI, social support, SATAQ-internalization subscale scores, and the interaction
86 WEIGHT AND THE THIN IDEAL
TABLE 3
INTERNALIZATION OF THE THIN IDEAL AND CHANGE IN WEIGHT AND SHAPE CONCERNS OVER SIX
MONTHS (n=16)

Variable Mean (SD) Pre Mean (SD) Post

Drive for Thinness 3.7(1.1 4.5(1.1)+

Body Dissatisfaction 9.0(1.6) 8.2(1.6)
Weight and Shape Concerns 35.3(4.6) 42.8(4.8)*

Correlation of Internalization Scores and Change Scoresa

Internalization Awareness
Drive for Thinness -.49* -.18
Body Dissatisfaction .14 -.12
Weight and Shape Concerns -.30 -.14

+p < .1, *p < .05,** p < .01

a. A negative correlation indicates that a high degree of internalization was associated with a change
score suggesting increasing concerns over the six months.

of BMI and SATAQ-I were entered stepwise to predict WSC and EDI-Body
Dissatisfaction scores at baseline. For weight and shape concerns, BMI, social
support, and internalization of the thin ideal all met entry criteria for the model
(p < .01), with social support negatively associated with weight and shape
concerns. The interaction term did not add significantly to the model. R for the
model was .64 (F(3, 67) = 15.8, p < .0001), and the inclusion of the internalization
score was responsible for 34% of the variance. For Body Dissatisfaction, BMI,
social support and internalization all met entry criteria (p < .05), and the interaction
of body mass and internalization accounted for a modest amount of additional
variance (9%). For the full model, R = .63, F(4,66) = 11.1, (p < .001), with
SATAQ-I scores accounting for roughly 26% of the variance.
Finally, having a high internalization of the thin ideal score was associated
with increased body image concerns in a subsample of women(n = 16) followed
over six months (see Table 3). Although the correlation for drive for thinness was
the only one to reach significance because of low power, the effect sizes were
large (r = .49 for Drive for Thinness and r = -.30 for Weight and Shape Concerns).

DISCUSSION

Consistent with previous research on the thin ideal, the Internalization sub-
scale of the Social Attitudes Towards Appearance Scale was associated with
body image and weight concerns in a sample of nondisordered undergraduate
women (Thompson & Stice, 2001). Further, awareness of the thin ideal
(SATAQ-A) by itself did not appear to be correlated with eating and body image
 WEIGHT AND THE THIN IDEAL 87
concerns except in the case of body dissatisfaction and maturity fears.
Interestingly maturity fears are correlated with both internalization and awareness
of the thin ideal in this sample. Given that the source of such ideals may be
exposure to popular media (Stice, Schupak-Neuberg et al., 1994; Stice & Shaw,
1994) it may be that media exposure, regardless of internalization, is associated
with more anxiety about maturation.
In addition, in this sample, body mass moderated the effects of internalization
scores on weight and body image concerns, with women high in internalization
and high in BMI reporting more dissatisfaction. Internalization of the thin ideal
and self-assessed body image as measured by the Stunkard Figure Rating Scale
also interacted, with those high in internalization and with larger than average
Stunkard scores reporting the most concerns. These findings are consistent with
those of Snyder, who found that perceptions of being overweight are correlated
with body dissatisfaction and drive for thinness (Snyder, 1997). Presumably a
greater body mass index combined with internalized sociocultural mandates to
be thin would produce more body dissatisfaction and body image concerns.
Similarly, having a body type that does not conform to the sociocultural ideal
may also increase risk for body image disturbance when it coexists with adherence
to the thin ideal. Further exploration of the synergistic effects of weight and
body type in combination with the thin ideal are warranted.
Finally, prospective analyses in a small subsample of participants suggest that
internalization of the thin ideal assessed at baseline (early fall of the academic
year) is associated with changes in self-reported body and weight concerns over
the subsequent six months. Specifically, high internalization in the fall is associated
with a greater drive for thinness and more weight and shape concerns six
months later. Given that residential colleges may create social environments that
foster eating concerns and intense awareness of body image, assessing and
addressing the degree to which sociocultural mandates about eating and body
image are internalized as students matriculate may be an important aspect of college
prevention programs. Previous research suggests that internalization of the
thin ideal predicts bulimic symptoms (Stice & Agras, 1998) and dieting in
adolescents (Stice et al., 1998); data from the present study suggest that adherence
to unrealistic sociocultural standards, as assessed by the SATAQ internalization
subscale, may also be associated with gradually increasing weight and shape
concerns in a residential college.
There are many limitations to the present study, including its modest sample
size, particularly for prospective analyses, and its single administration of the
SATAQ. Future research should employ larger samples in prospective designs to
determine the degree to which weight, body image and self-reported weight-
ideal discrepancies may interact with the thin ideal to produce eating and body
image-related symptomatology. Despite its limitations, the present study adds to
88 WEIGHT AND THE THIN IDEAL

the accumulating evidence (Thompson & Stice, 2001; Stice et al., 1998) that the
SATAQ-Internalization scale is a valid measure of ascription to the thin ideal, and
that adoption of unrealistic cultural standards for body image, especially in
combination with higher body mass, may increase risk for eating and body
image concerns.

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