When Media Become The Mirror: A Meta-Analysis On Media and Body Image

Media Psychology
ISSN: 1521-3269 (Print) 1532-785X (Online) Journal homepage: https://www.tandfonline.com/loi/hmep20
When media become the mirror: a meta-analysis

on media and body image
Qian Huang, Wei Peng & Soyeon Ahn
To cite this article: Qian Huang, Wei Peng & Soyeon Ahn (2020): When media
become the mirror: a meta-analysis on media and body image, Media Psychology, DOI:
10.1080/15213269.2020.1737545
To link to this article: https://doi.org/10.1080/15213269.2020.1737545
Published online: 22 Mar 2020.
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MEDIA PSYCHOLOGY
https://doi.org/10.1080/15213269.2020.1737545
When media become the mirror: a meta-analysis on media

and body image
a a
Qian Huang , Wei Peng , and Soyeon Ahnb
a
School of Communication, University of Miami, Coral Gables, Florida, USA; bSchool of Education and
Human Development, University of Miami, Coral Gables, Florida, USA
ABSTRACT
A growing body of research on the media’s effects on body image
suggests that media of different forms plays a vital role in shaping
people’s body image concerns and behavioral intentions. By con-
ducting a comprehensive meta-analysis of published and gray
literature (in total 127 studies yielding 543 effect sizes of seven
measures), this study examined the relationship between media
and a wide range of body image-related outcomes as well as
moderators (e.g., media type, outcome type, age group, gender
proportion in the sample, and study design). The analysis demon-
strated that the magnitude of this relationship significantly varied
across media types (i.e., television commercial, television program,
magazine commercial, magazine contents, and social media) and
outcome types (i.e., affective, cognitive, or behavioral outcomes).
Moreover, there were three major findings of this meta-analysis: 1)
both women and men of all age groups across multiple countries
could be affected by thin/athletic-ideal media exposure; 2) media
with a commercial purpose compared to those with no commer-
cial purpose was less effective in increasing body image con-
cerns; 3) media exposure was the most influential in provoking
the eating disorder and the internalization of thin-ideal.
Across the world, the question “what is an acceptable body image for me” has
never been a more important topic for people of all ages (Abarca-Gómez et al.,
2017; Wardle, Haase, & Steptoe, 2006). Media in general play a critical role in
building and promoting an ideal body shape and size in different populations
(Derenne & Beresin, 2018; Frederick, Sandhu, Morse, & Swami, 2016). Both
women’s and men’s body images are often heavily influenced with unrealistic
and unattainable physiological characteristics delivered by varying types of
media (Derenne & Beresin, 2006). As a result, perpetuation of the ideal body
along with the desire to have a particular body shape has led to a range of
concerns including body dissatisfaction (Grabe, Ward, & Hyde, 2008), negative
emotions (Aubrey, 2007), depression (Garvin & Damson, 2008), unhealthy
eating behavior1 (Bissell & Zhou, 2004), and excessive exercise (Dakanalis
et al., 2015; Derenne & Beresin, 2018).
CONTACT Qian Huang huangqian2013@gmail.com University of Miami, 5100 Brunson Drive, Coral Gables,
FL 33146
© 2020 Taylor & Francis Group, LLC
2 Q. HUANG ET AL.
Despite the prevalence of the media-body image relationship, studies exam-

ining this dyad have shown mixed results. While a number of theories have
explained the mechanism by which various media produce their negative effects
on body image, the magnitude of this relationship was found to vary in
outcome types and by a series of factors such as media type, age group, gender,
and study design. For instance, cross-sectional studies demonstrated
a correlation between media exposure and body image (e.g., Hargreaves &
Tiggemann, 2004; Lin et al., 2016), whereas some experimental studies discov-
ered no difference in body dissatisfaction between media exposure and control
conditions (e.g., Lorch, 2018). Likewise, Tiggemann (2005) found that the
stronger internalization of a skinny body was usually obtained from reading
fashion magazines rather than watching televisions, which by contrast was
found to motivate greater behavioral intents toward diet and excessive exer-
cises. Taken together, those discrepancies in the literature resulted in reconsi-
derations regarding the ubiquity of media effects.
Furthermore, previous meta-analyses primarily focused on the role of body
image in traditional mass media (e.g., televisions and magazines). However,
because the present media landscape has been reshaped by the proliferation of
image-based social media (e.g., Instagram, YouTube), the role played by social
media in influencing one’s perception of her/his body cannot be neglected (e.g.,
Ghaznavi & Taylor, 2015; Hendrickse, Arpan, Clayton, & Ridgway, 2017).
Viewing photos of peers on social media timeline was found to elicit drive for
thinness, body dissatisfaction, and eating disorder among young men and women
(Ferguson, Munoz, Garza, & Galindo, 2014). Hence, the present meta-analysis
aims to make contributions by including studies that specifically examined the
influence of social media. Additionally, although the previous meta-analyses have
examined different aspects of the relationship between appearance-focused media
exposure and body image concerns, a thorough meta-analysis that includes a wide
range of body image-related outcomes as well as moderators is still absent. To
summarize, the purpose of the present meta-analysis is to investigate the overall
magnitude (i.e., strength and direction) of the effect of appearance-related media
exposure on body image and to distinguish how this effect, if extant, is differ-
entiated by theoretical and practical factors across a series of body image
measures.
Literature Review
Body image relevant outcomes
Body image is a multifaceted construct that represents thought, feeling, and
behavior toward one’s own body shape, appearance, and attractiveness (Cash,
2004). A variety of outcomes were examined to identify the effects of being
exposed to media-presented images of thinness and attractiveness on one’s body
MEDIA PSYCHOLOGY 3
image concerns. Among seven outcomes, body dissatisfaction has been repeatedly
examined in body image-related studies over the past decades (e.g., Myers &
Biocca, 1992; Ridolfi & Vander Wal, 2008; Tiggemann, Brown, Zaccardo, &
Thomas, 2017). According to social comparison theory (Festinger, 1954), expo-
sure to images of thinness or muscularity from the media obtains its effects via the
act of comparison, leading to decreased body satisfaction and increased body self-
consciousness (e.g., Bissell & Zhou, 2004; Thornton & Maurice, 1997). While they
are examined concurrently, body dissatisfaction and body self-consciousness are
distinctive in their definitions. Body dissatisfaction refers to the negative thoughts
and feelings that one holds about his or her body and often only related to actual
and physical appearance (Cash, 1990), whereas body self-consciousness measures
the extent to which individuals monitor their bodies as an outside observer would
(McKinley & Hyde, 1996). In addition, the internalization of thin-ideal has been
tested to understand the extent to which one affirms the desirability of socially
defined ideals and behaviors to achieve the thinness and attractiveness displayed
in media (Heinberg, Thompson, & Stormer, 1995). In contrast to body dissatisfac-
tion and self-consciousness, internalization focuses more on the awareness of
cultural pressures regarding certain physical appearances (Cusumano &
Thompson, 1997). Alongside with the aforementioned cognitive outcomes,
researchers also found that continuous comparison between one’s own body
and the unrealistically skinny or athletic bodies in the media elicited negative
emotions (e.g., Anschutz, Engels, Becker, & Van Strien, 2009; Garvin & Damson,
2008), which may further develop into mental health risks, such as depression and
anxiety (e.g., Mazzeo, Trace, Mitchell, & Gow, 2007). Furthermore, negative
perceptions and emotions toward one’s body ultimately resulted in a series of
harmful health behaviors, namely disordered eating behavior and excessive exer-
cise (e.g., Cohen, Newton-John, & Slater, 2018; Irving, 1990; Tiggemann, 2005).
In addition, mechanisms highlighted by different theories that accounted
for the relationship differ in terms of the outcomes of exposure. For instance,
cultivation theory (Gerbner, 1969) elucidated the relationship between
chronic exposure to media contents (e.g., entertaining television programs
and fashion magazines) and body dissatisfaction (e.g., Bissell & Hays, 2010)
and low self-esteem (e.g., Schooler, Monique Ward, Merriwether, &
Caruthers, 2004). In comparison, other theories, such as self-objectification
theory (Fredrickson, Roberts, Noll, Quinn, & Twenge, 1998), social-cultural
theory (Levine & Smolak, 1996), and tripartite influence theory (Thompson,
Heinberg, Altabe, & Tantleff-Dunn, 1999), emphasize the psychological and
behavioral outcomes including eating disturbance (e.g., van den Berg,
Thompson, Obremski-Brandon, & Coovert, 2002), internalization of thin-
ideal (e.g., Stice, Schupak-Neuberg, Shaw, & Stein, 1994), and excessive
exercise (e.g., Bearman, Martinez, Stice, & Presnell, 2006) resulting from
appearance-oriented media contents. To summarize, given that the effect of
media exposure on body image determines a series of outcome measures, it is
4 Q. HUANG ET AL.
critical to explore whether outcome type moderated the effects of appear-

ance-based media exposure.
Other Moderators
In addition to different types of outcomes, research has located other factors
such as gender and media type that could also affect the strength of the
association between media exposure and body image outcomes (e.g., Barlett,
Vowels, & Saucier, 2008; Bell & Dittmar, 2011).
Media type
Media features distinguish not only media but also audience perceptions of
the images presented by the situational factors of a certain media vehicle
(Hirschman & Thompson, 1997). For example, exposure to images of bodies
embedded in magazine, compared to television use, was found to be more
strongly associated with body dissatisfaction among young girls (Murnen &
Kohlman, 2007). Furthermore, although mass media (e.g., television pro-
grams, magazines, music videos, and movies) as a whole were predominantly
employed as stimuli or routinely concentrated on mass media effects
(Thompson et al., 1999), sub-types within different media type also differed
significantly from one another in their ways of portraying the body and
frequencies of exposure (Tiggemann & Pickering, 1996). For instance, tele-
vision programs often presented characters and celebrities with an ideal
body, whilst music videos typically emphasized the body through moving
and dancing (Grabe & Hyde, 2009). Last, newly emerging media such as
social media plays a significant role in bringing forth negative body image
relevant outcomes through social comparison with peers or celebrities across
different age groups (e.g., Fardouly & Vartanian, 2015; Holland &
Tiggemann, 2016). Thus, the variation explained by social media in building
the idea of an acceptable body along with subsequent concerns and behaviors
should be considered. Since only few studies (e.g., Bell & Dittmar, 2011;
Murnen & Kohlman, 2007) have demonstrated whether media type would
differ in their effects on audiences’ body image concerns, it is necessary for
the present study to conduct a systematic comparison between different
media types in which an ideal body shape is presented.
Moreover, informational and advertising contents serve different purposes
and are thus not always to be combined even if displayed in the same media
outlet. Mills, Polivy, Herman, and Tiggemann (2002) conducted two separate
studies using magazine advertisement and magazine articles, respectively
(also see Posavac et al., 1998). Likewise, Dittmar and Howard (2004) found
that viewers rated higher on the item “attractive models are used to enhance
purchasing behavior” after they were told the stimulus materials were from
an advertisement. In this sense, knowing the purpose of the materials may
MEDIA PSYCHOLOGY 5
alter viewers’ focuses, responses, and perceptions toward the image of body
per se (e.g., Petty, Schumann, & Richman, 1993). Mathur and Chattopadhyay
(1991) found that the extent to which a television advertisement is processed
is affected by the mood generated by the television program. They concluded
that the value of exposure to the medium of appearance-focused products ad
is reduced when the ad is embedded into a sad television program compared
to being shown alone because the unpleasant connotation weakened the
association between the skinny body shown in the embedded advertisement
and negative outcomes. Therefore, advertising and informational contents,
even when displayed in the same type of media (e.g., television, magazine),
were treated as separate categories for media type in the present meta-
analysis.
Age group
The age of participants in studies that tested the relationship between
media exposure and body image concerns ranged from 7 to 50 years old.
Adolescents tend to be more impulsive and self-conscious than adults
because of the neurobiological changes that occur during this critical
developmental period (Levine & Smolak, 2018; Pechmann, Levine,
Loughlin, & Leslie, 2005). It is also evident that adolescents are at the age
of constructing an awareness of ideal body shape and are thus more likely
to be influenced by the ideal body types displayed in media (e.g.,
Borzekowski, Robinson, & Killen, 2000; Trekels & Eggermont, 2017). For
example, Tiggemann et al., (2003) found that viewing appearance videos
led to increased schema activation for older adolescent females (average
age = 17) but not for younger adolescent females (average age = 11).
Alternatively, body dissatisfaction and anger were found to increase
among both older and younger adolescents after viewing appearance
videos. Hargreaves and Tiggemann’s (2004) study demonstrated that after
viewing muscular-ideal images adolescent boys experienced more negative
mood than did the boys viewing control images. In contrast, these effects
on adults were not fully supported. Thus, younger adolescents, in compar-
ison with older adolescents or adults, might be more vulnerable to media
exposure on certain outcomes (e.g., negative schema activation). As no
empirical study probed whether age influenced the effects of media expo-
sure on body image concerns, it is important for the present meta-analysis
to investigate whether age moderated the relationship between appearance-
related media exposure and negative body image relevant outcomes.
Correlational and experimental studies

Both correlational and experimental studies have been conducted to test the
relationship between media exposure and body image concerns. Correlational
studies hold their merits on testing the cumulative effects of exposure to media
6 Q. HUANG ET AL.
contents, including body surveillance (e.g., Mazzeo et al., 2007), drive for
thinness (e.g., Tiggemann, 2005), and eating disorder (e.g., Moriarty &
Harrison, 2008). On the other hand, experimental studies attended to immedi-
ate effects of media exposure on body image such as body shame (e.g., Aubrey,
2010), perceived attractiveness (e.g., Bosson et al., 2008), and negative emotions
(e.g., Anschutz et al., 2009). The experimental design also offers a more robust
explanation in terms of the causal effect of media exposure after controlling
possible extraneous factors that may cause fluctuation in body image.
Nevertheless, studies using experimental design may not be able to capture
the chronic effects that people experience on a daily basis (Brown & Dittmar,
2005). Additionally, the ceiling effect will sometimes arise when participants
reach a maximum level of body image disturbance and feel habituated to such
media influence (Groesz, Levine, & Murnen, 2002). Therefore, considering the
distinctive features of correlational and experimental studies, it is necessary to
explore whether the study design altered the magnitude of the relationship
between media exposure and body image outcomes.
Gender proportion
In addition to the research examining how women tend to conform with the
perpetuated ideal thinness, scholarly attention has been paid to the effects of
media exposure onto males’ body image perceptions (see meta-analysis at
Barlett et al., 2008). Similar to the process that explains the effects of exposure
to thin bodies for women, repeated exposure to ideal muscular body types could
result in the internalization of ideal body types and body-related dissatisfaction
among men toward their bodies (e.g., Morry & Staska, 2001). While the ideal
body is slim or skinny for female reviewers, male viewers often seek a lean and
muscular body that is often not attainable (e.g., Hargreaves & Tiggemann, 2002;
Leit, Pope, & Gray, 2001). However, males are still underrepresented amongst
studies examining body image relevant issues (Barlett et al., 2008). With few
studies that paid specific attention to men’s body image, it remains unknown
whether the body image relevant outcomes and psychological mechanisms that
apply to females would also be found among males. Therefore, the present
meta-analysis explores if gender proportion could moderate the effects of media
exposure on body image concerns.
The current meta-analysis

To date, there are seven meta-analyses or meta-analytical reviews examining
the magnitude of the media-body image dyad, yet their analyses, moderators,
and results vary. Compared to other existing meta-analyses that mainly
attended to body image outcomes, the one conducted by Karsay, Knoll,
and Matthes (2018) investigated whether exposure to sexualizing media
increased overall self-objectification among individuals, rather than mere
MEDIA PSYCHOLOGY 7
objectification of one’s body. Also, effect sizes reported by previous meta-

analyses were inconsistent to some extent. Groesz et al. (2002) reported
a moderate effect (d = −.3) from 25 experimental studies yielding 43 effect
sizes. However, Holmstrom (2004) reported a small effect size (r = − .08)
based on 34 experimental and correlational studies. Grabe and Hyde (2006,
2008) reported a similar range of effect sizes on body dissatisfaction, the
internalization of thin-ideal, and eating behavior (d = – .28, d = − .39, and d
= − .30, respectively). Given the discrepancy, the present meta-analysis
included both experimental and correlational studies and treated study
design as a potential moderator.
Furthermore, the meta-analysis conducted by Barlett et al. (2008) included
studies with male participants only and found a moderate effect size (overall
d = – .22) of mass media exposure on men’s body dissatisfaction, self-esteem,
and behavioral outcomes based on 22 correlational studies. Since only few
studies paid attention to the negative influences on men’s body image, we
treated the gender proportion in the sample as a moderator in the present
meta-analysis. In this sense, the present meta-analysis is also the first to
examine if gender moderated the effects of media exposure on body image
concerns.
Compared to previous meta-analyses, the present study includes all exist-
ing types of body image concerns associated with media exposure using
a robust approach (i.e., Robust Variance Estimation) to account for the
interdependence among outcome measures examined concurrently in the
same study. Hausenblas et al. (2013) included only four general outcome
types (i.e., body esteem, body satisfaction, behavioral, and psychological
outcomes). Despite examining more outcome types, Barlett et al. (2008)
treated the outcome type as a moderator rather than as a separate meta-
analysis. This approach, however, added ambiguity to the meaning of the
summary effect size and moderator analyses (Olkin & Gleser, 2009). In
addition, the popularity of social media in our daily life raises the concerns
about its impact on body image (Fardouly, Diedrichs, Vartanian, & Halliwell,
2015; Ferguson et al., 2014). Hence, compared to previous meta-analyses, the
present meta-analysis added social media as a media type. An examination of
social media effects would hence shed light on some of the underlying
dynamics of body image concerns. While Holmstrom (2004), Grabe et al.
(2008), and Karsay et al. (2018) coded media types, their classification of
media seemed too broad without considering social media as a type (Karsay
and colleagues coded a category as “online”). Last but not least, it is worth
noting that most previous meta-analyses (except Grabe & Hyde, 2006; Grabe
et al., 2008) did not include unpublished studies. To examine the chance of
publication bias, the present meta-analysis included unpublished doctoral
and Masters’ theses.
8 Q. HUANG ET AL.
To summarize, the purpose of the present study is to examine whether the

existing studies of media’s influence on body image concerns and behaviors
are effective, and if age, the proportion of females in the sample, media type,
and other variables could potentially moderate this relationship. In addition,
the current research draws a broad picture of the media-audience dyad.
Understanding people’s perceptions toward themselves will improve inter-
ventions to help both men and women select media messages related to
acceptable looks, which can consequently lead to healthier levels of body
image self-acceptance. Therefore, the overarching research question is: How
effectively could the media influence people’s perception of themselves in
terms of all body image-related outcomes?
Method
Search process
An initial computerized literature search was conducted in February 2018 in
PsycINFO (1975–2018), ProQuest Dissertations & Theses Global (1975–2018),
and Communication and Mess Media Complete (1975–2018) via EBSCO using
keywords “media,” “television,” “self-objectification,” “body image,” “body dis-
satisfaction,” “thin-ideal internalization,” “body shame,” “disordered eating,”
“mental health risk,” “depression,” “anxiety,” “bulimia.” In addition to the
search across databases, studies included in previous meta-analyses also facili-
tated the preliminary search.2 Publicly available Doctoral and Master’s degree
theses that were unpublished were retrieved as well. As a result, a total of 541
citations were exported to Endnote. In the initial screening phase, two coders
screened abstracts of the 541 citations to determine if a study fit the criteria of
the present meta-analysis (see flow chart in Figure 1).
Inclusion and exclusion criteria

Our inclusion and exclusion criteria were as follows: 1) Both empirical
(including lab experiment and quasi-experiment) and cross-sectional
(including longitudinal) studies (e.g., survey) were included; qualitative
study, systematic review, or meta-analysis were excluded (k = 10); 2) only
studies conducted with human participants were involved; studies that did
not involve any subjects (e.g., content-analysis) were excluded (k = 5); 3)
studies where media exposure or consumption were either manipulated (e.g.,
showing participants in different conditions with different media stimuli) or
measured (e.g., asking the time spent on watching television programs per
week) were included; studies where media exposure was neither measured
nor manipulated were excluded (e.g., studies that measured perceived social
norm of an attractive body)(k = 24); 4) studies that were conducted any
MEDIA PSYCHOLOGY 9
Figure 1. Flow chart.
genders or mixed-gender participants were included; 5) studies that involved

any age group were included; 6) studies that were conducted either in the
United States or outside the United States were included; 7) studies that
focused on any media type, genres, and outlets (e.g., mass media, social
media) were included; 8) studies providing sufficient statistical results to
calculate effect size (e.g., mean difference and standard deviation, F-tests,
t – tests, Fisher’s r) were included; studies providing insufficient information
to calculate effect size were excluded (e.g., studies that reported only coeffi-
cients of regressions or partial correlations were not included as coefficients
or partial correlations are not computable into effect sizes and are under the
control of other factors) (k = 19); 9) studies that lack accessible version (k
= 2) were excluded; and 10) studies that pulled from the same sample but
published in different articles were excluded (k = 2). Authors (n = 19) of
studies with insufficient statistics were contacted to acquire data for effect
size calculation, among which 4 authors responded with no original dataset
available and 15 did not respond by the revision of this manuscript. In total,
130 studies (N = 35, 877) were included in the present meta-analysis (see the
list of all excluded studies at Supplements).
Coded variables
Based on the literature review, a systematic coding scheme was developed to
identify the salient features of each study. Specifically, variables regarding
study characteristics: (a) publication year, (b) publication type (1 journal; 2
10 Q. HUANG ET AL.
dissertation; 3 book or book chapter; 4 conference paper; 5 manuscripts; 6

other; 7 unknown). Variables regarding sample characteristics: (a) participant
age (mean and age range were coded), (b) sample size, (c) respective numbers
of female and male in the sample, (d) BMI, or other weight indices of the
sample. Variables regarding design characteristics: (a) study design: (1
between subject experimental; 2 within-subject design; 3. between-within
subject design; 4. quasi-experiment; 5 correlational; 6 other; 7 not reported),
(b) media type (1 magazine content; 2 magazine advertisement; 3 television
program; 4 television commercial; 5 movie clip; 6 music video; 7 print
noncommercial photos; 8 print commercial photos; 9 celebrity social media
content; 10 non-celebrity social media contents; 10 unspecified mass media),3
(c) length of exposure in minutes, (d) type of outcome variables (1 body
dissatisfaction/body shame/body-esteem; 2 self-objectification/self-
consciousness/self-concept/self-esteem/confidence; 3 internalization of the
thin ideal and drive for thinness; 4 eating behavior and health-related beliefs;
5 mental health (i.e., depression, anxiety, etc.); 6 emotional response (i.e.,
sadness, upset, etc.); 7 other (specify), (e) proportion of females in the
sample, (f) control variables used in the study such as restrained eater (e.g.,
Legenbauer, Ruhl, & Vocks, 2008; Mills et al., 2002) or people from particular
social groups (e.g., Japanese; see Yamamiya et al., 2005).
Coding procedure
The raters began coding in February 2018 and finished in August 2018. The
studies were screened and coded by the first two authors independently. Each
author coded 50% of the studies. Twelve studies were sampled to compute
the intercoder reliability. Intercoder reliability was computed with Cohen’s
Kappa(kk) (Fleiss & Cohen, 1973) for categorical variables and Intraclass
Correlation (ICC) for continuous variables (Shrout & Fleiss, 1979).
Intercoder reliabilities of coded variables ranged from 0.82 to 0.95 (Cohen’s
Kappa = 0.85, ICC = 0.87), within the satisfactory category of agreement
(Landis & Koch, 1977). All rating disagreements were resolved through
discussion until 100% agreement was achieved for each variable.
Effect size
Considering that we included studies of a relatively small sample size (e.g.,
Mills et al., 2002; Monro & Huon, 2005), random-effects Hedge’s g was applied
to indicate effect size, correcting for small sample sizes (Hedges, 1981; Hedges
& Olkin, 1985). A positive Hedge’s g indicates an increase in media effect on
body image relevant outcomes while a negative Hedge’s g indicates a decrease
in media’s effect on body image relevant constructs. For studies where media
exposure was linked to a reduction in outcome variables where the bigger score
MEDIA PSYCHOLOGY 11
means negative effects, the computed sign of the effect size was reversed so that
all positive difference reflected a decrease in positive body image relevant
outcomes (see detailed calculation procedure at the supplements).
Statistical Analysis
Outlier analysis
To rule out the influence of unusually large or small outliers on overall effect
size, we employed an approach named sample-adjusted meta-analytic
deviance statistic (SAMD; Huffcutt & Arthur, 1995), which computes the
difference between individual studies’ effect sizes and the mean sample-
weighted effect size. After the computation, we removed 16 effect sizes
from 6 studies (i.e., Dittmar, Halliwell, & Stirling, 2009 Study 1; Hargreaves
& Tiggemann, 2003; Mills et al., 2002 Study 1 and 3; Skorek & Dunham,
2012; Tiggemann & McGill, 2004) that were above (Mean + 2*SD) or below
(Mean – 2*SD) regular scale to see if that would have a considerable impact
on the conclusions. We then found that the removal of those 16 effect sizes
did not significantly alter the original results on all outcome types except the
internalization of thin-ideal and disordered eating behavior. After carefully
scrutinizing the studies that contain extremely large outliers (i.e., gs = 3.27,
3.61, 3.90, 4.40, 3.51, and – 3.42), we decided to remove the six outliers for
analyses on the internalization of thin-ideal and disordered eating behaviors
only. We thus concluded that our meta-analytical findings are robust to
outliers or influential cases.
Artifact correction
Necessary correction should be conducted to eliminate the influences
resulted in various artifacts such as the unreliability of measurement scales
and restriction of range in the independent or the dependent variable
(Hunter & Schmidt, 2004). As the range of restrictions applies only to
correlations, we did not include it in the artifact corrections. In studies
where reliability was reported, either by Cronbach’s alpha or Cohen’s
kappa, effect sizes and their associated standard errors were corrected for
the unreliability of measures. In studies where reliability was not reported but
a multiple-item measure was used, the average reliability of all studies
reporting reliability was imputed for artifact correction (Malpha = .74). Data
were analyzed using the package “psychmeta” (Dahlke & Wiernik, 2018) in
R software (R Core Team, 2013). This package can automatically make
corrections for reliability as it computes meta-analyses.
Statistical analysis
Because over 90% of the included studies in the present meta-analysis tested
a variety of body-image relevant outcomes using multiple measurements,
12 Q. HUANG ET AL.
more than one effect size was extracted from a single study. To handle the
interdependent effect sizes, we conducted a meta-regression model using the
Robust Variance Estimation (RVE; Gleser & Olkin, 2009; Hedges, Tipton, &
Johnson, 2010) for adjusting for effect size tendencies while retaining appro-
priate type I error rates. The overall and moderator analyses were perfumed
in R software using packages “robumeta” (Fisher & Tipton, 2015).
Results
Description of studies
After removing the six outliers, 543 effect sizes from 127 studies (N = 35,195)
were included in the present meta-analysis. The study characteristics and
descriptive information about participants are included in Table 1.
Sample sizes ranged from 13 to 12176 (M = 240.79, SD = 574.85), and
participant mean age ranged from 5.26 to 46.25 years old (M = 20.13,
SD = 5.97). The average proportion of female participants in the sample
size was 0.85 (SD = 0.34), ranging from 0 to 1. The average BMI was 22.42
(SD = 2.16). In total, 543 effect sizes fell into seven types of outcome variables
(see Table 2). Effect sizes and moderators coded for each study can be located
in study information in Table 5.
Publication bias
Publication bias refers to the possibility that studies finding null or negative
results are less likely to be published than studies finding positive effects
(Hedges, 1992). This bias can decrease the confidence of meta-analytical
results (Sutton, 2009). In addition, a funnel plot is provided to examine
whether there is publication bias (see Figure 2).
Begg and Mazumdar (1994) rank correlation test (Kendall’s tau) suggested
there was an insignificant relationship between standard error and effect size
(Kendall’s tau = 0.018, p = .53), which indicated insufficient evidence of the
publication bias. Furthermore, Egger’s regression (Sutton, 2009) test showed
an insignificant relationship between standard error and effect size
(z = −1.45, p = .15), which also provided less evidence for publication bias.
Duval and Tweedie (2000) trim and fill method was used to check to estimate
the effect size without publication bias (see Figure 3 for Funnel Plot after
trim and fill and Egger’s regression). It suggested that 0 studies were missing
on the right side of the funnel plot (SE = 12.45). Rosenthal’s (1979) Fail-safe
N was 145, 564 at the observation significance level of .0001 and a target
significance level of .05. Therefore, we concluded that it is unlikely that this
meta-analysis could have missed a substantial number of studies. Thus, the
MEDIA PSYCHOLOGY 13
Table 1. Descriptive Information of Studies (with outliers: k = 130; without outliers: k = 127).
Characteristics Number of studies (k) Percentage
Year of report
Before 1990 2 2%
1991–2000 35 27%
2001–2010 69 53%
2011– to date 24 18%
Source of study
Journal 108 83%
Thesis 20 15%
Book 2 2%
Study Location
U.S. 78 60%
UK 9 7%
Australia 21 16%
Belgium 2 2%
Canada 13 10%
Germany 2 2%
France 1 1%
Netherlands 2 2%
Israel 1 1%
Fiji 1 1%
Type of control
No control 81 62%
Weight 10 8%
Other (e.g., restrained eater) 34 26%
Unspecified 5 4%
Age group
Adolescents (younger than 18) 25 19%
Emerging Adults (18–32) 73 56%
Adults (older than 32) 5 4%
Not reported 27 21%
Study design
Between-subject 62 48%
Within-subject 5 4%
Mixed 15 12%
Quasi-experiment 5 4%
Correlational 38 29%
Unspecified 2 2%
Media type
Magazine contents 41 32%
Magazine ads 18 14%
TV programs 20 15%
TV commercials 14 11%
Movie clips 3 2%
Music videos 2 2%
Print noncommercial photos 8 6%
Print commercial photos 16 12%
Non-celebrity account on SNS 3 2%
Celebrity account on SNS 1 <1%
Unspecified mass media 4 3%
conclusion of the meta-analysis is robust to this threat. Our analysis demon-

strated that publication bias does not concern the results.
14 Q. HUANG ET AL.
Table 2. Summary of Effect Sizes by Outcome Type (with outliers).

Outcome type Experimental Correlational Unspecified Total
Body image/dissatisfaction 111 47 2 160
Body self-consciousness 86 37 2 125
Internalization of thin-ideal or drive of thinness 26 49 - 75
Eating behavior or food choice 32 33 - 65
Mental health risk 36 10 - 46
Emotional response 28 0 - 28
Attitudinal response (e.g., gender role, feminism 33 17 - 50
ideology, etc.)
Total 352 193 4 549
Figure 2. Funnel plot.
Overall analysis
The overall effect size was found to be statistically significant, t (119) = 4. 37,
p < .001, I2 = 93.09, T2 = .22, indicating that more appearance-related media
exposure was significantly associated with negative body-image outcomes
(g = − .18, SE = .04, rho = .08, 95%CI [−.26, −.10], p < .001). General effect
sizes were also computed using artifact correction (see Table 3 for results).
Moderator analyses
On average, outcome type, media type, study design, age group, and
publication year were found to significantly moderate the overall effect size.
On the other hand, gender proportion, study location, and study location,
MEDIA PSYCHOLOGY 15
Figure 3. Trim and fill plot.
Table 3. Effect sizes by outcome types after artifact correction (k = 127).

Weighted Weighted
Total mean of Variance of SE
sample Weighted corrected corrected Variance of
Outcome type size ESs variance ES of ES ESs 90% CV
Body satisfaction 14,395 −.23 .007 .26 .25 .50 −1.21,.75
Body self- 26,684 −.10 .004 .18 .17 .41 −.82,.79
consciousness
Internalization of 9,180 −.18 .004 .30 .29 .54 −1.44,.68
thin- ideala
Disordered eating 7,293 −.20 .007 .15 .14 .38 −.94,.53
behaviora
Mental health risk 4,331 −.26 .006 .40 .40 .63 −1.50,.97
Emotional 1,873 −.19 .01 .55 .54 .74 −1.72, 1.15
responses
Attitudinal 3,332 −.02 .01 .25 .24 .49 −.99,.94
Response
Overalla 35, 195 −.25 .006 .26 .26 .50 −1.16,.83
a
After removing six outliers.
and publication type were not found to significantly moderate the effect size
(see Table 4 for results of all moderator analyses).
16 Q. HUANG ET AL.
Table 4. Effect sizes by moderators (k = 127).

95%CI
Moderators kt g SE t df LL UL
Age group***
Adolescents (<18) 12 −.29** .13 −3.09 18.68 −.67 −.13
Emerging adults (18–32) 54 −.16** .04 −3.93 58.62 −.25 −.08
Adults (>32) 2 .11 .22 .52 2.99 −.57 .80
Not reported 10 .02 .07 −.30 17.48 −.17 .13
Proportion of female in the sample
Mixed 8 −.66 .36 −1.85 5.65 −1.55 .23
Males only 20 −.13 .08 −1.71 15.18 −.30 .03
Females only 96 −.14** .04 −3.99 88.12 −.22 −.07
Publication type
Published (journal and book) 98 −.18** .05 −3.93 87 −.27 −.09
Unpublished 14 −.15* .05 −2.70 12.8 −.27 −.03
Publication year**
Before 1990 2 .03 <.001 135.98 1.00 .033 .034
1991–2000 32 −.11† .06 −1.77 30.3 −.23 .02
2001–2010 65 −.24** .07 −3.50 48.8 −.38 −.10
2011 to date 24 −.14* .07 2.08 18.9 −.27 .0001
Study design*
Experimental 64 −.13** .06 −2.82 63.3 −.29 −.05
Correlational 36 −.20** .04 −4.25 34.9 −.30 −.10
Unspecified 2 .10 .13 .76 1.00 −1.53 1.73
Study location
U.S. 68 −.17** .04 −4.30 61.1 −.26 −.09
Not U.S. 47 −.18* .08 −2.12 38.8 −.35 −.01
Media type***
Magazine contents 41 −.18** .06 −3.15 36.68 −.30 −.06
Magazine ads 14 −.17 .11 −1.64 9.65 −.41 .06
TV programs 18 −.14* .06 −2.26 15.26 −.28 .006
TV commercials 16 −.37 .26 −1.40 10.03 −.95 .21
Movie clips 3 −.16 .23 −.68 1.93 −1.20 .89
Music videos 2 −.20** .003 −54.17 1.00 −.25 −.16
Print noncommercial photos 9 .16 .11 1.53 5.81 −.10 .43
Print commercial photos 10 −.03 .11 −.26 5.87 −.25 .31
Celebrity account on SNS 3 −.12 .09 −1.30 2.00 −.51 .27
Non-celebrity account on SNS 3 −.20* .26 −4.18 1.6 −.54 −.10
Unspecific mass media 8 −.41** .11 −3.64 7.92 −.67 −.15
Outcome type***
Body satisfaction 80 −.13* .07 − 2.03 58.6 −.26 −.001
Body self-consciousness 61 −.09* .04 −1.99 35.62 −.18 .002
Internalization of thin-ideala 36 −.40* .16 −2.49 29.70 −.73 −.07
Disordered eating behaviora 35 −.21** .05 −4.07 20.8 −.32 −.10
Mental health risk 21 −.27 .21 −1.29 14.40 −.73 .18
Emotional responses 16 −.17 .17 −1.04 10.0 −. 55 .20
Attitudinal Response 28 −.03 .08 −.41 18.6 −.21 .14
*** p < .001; **p < .01; * p < .05; †p < .1. k = number of effect sizes; Statistical results associated with the
degree of freedom (df) less than 4 are not reliable (Fisher & Tipton, 2015), which resulted from no variation
in effect sizes.
a
After removing six outliers.
Outcome type
Outcome type significantly moderated effect size, Q (7) = 55.06, p < .001.
Media exposure showed a small to moderate magnitude effect on body
satisfaction (g = − .13), body self-consciousness (g = − .09), internalization
Table 5. Characteristics of Studies Included in Meta-Analysis (k = 127).
Publication Type of Mean Female Hedge’s
Author Year type Location Design control BMI Media type Measure age ratio N g
Abramson and 1991 1 1 5 1 General mass Fat attitude test (FAT) 21.8 0.61 165 -.07
Valene media
Bulimia Test (BUILT) -.39
Restraint Scale (RS) -.34
Alperin 2005 2 1 5 1 General mass Body image 0.68 198 .25
media
Anschutz et al. 2009 1 2 1 1 22.39 Movie clip DEBQ 20.05 1.00 71 -.08
Thin ideal internalization .23
Mood VAS-sad .75
Body focused anxiety PASTAS .09
Aubrey 2007 1 1 1 1 22.66 TV program TSOQ 19.6 0.59 384 -.18
body surveillance -.34
Body shame -.45
Appearance anxiety -.54
BISC -.39
Sexual esteem -0.14
Magazine TSOQ -.28
contents
body surveillance -.49
Body shame -.45
Appearance anxiety -.58
BISC -.24
Sexual esteem .06
Aubrey- study 1 2006 1 1 7 4 TV program TSOQ-1 19.6 1.00 149 -.0001
Magazine TSOQ-2 -.06
contents
Aubrey- study 2 2006 1 1 7 TV program Surveillance Sub-Scale of the Objectified .09
Body Consciousness Scale-1
MEDIA PSYCHOLOGY
Magazine Surveillance Sub-Scale of the Objectified -.36

contents Body Consciousness Scale-2
(Continued )
17
18
Table 5. (Continued).
Aubrey-study 2 2010 1 1 1 1 22.66 Magazine Body shame questionnaire 20.11 1.00 103 .33
contents
Motivations for Exercise -.29
Bair et al. 2012 1 1 5 Commercial EDI-BD 19.2 1.00 421 -.20
poster
Q. HUANG ET AL.
TV programs -.26
TV commercial -.30
Magazine -.24
contents
Barta 1999 2 1 4 1 24.24 Magazine PANAS 21.05 0.00 169 -.68
contents
BPSS -.19
Becker et al. 2002 1 2 2 2 24.5 TV programs EAT-26 17.3 1.00 128 -.48
Vomiting control -.86
Birkeland et al. 2005 1 1 2 1 Magazines ads Profile of Mood States-anger 21.88 1.00 138 -.17
Body Dissatisfaction subscale of Eating .16
Disorder Inventory
Profile of Mood States-anxiety .07
Profile of Mood states-depression .02
Confidence .16
Body satisfaction 0.01
Bissell and 2004 1 1 5 2 TV programs Bulimia 1.00 218 -.39
Zhou-study 1
Anorexia -.28
Bissell and 2004 1 1 5 2 Magazine Bulimia 1.00 218 .06
Zhou-study 2 contents
thinness .14
body dissatisfaction .18
Borowiak 2002 2 1 3 1 TV commercial body dissatisfaction 19.76 1.00 200 -.30
Borzekowski et 2000 1 1 5 2 22.9 General mass Importance of appearance 14.9 1.00 837 -.34
al. media
(Continued )
Weight concerns -1.32
Bosson et al. - 2008 1 1 1 1 General mass Self-Esteem Scale (RSES) 19 0.73 293 -.44
study 1 media
Bosson et al. 2008 1 1 1 3 Non-commercial Self-Esteem Scale 19 1.00 113 -.45
-study 2 photos
Brown and 2005 1 2 1 2 21.51 Magazine ads Thin-ideal internalization 21.23 1.00 52 -.43
Dittmar
schema activation -.78
weight related anxiety -.70
Cameron and 2004 1 1 1 1 Magazine Geriatric Depression Scale-short form 1.00 90 -.40
Ferraro contents
State-Trait Anxiety Inventory -2.29
Self-Esteem Scale (RSES) Rosenberg 1965 1.82
Eating Attitude Test -1.62
Cash et al. 1983 1 1 1 1 Magazine ads Body satisfaction 22.7 1.00 51 -.31
Cattarin et al. 2000 1 1 3 1 TV commercial Depression VAS 22.97 1.00 180 -.18
Anxiety -.01
Anger .39
Appearance dissatisfaction .23
Clay et al. study 2005 1 2 1 1 Magazine Body satisfaction 1.00 136 .56
1 contents
Self-esteem .46
Cohen et al. 2018 1 2 4 2 22.45 Celebrity SNS Thin ideal internalization 22.97 1.00 259 .12
account
Body Satisfaction -.06
Self-Objectification .06
Drive for Thinness .12
Bulimia .08
MEDIA PSYCHOLOGY
Coolican 2000 2 2 1 2 21.8 TV program Appearance evaluation 23.3 1.00 78 -.02

Body areas satisfaction -.55
Self-classified weight scale .95
19
(Continued )
20
weight concern -.30
sexual attractiveness -.12
Cornelious 2012 2 1 3 1 Magazine Bulimic Eating behavior 43.73 1.00 159 -.10
contents
control eating behavior -.45
Q. HUANG ET AL.
Crouch and 1998 1 1 1 1 Commercial self-attractiveness 15.4 1.00 40 -.68

Degelman poster
Crowley 1999 2 1 3 1 TV commercial Internalization 19.34 1.00 173 -.08
ideal body size .43
Cusumano and 1997 1 1 5 1 Magazine EDI-BD 24 1.00 175 .14
Thompson contents
MBSRQ-PAE .02
EDI-B .08
EDI-DT .22
SATAQ-A -.14
SATAQ-I -.28
RSE -.02
Darlow and 2010 1 1 1 1 Non-commercial Sociocultural Attitudes Towards 18.4 1.00 175 1.10
Lobel photos Appearance Questionnaire (SATAQ)
Affect Balance Scale (ABS) .27
State Self-Esteem Scale (SSES) .04
Dittmar et al.- 2009 1 2 3 1 22 Non-commercial Weight related self-discrepancy index 26.6 1.00 87 -5.18
study 1 photos
Dohnt and 2006 1 2 4 1 15.84 mixed Appearance satisfaction 5.26 1.00 128 -.03
Tiggemann
Diet awareness -2.62
Self-esteem .38
Durkin and 2002 1 2 3 1 Magazine ads BAQ-feeling fat 12.9 1.00 116 .04
Paxton-study
1
Physical appearance comparison .18
(Continued )
SATAQ-internalization .19
Self-esteem .01
Depression .07
Self-concept clarity .39
Durkin and 2002 1 2 3 1 Magazine ads BAQ-feeling fat 15.5 1.00 125 -.16
Paxton- study
2
Physical appearance comparison -.001
SATAQ-internalization .08
Self-esteem .44
Depression -.22
Self-concept clarity .56
Erchull, Liss, & 2013 1 1 5 1 General mass Body surveillance 23.12 1.00 160 -1.85
Lichiello media
Body shame -1.31
Disassociation -.28
Depressive -.63
Self-harm .34
Esteban 2001 2 1 2 1 Magazine Body esteem 21.4 1.00 112 -.14
contents
Sexual attractiveness -.48
Weight concern -.64
Frederick et al. 2016 1 1 5 1 27.7 TV programs Appearance Satisfaction 46.25 0.74 12176 .26
Frisby 2004 1 1 1 3 Commercial Self-esteem 19.9 1.00 48 -.14
poster
Garvin & 2008 1 1 3 1 Magazine State Anxiety Trait Inventory (STAI-Y1) 23.4 0.50 96 -2.12
Damson contents
Profile of Mood State (POMS) 1.03
MEDIA PSYCHOLOGY
Depression -1.45
Grogan et al. 1996 1 2 2 1 Magazine body esteem 24.5 1.00 45 .14
contents
21
(Continued )
22
body esteem 0.00 49 .80
Halliwell and 2004 1 2 1 1 23.31 Commercial PASTAS 30.8 1.00 137 -1.76
Dittmar poster
Halliwell et al. 2005 1 2 1 3 Commercial Body-focused anxiety 32 1.00 49 .06
poster
Q. HUANG ET AL.
Hargreaves and 2002 1 2 3 1 21.1 TV commercial Weight Dissatisfaction 15.8 0.49 401 -2.37
Tiggemann
Overall appearance -3.91
Hargreaves and 2003 1 2 4 1 21.9 TV commercial VAS 17.2 1.00 42 -1.15
Tiggemann
Drive for thinness 1.00 -1.25
VAS 0.00 38 -.76
Drive for thinness 0.00 -.66
Hargreaves and 2004 1 2 1 1 TV commercial Body dissatisfaction 14.3 0.52 595 -3.27
Tiggemann
Negative mood -4.40
Harrison-study 2000 1 1 5 1 TV commercial Bulimia 14.6 1.00 178 .14
1
Drive for thinness .04
Body dissatisfaction -.10
Bulimia 0.00 180 -.30
Body dissatisfaction .08
Harrison-study 2000 1 1 5 1 Magazine Bulimia 1.00 178 -.12
2
Drive for thinness -.34
Bulimia 0.00 180 -.26
Hass et al. 2012 1 1 1 2 24.57 Magazine ads body esteem 19.79 1.00 160 -.14
(Continued )
Weight concern -.08
Physical condition -.53
Hawkins et al. 2004 1 1 1 1 Magazine ads Body Dissatisfaction 20.23 1.00 145 -1.01
Profile of Mood State (POMS) -.70
Self-esteem -.63
SATAQ .97
ABI (eating disorder) -.58
Hefner et al. 2014 1 1 5 2 Movie clips Disordered eating 44.57 1.00 166 -.16
Self-discrepancy -.34
Food choice -.04
Heinberg and 1995 1 1 1 2 TV commercial SATAQ 22.88 1.00 138 -.31
Thompson
BCDS-PA -.28
VAS -.51
Henderson-King 2001 1 1 1 1 Weight Self-Esteem 19 1.00 222 .38
et al. Study 1
Henderson-King 2001 1 1 5 1 Magazine ads Importance of Attractiveness 19 1.00 112 .04
et al. Study 2
Sexual Attractiveness .10
Weight-esteem .20
Physical condition .22
State self-esteem .26
Current Attractiveness .28
Hendrickse et 2017 1 1 5 1 Celebrity SNS Appearance-related comparison on 21.04 1.00 185 -.87
al. account Instagram
Intrasexual Competitiveness -.15
MEDIA PSYCHOLOGY
Drive for thinness -.09

Body Dissatisfaction .23
(Continued )
23
24
Hofschire and 2001 4 1 5 1 TV programs Body Dissatisfaction 16 0.47 382 -.24
Greenberg-
study 1
diet and exercise -.26
Hofschire and 2001 4 1 5 1 Magazine Body Dissatisfaction 1.00 179 -.24
Q. HUANG ET AL.
Greenberg- contents
study 2
Body Dissatisfaction 0.00 203 -.49
Body Dissatisfaction -.54
diet and exercise 1.00 179 -.63
Irving 1990 1 1 1 3 Non-commercial Self-esteem 1.00 79 .09
photos
Weight satisfaction -.02
Physical strength .18
Jones et al. 2014 1 1 5 1 20.09 Magazine Peer Appearance Criticism 13.51 1.00 430 -.08
contents
Internalization -.60
Peer Appearance Criticism 0.00 346 -.20
Joshi et al. 2004 1 2 1 1 Magazine Appearance state self-esteem 20.25 1.00 31 1.00
contents
social self-esteem 47 .36
self-image 46 -.44
3 Appearance state self-esteem 30 -.43
social self-esteem 45 -.68
self-image .56
(Continued )
Kalodner 1997 1 1 1 1 18.97 Magazine BSC private 18.97 1.00 61 -.56
contents
BSC public -.40
BSC Competence -1.04
GSC Private -.15
GSC Public -.12
GSC Social Anxiety .16
Anxiety -.46
BSC private 0.00 22 .52
BSC public .44
BSC Competence .41
GSC Private -.10
GSC Public -.07
GSC Social Anxiety -.38
Anxiety -.32
Knobloch- 2012 1 1 3 1 22.94 Magazine Body Satisfaction change 1.00 140 -.31
Westerwick contents
and Crane
Lavin and Cash 2001 1 1 1 1 General mass Mood 20 1.00 66 -.40
media
Body image state -.70
Lavine et al. 1999 1 1 1 1 TV commercial Perceived actual body size 19.31 1.00 57 -.58
Actual-thin body size discrepancy -.50
Perceived actual body size 19.31 0.00 51 -.59
Actual-thin body size discrepancy -.53
Own-other ideal discrepancy -.80
Legenbauer et 2008 1 2 2 Non-eating 21.29 TV commercial Ideal body image 23.08 1.00 25 .12
al. disorder
MEDIA PSYCHOLOGY
Body and Self-esteem -.19

Dietary Restraint .10
Internalization and Social Comparison -1.12
25
(Continued )
26
State mood -.19
Eating 22.55 Ideal body image 25 1.00 25 .27
disorder
Body and Self-esteem -.40
Dietary Restraint -.05
Q. HUANG ET AL.
Internalization and Social Comparison -1.42

State mood -.20
Lew et al. 2007 1 1 1 3 23.24 Magazine ads Desire to lose weight 19.09 1.00 95 .51
Lin and Kulik 2002 1 1 1 1 Non-commercial Body satisfaction 20 1.00 45 .61
photos
Confidence .77
Self-esteem .27
Male Attractiveness .78
Lorch-Phase 2 2018 2 1 3 1 25.4 Non-commercial Body dissatisfaction 19.2 1.00 121 -.17
photos
Thin-ideal Internalization -.02
Perceived Media Pressure -.07
25.6 Body dissatisfaction 19.4 1.00 118 -.15
Thin-ideal Internalization -.18
Perceived Media Pressure -.15
Martin & 1993 1 1 1 3 Commercial Comparison Standard 1.00 145 .44
Kennedy poster
Self-Perception of physical attractiveness .16
Mazzeo et al. 2007 1 1 1 1 TV programs SATAQ pressure 1.00 148 -.27
Rosenberg Self-Esteem .21
McLean et al. 2016 1 2 1 3 Magazine ads State body satisfaction 13.11 1.00 83 -.01
Mills et al.- 2002 1 2 1 Restrained 25.83 Magazine ads Anxiety 19.72 1.00 32 -.66
Study 1 eater
Depression -.23
Hostility -.82
Total negative affect -.61
(Continued )
Appearance self-esteem -.97
Total state self-esteem -2.07
Current body size 2.02
Ideal body size 4.01
Food intake (gram) -2.38
Unrestrained 21.72 Anxiety 41 .40
eater
Depression .63
Hostility .24
Total negative affect .45
Appearance self-esteem .87
Total state self-esteem -2.13
Current body size -.05
Ideal body size -.48
Food intake (gram) .84
Mills et al.- 2002 1 2 1 1 Magazine Anxiety 19.72 1.00 61 2.37
Study 2 contents (high
thinness)
Depression 61 3.52
Hostility 61 1.68
Total negative affect 61 2.74
Appearance self-esteem 61 -2.53
Total state self-esteem 61 -2.29
Current body size 61 0.13
Ideal body size 61 -1.09
Magazine Anxiety 1.00 61 -2.17
contents (low-
thinness)
MEDIA PSYCHOLOGY
Depression 61 -2.04
Hostility 61 -1.22
Total negative affect 61 -1.98
27
(Continued )
28
Appearance self-esteem 61 1.57
Total state self-esteem 61 -.55
Current body size 61 .16
Ideal body size 61 -1.00
Mills et al.- 2002 1 2 1 Restrained Magazine Depression 1.00 105 1.06
Q. HUANG ET AL.
Study 3 eater contents

Unrestrained -3.61
eater
Monro and 2005 1 2 1 low self- 21.68 Magazine ads Body shame 20.22 1.00 18 -.05
Huon objectification
Appearance Anxiety .17
High self- 21.54 Body shame 19.16 1.00 19 .05
objectification
Appearance Anxiety -.09
Moore 2004 2 1 1 1 Magazine Beck Depression Inventory 21.51 1.00 97 -.12
contents (high-
risk)
State-Trait Anxiety Inventory -.19
Self-body evaluation .14
Ideal body -.12
Magazine Beck Depression Inventory -.12
contents (low-
risk)
State-Trait Anxiety Inventory -.19
Self-body evaluation -.07
Ideal body -.03
Moriarty and 2008 1 1 5 1 TV programs Perceived body size 9.78 1.00 315 -.10
Harrison
Interest in dieting and fitness television -.37
Children’s Eating Attitudes Test -.58
(Continued )
Morry and 2001 1 2 5 1 Magazine Body shape questionnaire 18.8 1.00 89 -.34
Staska contents (fitness)
Self-objectification 89 -.28
Eating behaviors 89 -.40
Internalization 89 -.08
Awareness 89 .10
Magazine Body shape questionnaire 89 -.26
contents
(beauty)
Awareness 89 .10
Magazine Body shape questionnaire 19.8 0.00 61 -.53
contents (fitness)
Awareness 61 -.24
Magazine Body shape questionnaire 61 .12
contents
(beauty)
Awareness 61 -.34
Myers and 2007 1 1 5 1 23.3 General mass Social influence 19.6 1.00 195 -.28
Crowther media
MEDIA PSYCHOLOGY
Self-objectification -.54
Thin-ideal internalization -1.35
29
(Continued )
30
Feminist beliefs -.36
P. Myers and 1992 1 1 1 1 TV commercial Chest dissatisfaction 1.00 62 .36
Biocca-study
1
Waist dissatisfaction .77
Q. HUANG ET AL.
Hips dissatisfaction .68

Depression .69
Hostility -.16
Anxiety .29
Chest dissatisfaction .16
TV programs Waist dissatisfaction .04
Hips dissatisfaction .08
Depression .09
Hostility -.15
Anxiety .21
Posavac et al.- 1998 1 1 1 Body Magazine Weight concern (Body Esteem Scale) 1.00 82 -.53
Study 1 dissatisfied contents
Body satisfied 74 -.23
Posavac et al.- 1998 1 1 1 Body Non-commercial 85 -.52
Study 2 dissatisfied photos
90 .54
Body satisfied 34 -.51
-.28
Posavac et al.- 1998 1 1 1 Body Commercial 40 .63
Study 3 dissatisfied poster
Body satisfied 13 -1.16
Reed 1998 2 1 1 1 Magazine Current body image 116 .04
contents
Ideal body image .35
Attractive to the opposite sex .22
(Continued )
Most attractive body image in opposite -.28
sex
Current body image 0.00 29 .50
Ideal body image .55
Attractive to the opposite sex .48
Most attractive body image in opposite .19
sex
Adversarial sexual belief -.15
Sex role stereotyping -.45
Sexual conservatism .30
Acceptance of interpersonal violence -.88
Richins-study 2 1991 1 1 5 1 Commercial Satisfaction with appearance 1.00 80 .74
poster
Self-rated attractiveness -.18
Richins-study 3 1991 1 1 1 1 Commercial Satisfaction with appearance .48
poster
Ratings of Comparison Standard Stimuli -.81
A
B
Self-rated of Attractiveness -.22
Richins-study 4 1991 1 1 1 1 Commercial Satisfaction with appearance 1.00 145 .55
poster
Ratings of Comparison Standard Stimuli .54
A
B
Self-rated attractiveness .11
MEDIA PSYCHOLOGY
Satisfaction with appearance .51

Ratings of Comparison Standard Stimuli .40
A
31
(Continued )
32
B
Self-rated attractiveness .25
Roberson 2001 2 1 1 1 Magazine ads Body Esteem Scale 20.25 1.00 60 .21
Q. HUANG ET AL.
Body Esteem Scale 0.00 36 -.61

Rocchio 1995 2 1 1 1 Commercial MBSRQ 21.79 0.68 180 -.26
poster
Body satisfaction .29
Figure rating -.32
Rosenberg Self Esteen Scale -.25
Self-figure -.44
Rodgers et al. 2010 1 2 5 1 21.27 General mass Body dissatisfaction 21.7 1.00 200 -.72
media
Self-esteem .12
Anxiety -.28
Depression -.08
Social Phobia -.39
Rühl et al. 2011 1 2 1 Bulimia 21.9 TV commercial Dietary restraint 23.9 1.00 26 -.37
Eating and loss of control -.10
Body dissatisfaction (CDRS) -.41
Normal 21 Dietary restraint 24.7 1.00 30 .52
Eating and loss of control .23
Body dissatisfaction (CDRS) -.08
Sands and 2003 1 2 5 3 18.42 Magazine Awareness of sociocultural standard of 10.83 1.00 321 -.22
Wardle contents appearance
Shaw-study 1 1995 1 2 3 3 19.9 Magazine Body Dissatisfaction-1 14.5 1.00 24 -.11
contents
(Continued )
Body Dissatisfaction-2 14.5 1.00 24 -.26
Dieting 14.5 1.00 24 .39
Bulimia 14.5 1.00 24 -1.11
Oral control 14.5 1.00 24 .12
Shaw-study 2 1995 1 2 3 3 19.9 Magazine Body Dissatisfaction 27.3 1.00 24 -.04
contents
Dieting 27.3 1.00 24 .29
Bulimia 27.3 1.00 24 .23
Oral control 27.3 1.00 24 -.10
Skorek and 2012 1 1 1 high vs. low TV commercial IAT Self-Esteem 19.71 0.00 160 -1.74
Dunham
high vs. IAT Self-Esteem -4.72
control
Actual-Ideal body discrepancy 2.26
Slevec and 2011 1 2 5 3 26.67 Magazine Internalization of the thin ideal 44.26 1.00 101 -.69
Tiggemann- contents
study 1
Social Comparison .72
Appearance investment .84
Aging Anxiety .74
Disordered Eating .26
Slevec and 2011 1 2 5 3 26.67 TV programs Internalization of the thin ideal .72
Tiggemann-
study 2
Social Comparison .87
Appearance investment .84
Aging Anxiety .53
MEDIA PSYCHOLOGY

Disordered Eating .41
(Continued )
33
34
Stargardt 2015 2 1 4 3 General mass Rosenberg Self-Esteem Scale (RSES). 1.00 60 -.32
media
Body Esteem Scale (BES). -.49
SATAQ-3 .36
Rosenberg Self-Esteem Scale (RSES). 0.00 30 -1.22
Q. HUANG ET AL.
Body Esteem Scale (BES). -.84

SATAQ-3 .59
Stice and Shaw 1994 1 1 5 1 General mass Gender-role endorsement 20 1.00 238 .27
media
Ideal-body stereotype internalization -.001
Eating Disorder Symptomatology -.51
Strahan- study 2002 2 2 1 1 22.8 Commercial Response Latency to overweight 1.00 68 -.34
1 poster
Mood -.70
Self-esteem .53
Importane of Weight -.57
Importane of Physical Attractiveness .57
Importance of Physical Measurement -.72
Concern with other’s perception -.61
Strahan-study 2 2002 2 2 1 1 TV commercial Amount of food eating in gram 1.00 26 .91
Strahan-study 3 2002 2 2 1 1 22 Commercial Amount of food eating in gram 1.00 35 .68
poster
Strahan-study 4 2002 2 2 1 1 22.6 Commercial Amount of food eating in gram 1.00 85 1.03
poster
Strahan-study 5 2002 2 2 1 1 20.7 Commercial Amount of food eating in gram 1.00 109 -.63
poster
Strauss et al. 1994 1 1 1 1 TV commercials Food consumption 1.00 86 -.78
(diet product)
(Continued )
TV commercials Food consumption 1.00 86 -.58
(natural product)
Suplee 2016 2 1 5 1 24.69 Celebrity SNS Body Dissatisfaction 19.11 1.00 746 -.45
account
Sociocultural Pressure -.12
Appearance Comparisons -.19
Eating Disorder Pathology .04
Te’eni-Harari 2015 1 2 5 3 TV programs Social Comparison 14.26 0.54 756 .18
and Eyal
Thomsen et al. 2002 1 1 5 1 22.11 Magazine beliefs about men’s expectations for 21.3 1.00 340 -.43
contents female thinness
(fitness)
Body shape concern -.72
Weight estimation -.41
Magazine beliefs about men’s expectations for -.22
contents female thinness
(beauty)
Body shape concern -.18
Weight estimation .10
Anorexic Cognitions 1.00 536 -.36
Thornton and 1997 1 1 1 1 Commercial Self-esteem 20.8 1.00 176 .62
Maurice poster
Social Physique Anxiety -.94
Public Self-Consciousness -.37
Private Self-Consciousness .08
Eating Disorder Potential .18
MEDIA PSYCHOLOGY
Tiggemann- 2003 1 2 5 1 Magazine body dissatisfaction 20.7 1.00 104 -.32

study contents
internalization of body shape ideal -.45
35
(Continued )
36
Disordered eating -.24
Self-esteem .06
TV programs body dissatisfaction 20.7 1.00 104 -.45
internalization of body shape ideal .08
Disordered eating -.12
Q. HUANG ET AL.
Self-esteem .36
Tiggemann and 2004 1 2 1 1 22.6 Magazine ads Negative Mood 20.6 1.00 126 -1.64
McGill
VAS body dissatisfaction -3.42
State Weight Anxiety -3.24
State Appearance Comparison -.64
Negative Mood -.87
VAS body dissatisfaction -2.00
State Weight Anxiety -.54
State Appearance Comparison -.67
Tiggemann and 1996 1 2 5 3 19.88 Music video Perceived weight 15.5 1.00 94 -.30
Pickering
Body satisfaction -.30
Drive for Thinness -.02
Tiggemann and 2003 1 2 1 1 24.38 Music Video VAS body dissatisfaction 20.23 1.00 84 .36
Slater
Appearance and Comparison Processing -.76
Tiggemann- 2005 1 2 5 3 Magazine Internalization of beauty ideals 14.37 1.00 799 -.45
study contents
Appearance Schemas -.37
drive for Thinness -.37
Bulimia -.24
drive for muscularity -.30
Internalization of beauty ideals 0.00 652 -.22
(Continued )
Bulimia -.06
drive for muscularity .02
TV programs Internalization of beauty ideals 14.37 1.00 799 -.37
Internalization of beauty ideals 14.37 0.00 652 -.39
drive for muscularity -.28
Tiggemann- 2006 1 2 5 3 Magazine Internalization of appearance ideals 13.98 1.00 214 -.70
study 1(Time contents
2)
Internalization of appearance ideals -.67
Tiggemann- 2006 1 2 5 3 TV programs Internalization of appearance ideals -.32
study 2 (Time
2)
Tiggemann et 2017 1 2 1 high vs. low 22.89 TV programs VAS body dissatisfaction 20.25 1.00 320 .88
al.
State appearance comparison -.29
MEDIA PSYCHOLOGY
high vs. VAS body dissatisfaction -.69

control
37
(Continued )
38
low vs. VAS body dissatisfaction .15
control
Trekels and 2017 1 2 5 3 17.1 TV programs Internalization subscale of the 11.25 1.00 1597 -.30
Eggermont Sociocultural Attitudes towards
Q. HUANG ET AL.
Appearance Scale
Beliefs About Appearance Scale (wave 2) -.20
-.16
Appearance conversations -.28
Attributing benefits to attractiveness -.30
van den Berg et 2007 1 1 5 3 23.77 TV programs Rosenberg Self-Esteem Inventory 19.37 1.00 1386 .22
al.-study 1
Magazine Rosenberg Self-Esteem Inventory 19.46 0.00 1130 .02
contents
Body Shape Satisfaction Scale -.22
Depressive mood scale -.14
van den Berg et 2007 1 1 5 23.77 TV programs Body Shape Satisfaction Scale 19.37 1.00 1386 -.39
al.-study 2
24.46 Magazine Rosenberg Self-Esteem Inventory 19.46 0.00 1130 .14
contents
Body Shape Satisfaction Scale -.20
Van den Bulck 2000 1 2 5 4 20.7 TV programs Ideal body mass index 0.00 480 -.06
20.3 1.00 534 .12
Varnado 2000 2 1 1 3 22.48 Non-commercial BPS1 20.03 1.00 128 -.02
photos
BPS2 -.03
BA1 -.05
BA2 -.08
guilt -.14
(Continued )
shame -.04
anxiety .42
stress .49
depression .31
PA .78
Veldhuis et al. 2017 1 2 1 high vs. low 22.01 Magazine body satisfaction 21.91 0.67 150 -.001
contents
high vs. -.02
control
low vs. -.14
control
Want et al.- 2015 1 2 3 3 21.39 Magazine Visual Analogue Scale (VAS) (Mood) 19.39 1.00 116 -.68
study 1 contents
Visual Analogue Scale (VAS) -.54
(Appearance)
Want et al.- 2015 1 2 3 3 21.74 Magazine Visual Analogue Scale (VAS) (Mood) 18.9 1.00 177 -.16
study 2 contents
Visual Analogue Scale (VAS) -.15
(Appearance)
Wegner et al. 2000 1 1 1 3 Magazine Self-consciousness Scale 20 1.00 67 -.78
contents
Body Self-consciousness Questionnaire -1.27
Wilcox and 2000 1 1 1 1 Magazine ads self-esteem 20 1.00 41 -.66
Laird
Body Esteem Scale -.66
MEDIA PSYCHOLOGY
Yamamiya et al. 2005 1 1 1 3 24.1 Magazine ads BISS 21.4 1.00 123 -.70
39
40 Q. HUANG ET AL.
of the thin-ideal (g = – .40), and eating behavior (g = − .21). By contrast, we
found the effects of media exposure on attitudinal responses (g = – .03),
emotional responses (g = − .17), and mental health risk (g = − .27) were not
statistically significant.
Media type
Media type was also found to differentiate the effect on body-related out-
comes, Q (11) = 68.99, p < .001. Specifically, studies using magazine contents
showed a moderate effect on all body image-related outcomes (g = − .18)
while those using magazine advertisement showed a non-significant effect
(g = .17). Studies using television program showed a small to moderate effect
(g = – .14) whereas those using television commercial showed a non-
significant effect (g = .37). Music videos had a significantly large effect size
(g = − .20), whereas movie clips did not show significant results (g = − .16).
Neither print noncommercial photos (g = .16) nor print commercial photos
(g = .03) showed a significant effect. Moreover, non-celebrity social media
account showed a greater effect on disordered eating behavior (g = − .20)
than did celebrity social media account (g = − .12).
Study design
Study design was found to significantly moderate the average effect size,
Q (2) = 7.67, p < .05. The average effect size of experimental studies was g = -.
13, indicating an overall small effect of media exposure on body image
constructs in experiments. For correlational studies, the average effect size
was g = – .20, indicating a slightly greater association between media exposure
and body image constructs compared to it is of experimental studies. Average
effect size of four unspecified studies was not significant (g = .10).
Age group
Age was found to significantly differentiate the effects on overall body image
concerns, Q (3) = 22.27, p < .001. While media exposure showed moderate to
large effects on adolescents (g = – .29) and emerging adults (g = − .16), its
effect on adults (age > 32) was not found to be significant (g = − .11).
Publication year
Publication year significantly moderated the relationships between media
exposure and body image-related outcomes, Q (3) = 14.74, p < .01. Studies
published during 2001 and 2010 showed a significant effect size (= – .24)
compared to studies published during other time frames, including those
published before 1991 (= − .03), during 1991 and 2001 (= − .11), and after
2010 (= − .14).
MEDIA PSYCHOLOGY 41
Gender proportion
The proportion of female in the sample was not found to significantly
moderate the effect size, Q (2) = 3.45, p = .18. Studies including only female
samples showed a significant effect size of g = − .14 while studies including
only male sample (g = − .13), and mixed-gender sample (g = − .31) showed
insignificant effect sizes.
Study location
Study location did not moderate the effects of media exposure on all out-
comes, Q (1) = 0.61, p = .44. Studies that were conducted within the US
(= − .14) showed a similar effect size to those conducted outside the
US (= − .18).
Publication type
Publication type was not found to differentiate the average effect size,
Q (1) = 0.64, p = .42. The average effect size of published studies was = –
.15, and that of unpublished studies was = − .18.
Discussion
The present meta-analysis aimed to investigate the magnitude of the relation-
ship between appearance-based media exposure and a variety of body image
concerns and behaviors. The findings revealed a small to moderate overall
effect size of media’s influence on body image, indicating the effectiveness of
thin-media exposure on both men’s and women’s body dissatisfaction levels.
A set of moderators were found to differentiate the effects on audiences’ self-
concepts and related behaviors. Altogether, media exposure is associated with
how people evaluate their body shape in daily life and deal with the dis-
satisfaction or pressure of that phenomenon. The results from the present
meta-analysis lent support to a variety of theories that account for media and
body image concerns. The results supported the tripartite influence model
(Thompson et al., 1999), which highlighted the strong links between societal
factors (e.g., pressure from mass media), peer factors (e.g., pressure from
body image contents posted by peers on social media), and psychological
factors (e.g., internalization of thin-ideal body and body self-esteem). While
the present meta-analysis drew on the relationship between media and body
image concerns as suggested by the tripartite influence model, future meta-
analytical work may synthesize the relevant literature examining parental
influences on body image concerns.
Different media vary in the presentation of an ideal body to their audi-
ences (Hirschman & Thompson, 1997). Results of the present meta-analysis
discovered a new pattern that a skinny or muscular body is more likely to be
conspicuous to audiences when embedded in certain media contexts.
42 Q. HUANG ET AL.
Specifically, media contents without obtrusively commercial purposes, such

as television programs and music videos, may produce greater effects on
negative body outcomes than commercial contents, such as television adver-
tisements. This contrast between media contents with distinct purposes also
underlines the findings of previous studies that audiences’ perception toward
the same advertisement could be altered by media context (e.g., Pechmann
et al., 2005; Puccinelli, Wilcox, & Grewal, 2015). Hence, researchers and
practitioners should be concerned about program-context effects because
their advertisements may not be processed as extensively and may be less
prominent. Given that most previous research did not distinguish the pur-
pose of media contents when examining the effects of exposing ideal bodies
to audiences, future study should test specific media characteristics that
differentiate the perception of a body among audiences.
The discrepancy between correlational and experimental studies on effect
sizes analyzed in the present study indicated that media effects, especially
perceptions and behaviors (e.g., internalization and disordered eating beha-
vior), tend to result from long-term exposure, instead of short-time exposure,
to appearance-related media contents (Dohnt & Tiggemann, 2006). In com-
parison to correlational studies, experimental studies showed a rather smaller
effect on outcomes that would only be observed through excessive exposures
to appearance-related media contents (e.g., disordered eating behavior and
mental health risks). To that end, extensive studies regarding chronical out-
comes of appearance-related media exposure are needed to validate such
findings further. More longitudinal research is warranted to understand the
magnitude of chronic media exposure on body image concerns over a longer
period of time.
More importantly, the discrepancy between non-celebrity and celebrity
images on social media spoke to social comparison theory in that upward
comparison engendered negative appearance evaluations with peers. Pressure
and negative perceptions of one’s own body occur only when people compare
themselves with familiar ones, rather than with celebrities who are perceived
as irrelevant people (Mussweiler, Ruter, & Epstude, 2004). That is, peer
competition might emerge as a new type of social comparison, especially
on social media (Fardouly et al., 2015). In this sense, social media provides
a new arena for studying peer comparison, which differs from the compar-
ison between oneself to characters in television shows or models in fashion
magazines (Perloff, 2014). To further examine this relationship, future stu-
dies may explore specific psychological mechanisms through which social
media influences users’ body image concerns.`
The results also revealed a dynamic influence of age produced on the relation-
ship between media exposure and body image relevant outcomes. Aligned with
previous meta-analyses (e.g., Grabe et al., 2008), adults, in comparison with
adolescents and emerging adults, were less likely to internalize the ideal body
MEDIA PSYCHOLOGY 43
presented in media or to be emotionally anxious. These findings are also echoed

in the prediction of socioemotional selection theory (Carstensen, Isaacowitz, &
Charles, 1999) that age-related differences in social goals were ensured by
chronological age. This disparity in responses across different age groups
might be explained by the variations in life experiences (Lin et al., 2016). In
other words, because adults have experienced more life events than adolescents
and emerging adults, they might be less likely to be effectively influenced by
appearance-related media contents per se.
More broadly, one arguable concern is that media effects tend to be concep-
tualized in terms of binary relationships, i.e., “media is (not) detrimental for X.”
This approach lacks either a functional developmental perspective or a nuanced
perspective of user experiences (Tiggemann, 2011). Lost in such an approach is
a consideration of why an individual would imitate negative behaviors witnessed
in media. This is not to say it is never possible, but to emphasize that media effects
research rarely takes a functional and developmental approach to theory (Sherry,
2004). Given that real-world environmental contingencies to behavior may differ
from those in fictional media, few media effects theories have sufficiently
addressed the question of why media consumers failed to make such
a distinction. Communication scholars should move beyond traditional binary
media effects models in favor of alternative approaches with regards to media
consumption from a functional and developmental perspective (Gill, 2012).
For example, self-determination theory (Ryan & Deci, 2000; Deci & Ryan,
2008) provides a unique channel for communication scholars to understand
media usage in relation to body image perception. Self-determination theory
proposes that various motivations, such as autonomous and controlled motiva-
tion, could be the predictors of individuals’ performance and well-being across
contexts including education, health care, and workplace (e.g., Gagné & Deci,
2005; Ng et al., 2012; Reeve, 2012). Ryan, Rigby, and Przybylski (2006) explained
that the motivation of playing video games is to seek a sense of control,
regulation, and autonomy that related to an enjoyment and psychological well-
being in the real world. In this sense, to pursue a thinner or more athletic body is
motivated by intrinsic feelings to control one’s own body and to regulate the
body into an ideal shape. The motivation to control one’s body shape and weight
means autonomy, self-discipline, and competence. Thus, it might be oversim-
plifying to conclude that people pursue a thinner or more athletic body only to
comply with the norm manifested on media. Furthermore, the field of commu-
nication would benefit from viewing media viewers as a more active rather than
a passive receiver of media contents. We look forward to seeing more debates on
these issues and hope future research will increasingly consider the nuances of
media effects on different audiences. Future studies may investigate additional
moderators such as cohort effect, which refers to the extent to which other
viewers’ opinions influence the individual perception of body shape portrayed in
the media (Winter, Krämer, Benninghoff, & Gallus, 2018).
44 Q. HUANG ET AL.
Last but not least, from a practical perspective, this meta-analysis also guides
practitioners who plan to use media content as an intervention to correct certain
undesirable health behaviors such as disordered eating and the maladaptive effects
of media use. Informing women about what the average woman looks like and the
alterations of images in the media may produce a positive effect on women’s views
about their own bodies (Posavac et al., 1998). Meanwhile, youth are often
a targeted group for negative media, which affects their perceptions of body
image as they come of age (Ferguson et al., 2014). Therefore, it is more urgent
and critical for both parents and pediatricians to implement necessary interven-
tions that could prevent youth from engaging in harmful dieting with possible
consequences of depression. In addition, media interventions will be more suc-
cessful when targeting specific populations, such as gay population (e.g., Evans,
2007). Likewise, the current meta-analysis has offered valid and timely evidence
for the industry regarding how unrealistically skinny or athletic models in adver-
tisements can negatively impact both women and men. Fortunately, we are
witnessing a trend in which multiple fashion brands have started to use diversely
sized models, which can help people perceive themselves in a more healthy way.
Limitations
The present study has several limitations. First, we did not cod racial/ethnic
proportion as a potential moderator. Grabe and Hyde (2006) found that racial/
ethnic identity significantly predicted the relationship between media con-
sumption, body satisfaction, and beauty ideals. Future studies should consider
possible moderating effects of racial proportions within the sample on the
relationship between the appearance-related media exposure and body image.
Also, the present study did not account for the length of media exposure
because less than 10% of studies reported the duration of exposure in experi-
mental study or participants’ self-reported data on the duration of media
viewing behavior within a given period of time in cross-sectional studies.
Since the duration of exposure to appearance-related media was found to be
a crucial indicator of body image perception, dissatisfaction, and internalization
(e.g., Bearman et al., 2006; Hargreaves & Tiggemann, 2003), we suggest future
studies to report the duration of exposure to stimuli. Last, the present study did
not consider the impact of the controlled variables on the relationship of media
exposure and body image concerns. Research has revealed that unrestrained
eaters perceive their body satisfaction higher than the restrained eaters (e.g.,
Mills et al., 2002). Similarly, individuals who are identified as high-objectified
tend to be more anxious regarding their body image than their low-objectified
counterparts. Therefore, future study could explore which and how other
individual- and contextual factors could moderate this relationship.
In conclusion, the present meta-analysis has offered an important distilla-
tion of the current state of knowledge on the relationship between media
MEDIA PSYCHOLOGY 45
exposure and various body image concerns. Across measures and methodol-
ogies, the research has demonstrated that media exposure is significantly
linked to body image concerns and subsequent behaviors such as eating
disorder. With the evolution of media and devices in our society, it is vital
that future research continues to explore the underlying processes that can
better understand how media affects body image.
Notes
1. From the health perspective, disordered eating and eating disorder differ to a slight
extent. When someone’s eating patterns take them away from normal functioning, it is
called eating disorder. In contrast, disordered eating behavior is an indicator of an
eating disorder. Nevertheless, based on the longitudinal work conducted by Neumark-
Sztainer et al. (2006) we consider them as the same construct.
2. As this manuscript was completed before the publication of Karsay et al. (2018), we
were not able to check Karsay et al. (2018) reference list.
3. Specifically, because book, newspapers, animation, computer games, and lyrics did not
emerge from all inclusion articles in the initial coding process, those categories were
finally ruled out from media type for the present meta-analysis.
Disclosure Statement
No potential conflict of interest was reported by the authors.
Funding
The authors declared no potential conflicts of interest with respect to the authorship and/or
publication of this article. The authors received no financial support for the research and/or
authorship of this article.
ORCID
Qian Huang http://orcid.org/0000-0002-3447-5552
Wei Peng http://orcid.org/0000-0002-2229-4682
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Media Psychology

ISSN: 1521-3269 (Print) 1532-785X (Online) Journal homepage: https://www.tandfonline.com/loi/hmep20

When media become the mirror: a meta-analysis

Qian Huang, Wei Peng & Soyeon Ahn

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When media become the mirror: a meta-analysis on media

Despite the prevalence of the media-body image relationship, studies exam-

critical to explore whether outcome type moderated the effects of appear-

Correlational and experimental studies

The current meta-analysis

objectification of one’s body. Also, effect sizes reported by previous meta-

To summarize, the purpose of the present study is to examine whether the

Inclusion and exclusion criteria

Figure 1. Flow chart.

genders or mixed-gender participants were included; 5) studies that involved

dissertation; 3 book or book chapter; 4 conference paper; 5 manuscripts; 6

conclusion of the meta-analysis is robust to this threat. Our analysis demon-

Table 2. Summary of Effect Sizes by Outcome Type (with outliers).

Figure 2. Funnel plot.

Figure 3. Trim and fill plot.

Table 3. Effect sizes by outcome types after artifact correction (k = 127).

Table 4. Effect sizes by moderators (k = 127).

Magazine Surveillance Sub-Scale of the Objectified -.36

Coolican 2000 2 2 1 2 21.8 TV program Appearance evaluation 23.3 1.00 78 -.02

Crouch and 1998 1 1 1 1 Commercial self-attractiveness 15.4 1.00 40 -.68

Drive for thinness -.09

Body and Self-esteem -.19

Internalization and Social Comparison -1.42

Study 3 eater contents

Hips dissatisfaction .68

Satisfaction with appearance .51

Body Esteem Scale 0.00 36 -.61

Body Dissatisfaction .47

Body Esteem Scale (BES). -.84

Tiggemann- 2003 1 2 5 1 Magazine body dissatisfaction 20.7 1.00 104 -.32

high vs. VAS body dissatisfaction -.69

Specifically, media contents without obtrusively commercial purposes, such

presented in media or to be emotionally anxious. These findings are also echoed

Aubrey, J. S. (2006). Effects of sexually objectifying media on self-objectification and body

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