Chapter 2

REVIEW OF RELATED LITERATURE

Body image refers to the mental representation that individuals have regarding the look and
aesthetic of their body appearance, shape, and size (Fisher, 2014). The perceptual image that a person has
does not always match the reality of their body type; for instance, a person might be appear thin and
emaciated, but feel as though they are overweight (National Eating Disorders Collaboration, 2016). The
feelings that are associated with body image impact the level of satisfaction or dissatisfaction that they
experience, and can affect subsequent cognitions and behaviors (Fisher, 2014). This section will discuss
body image acquisition and cultural stereotypes associated with body image. In addition, a literature
review regarding the differentiation between positive and negative body image constructs will be
discussed, as well as body size stereotypes and the internalization of body ideals.

When exploring the origin of body image, mass media exposure is commonly investigated, as it
oftentimes plays an important role in communicating acceptable social and behavioral cultural stereotypes
(Perloff, 2014). While print media and broadcasting methods have historically revealed body ideals
through various formats, the modern-day widespread use of social media now presents a new outlet for
exposure to physique paradigms (Fuchs, 2017; Lenhart, Duggan, Perrin, Rainie, & Parker, 2015). This
new channel of communication is vital to explore, since over 80% of adults in the United States ages 18
to 49 participate in social media usage, and 64% of those in the 50 to 64-year-old range do as well (Pew
Research Center, 2017); providing countless opportunities for body image expectations to present
themselves, each time a user logs on to a website or app.

“Body image flexibility” is another term associated with positive body image and encompasses the
ability to accept unpleasant cognitions and feelings associated with body image, rather than engaging in
avoidance (Sandoz, Wilson, Merwin, & Kellum, 2013). It includes embracing a sense of mindfulness that
helps an individual to incorporate acceptance techniques that are adaptable and flexible. Moore, Masuda,
Hill, and Goodnight (2014) explained that body image flexibility helps people to regulate and experience
feelings associated with eatingdisordered thoughts, and provides a buffer between these ideas and the
development of eating disorder symptoms.

Body image dissatisfaction occurs when a person negatively assesses their weight, body shape, or
appearance (Balcetis, Cole, Chelberg, & Alicke, 2013), and research has shown that this type of
discontent is a powerful risk factor for predicting eating-disordered behavior (Crowther, Hobfoll,
Stephens, & Tennenbaum, 2013). Timko, Juarascio, Martin, Faherty, and Kalodner (2014) explained that
there are many factors that are influential in this respect, “including neuroticism, self-esteem,
perfectionism, body surveillance, and having a family member with an eating disorder” (p. 203).

Perloff (2014) posits that negative body image originates from a variety of sources, with mass
media playing a significant role in its ability to communicate cultural standards and stereotypes regarding
body ideals. Tiggemann (2011) assigned predominant importance to media exposure, explaining that the
imagery that readers, viewers, and users are subjected to has significant correlations to levels of body
dissatisfaction. She noted that body discontent is commonly experienced when unrealistic images of body
shape, size, and beauty are repeatedly displayed. Similarly, Knobloch-Westerwick and Crane (2014)
determined that body dissatisfaction was linked to self-internalization of thin ideal standards when
participants were exposed to media imagery for prolonged time periods.

Brechan and Kvalem (2015) studied the effects of body image discontent and eatingdisordered
behavior by examining participants’ levels of self-esteem and their propensity for displaying symptoms of
depression. They concluded that women may use binge-eating behavior, as well as controlled food intake
behavior, as methods of escaping negative feelings associated with depression and low self-esteem. While
relief from these negative thoughts is fleeting and does not repair the cyclical nature of self-evaluation,
nor feelings of body dissatisfaction, the short-term distraction from critical emotions serves as a type of
temporary comfort (Brechan & Kvalem, 2015).

Guided largely by feminist theories, researchers have argued that internalizing ideal media images
causes women and girls to place a high level of importance on their appearance, rather than other
personality characteristics or abilities (Fredrickson & Roberts, 1997; McKinley & Hyde, 1996). This is
what is referred to as thin-ideal internalization. Women’s endorsement of the cultural emphasis on
appearance then prompts them to seek out references against which to evaluate their own appearance and
their progress toward attaining the thin-ideal. In this way, appearance and body comparisons are
perceived by women as processes that provide useful diagnostic information. Although motivated by
hopes of self-improvement, in actuality these comparison processes typically have detrimental effects on
body esteem (Rodgers, McLean, & Paxton, 2015).

Dakanalis et al. (2015) found that the internalization of media-induced body ideals resulted in self-
objectification that subsequently led to negative emotions associated with body appearance. Researchers
also noted that these negative emotions predicted subsequent eatingdisordered behavior, including the
restriction of food and binge-eating habits. Eating-disordered behaviors that stem from body discontent
tend to incorporate a gendered component, which is demonstrated by the disproportionate number of
females with eating disorders, as compared to males. Currently, females represent nearly 75% of those
suffering from anorexia nervosa or bulimia nervosa (Karazsia, Murnen, & Tylka, 2017).

In order to address the growing prevalence of eating disorders, especially among adolescent girls
and young women, it is necessary to gain an understanding of the risk factors associated with the
development of these behaviors. Body dissatisfaction, or the negative subjective evaluation of one’s own
body weight or shape, is one of the most robust and consistent predictors of future disordered eating
behaviors (Stice, 2002).

Adolescents with eating disorders are also significantly more likely to develop anxiety disorders,
cardiovascular symptoms, chronic fatigue, chronic pain, depressive disorders, limitations in activities due
to poor health, infectious diseases, insomnia, neurological symptoms, and suicide attempts during early
adulthood (Johnson, Cohen, Kasen, & Brook, 2002).