There has been a significant increase in research into body image in men, women and children in the last 20 years. This editorial reviews definitions of the concept of body image, and considers potential health consequences of lowered body satisfaction and increased body concern. The articles that form this Special Issue are contextualized within contemporary research literature around relevant themes. These include sociocultural influences, gender, effects of weight and appearance and perceptual factors. Implications of findings for health psychologists involved in designing health promotion interventions are discussed.

Body Image and Health Contemporary Perspectives

OBJECTIVE: Numerous stand-alone interventions to improve body image have been developed. The present review used meta-analysis to estimate the effectiveness of such interventions, and to identify the specific change techniques that lead to improvement in body image.

METHODS: The inclusion criteria were that (a) the intervention was stand-alone (i.e., solely focused on improving body image), (b) a control group was used, (c) participants were randomly assigned to conditions, and (d) at least one pretest and one posttest measure of body image was taken. Effect sizes were meta-analysed and moderator analyses were conducted. A taxonomy of 48 change techniques used in interventions targeted at body image was developed; all interventions were coded using this taxonomy. 

RESULTS: The literature search identified 62 tests of interventions (N = 3,846). Interventions produced a small-to-medium improvement in body image (d+ = 0.38), a small-to-medium reduction in beauty ideal internalisation (d+ = -0.37), and a large reduction in social comparison tendencies (d+ = -0.72). However, the effect size for body image was inflated by bias both within and across studies, and was reliable but of small magnitude once corrections for bias were applied. Effect sizes for the other outcomes were no longer reliable once corrections for bias were applied. Several features of the sample, intervention, and methodology moderated intervention effects. Twelve change techniques were associated with improvements in body image, and three techniques were contra-indicated. 

CONCLUSIONS: The findings show that interventions engender only small improvements in body image, and underline the need for large-scale, high-quality trials in this area. The review identifies effective techniques that could be deployed in future interventions.

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A meta-analytic review of stand-alone interventions to improve body image

Idealised media images: The effect of fitspiration imagery on body satisfaction and exercise behaviour

Men's body image problems may manifest as an unhealthy drive for muscularity and propensity to use anabolic-androgenic steroids (AAS). Aspects of objectification theory were integrated with literature on men's drive for muscularity and AAS use to identify correlates of these problems. The resultant model was tested with path analyses of data from 270 college men. First, consistent with prior research on objectification theory, results indicated that body surveillance partially mediated the link of internalization of cultural standards of attractiveness with body shame. Second, positive outcome expectation for AAS use partially mediated the link of drive for muscularity with intention to use AAS. Third, drive for muscularity partially mediated the links of internalization with outcome expectation for AAS use and intention to use AAS. Finally, outcome expectation for AAS use was an additional partial mediator of the link of internalization with intention to use AAS. Body surveillance and body shame did not have unique direct or mediated relations with drive for muscularity or AAS variables. These findings point to internalization of cultural standards of attractiveness as the nexus of overlap between the objectification theory variables and men's drive for muscularity and propensity to use AAS.

His Biceps become Him: A Test of Objectification Theory's Application to Drive for Muscularity and Propensity for Steroid Use in College Men.

Objectives Male bodybuilders have been found previously to have higher levels of disordered eating and body-image disturbance than do other men. This study investigated whether objectification theory (Fredrickson & Roberts, 1997) could be used to explain these observed differences in male body-image.

Design A cross-sectional, self-report design was used.

Methods Three samples of men were recruited: bodybuilders (N = 31), weightlifters (N = 17), and non-athletic controls (N = 35). Participants completed a questionnaire containing measures of self-objectification, self-surveillance, body shame, appearance anxiety, and four outcomes: body dissatisfaction, drive for muscularity, bulimia, and depression.

Results As predicted, bodybuilders had significantly higher levels of self-objectification than weightlifters and controls, and higher levels of body dissatisfaction and drive for muscularity than controls. Overall, the relationships between self-objectification and the outcome variables, and self-surveillance and the outcome variables, were mediated by appearance anxiety.

Conclusions . Bodybuilding is associated with outcomes that suggest it may not result in greater overall health for men. It was concluded that objectification theory provides a useful framework for examining body-image differences in men.

Individual differences in male body-image: An examination of self-objectification in recreational body builders

In this study, we interviewed an opportunity sample of seven women body builders, who all compete (or have competed in the past) in Physique-level body building competitions. They were asked about training details, and motivations for body building including social pressures to become more muscular (and not to become more muscular). Women’s accounts were complex and in some cases apparently contradictory, for while emphasising freedom to choose to be muscular within a cultural context where slimness is the norm, they stressed the importance of aspects of traditional femininity. Women’s accounts are discussed in relation to Western cultural pressure on women to be slender. It is argued that these women had shifted their body-shape ideal to a more muscular figure, and their primary social reference group to those within the body building community. Women experienced pressures from within the body building community defining the acceptable size and appearance of their bodies. They were engaged in a ‘balancin...

Femininity and Muscularity: Accounts of Seven Women Body Builders

This study was designed to investigate anabolic steroid users' experiences of, and motivations for, use. Five men and six women users took part in in-depth interviews. Four themes emerged: Steroid Use vs Abuse; Side-effects; Trusted Information Sources; and Social Pressure. Many users believed that steroids used in moderation were safe. Serious side-effects (liver and kidney damage, hypertension) were not significant disincentives. Information from health professionals tended to be mistrusted because it was not based on first-hand experience of use. Social support, especially from within the body building community, was an important motivator. It is concluded that intervention programmes need the support of the body building community in order to be effective.

Ruth Evans

Papers

Femininity and Muscularity: Accounts of Seven Women Body Builders

Experiences of anabolic steroid use: in-depth interviews with men and women body builders.