Dr. Ana Stefanic

Global Issues in Social and Behavioral Health GPH-GU 2140

Sociocultural Perception of Attractiveness and the Development of Eating Disorders among

Adolescent Girls

Sahimar Yammine

21/12/2015

Index

Abstract .............................................................................................................................................3

Introduction .......................................................................................................................................4

Methods .............................................................................................................................................6

Results ...............................................................................................................................................7

Discussion..........................................................................................................................................9

Conclusion ....................................................................................................................................... 12

Appendix.......................................................................................................................................... 14

Figure 1 ...........................................................................................................................................

Figure 2: ..........................................................................................................................................

Figure 3: ..........................................................................................................................................

Figure 4: ..........................................................................................................................................

Table summarizing main articles .................................................................................................... 17

References ....................................................................................................................................... 20

Abstract

Eating disorders are biopsychological complex conditions in which individuals engage in

eating behaviors that could be fatal if left unattended. [13-15] These psychiatric disorders are

commonly characterized by having food as their trigger. Some behaviors associated with eating

disorders are refusing or restricting food, overeating to the point of death, purging after food

consumption, laxative intake, use of diet pills, etc. However, clinical factors cannot fully explain

the whole framework that goes behind the increase of eating disorders. [1,15] This literature review

proves the essential influence that “sociocultural perception of attractiveness” has a profound

influence on the progress of eating disorders. The strong prominence on appearance and slimness

in Western societies has lead individuals into an intense body preoccupation and desire to

achieve slimness and physical perfection. [13] Following societal beauty standards of “thinness as

social attractiveness” is linked to weight preoccupation, especially during the adolescence

period, [1] since there is a desire for adolescents of being accepted in the society by being

physically attractive. The “thin ideal body shape” messages are believed to be transmitted

through media, parents, peers and best friends. [1,10,12,17] In addition, studies suggest that physical

appearance has been associated with positive attributes such as being socially, professionally,

and maritally acceptable. [6,9] It is concluded that body image is a combined concept determined

by one’s distress of their body image and how unsatisfied they are with what they see. The

mixtures of those two standings result in the development of self-esteem, and adolescent self-

perception. [1] This component of self-perception of body image begins during adolescence, the

period in which girls are more concerned about their looks and body changes. [14] In addition,

excessive concern about body weight is associated with the development of eating disorders. [3]

Hence, eating disorders are an important health concern that should be tackled at an early stage

and, by understanding the sociocultural and psychological issues surrounding body weight

concern and body image dissatisfaction, research and health practitioners can develop future

recommendations for weight control, maintenance and management of eating disorders.

Introduction

Eating disorders are a biopsychological complex in which individuals engage in eating behaviors

that could be fatal if left unattended. Anorexia Nervosa (AN), Bulimia Nervosa (BN), Binge

Eating Disorders (BED), and Eating Disorders Not Otherwise Specified (EDNOS) are some of

this complex psychiatric disorders commonly characterized by having food as a trigger. [13-15]

Some behaviors associated with eating disorders are refusing or restricting food, overeating to

the point of death, purging after food consumption, laxative intake, use of diet pills, etc.

However, clinical factors cannot fully explain the whole framework that goes behind an increase

of incidence and prevalence in eating disorders. [15] Every period in history has had its own

standards of beauty. In addition, every culture develops its own idea of beauty in terms of

“proper” body size and shape. Nevertheless, in the last 20 years there has been a marked move

towards thinness in women’s beauty: “There has been documented a significant decrease in body

weight and in measurements during the 20 past year’s period.”[15] Therefore, one influence that

can have an impact on the advancement of eating disorders is the sociocultural pressure of

women to achieve societal beauty standards of “thinness as social attractiveness.” Moreover,

there is an increased pressure to be thin and to look good in the eyes of society: “looking healthy

now signifies being healthy and thinness has been associated with beauty and success.”[7] The

resilient and never-ending stress on appearance and slenderness in Western societies has led to

an intense body obsession and yearning to achieve thinness and physical perfection so to say. [16]

In addition, studies suggest that physical appearance has been associated with positive attributes

such as being socially, professionally and maritally acceptable. [1,10,12,17] Nevertheless, an

increased focus on body image is more predominant among women than men. [6,9] Women

perceive their body to be an aesthetic and evaluative attribute. This component of self-perception

begins during adolescence, the period in which girls are more concerned about their looks and

body changes. [2,3,12] In addition, excessive concern about body weight in associated with the

development of eating disorders. [3,6,8,9,12] Hence, eating disorders is an important health concern

that should be tackled at an early stage: Eating disorders are categorized as the third most

common ailment among young females. [3] Nevertheless, eating disorder behaviors can lead to

potential mental and health consequences. Therefore, I chose female adolescents to compromise

my study population. The purpose of my article is to study the sociocultural-induced aspects of

“social attractiveness” in society and its impact on the progress of eating disorders among female

adolescents in Western populations. It is hypothesized that sociocultural pressure to be thin,

driven by society, is a determinant for the development of eating disorders among adolescents.

Some sociocultural factors underlying the extreme concerns with body image include social

standards of physical attractiveness. [1,6,8-12,17] In the literature, women’s body image is well-

defined in expressions of body displeasure. In addition, body image plays an important role in

self-perception which is an important term that not only influences the way we perceive

ourselves, but determines our social and personal relationships. [1,14] Therefore, more people will

focus on their bodies and its faults, leading them to further try to achieve an unrealistic beauty

stereotype. They will do anything from engaging in many weight loss strategies, to diet products,

and extreme restrictive diets. Thus, we come to a conclusion that harmful eating behaviors

happen in response to body discontent and weight unease. [4,5] Research suggests that eating

disorders serve as a strategy to regulate the threat they feel and result in a feeling of safety and

physically acceptable in social groups. [4] In other words, attractiveness relates to self-acceptance.

[14]

Methods

We searched on the Pub-Med database for literature that addresses the effect of sociocultural

factors on body dissatisfaction and body image concern. Using the query “Sociocultural

perception of attractiveness and eating disorders”, the literature search included 168 related

articles. However, we limited our scope to young adolescent girls. Therefore, by adding

“adolescent girls” to the database search tool we further limited our decision to 38 possible

scientific articles. After carefully reading those 38 abstracts, we chose 5 articles that clearly

addresses how thin internalization idea set by society leads to one’s physical appearance

dissatisfaction and plea to lose weight in many adolescent girls. [3,6,8,9,11] In addition, we had a

look at the list of “similar articles” offered by Pub-Med database. After reviewing abstracts from

the 9 items list, we chose 4 articles [1-3,10,17] that were commonly addressing how pressure from

parents, friends, peers and best friend lead to desire to change body weight and shape. Therefore,

our literature review considers media, peer, and parents as potential social factors that might

influence body satisfaction and hence, result in young female girls engaging in extreme and

unhealthy weight loss strategies to achieve that unrealistic ideal body shape. Nevertheless, to

further justify the hypothesis that not puberty, but rather society influence body image concerns

during adolescent we chose an additional article[12] that was addressed puberty as a possible risk

aspect for the advancement of eating illnesses. Additionally, to provide the literature review with

strong and reliable background information, from those 168 initially found articles we chose 7

that were commonly addressing culture as a strong determinant for weight concern and social

interaction. [4,5,7,13-16]

Results

Thin ideal body shape portrayed by society predicted changes in body satisfaction, dieting, and

compulsive exercise. [8] This result is also supported in the study “Prospective Study of Pressure

from Parents, Peers, and the Media on Extreme Weight Change Behaviors among Adolescent

Boys and Girls,” in which researchers state that “weight change behaviors are shaped by

biological, psychological, and social factors.”[12] These social aspects comprise of apparent

pressure from peers, parents, and television to alter their weight and shape.[12] In addition,

adolescents, both boys and girls, perceive that they should respond and conform to the

sociocultural pressure to have the ideal weight according to their gender. [17] There is an existing

significant association between social reputation and dietary intake: “Adolescent Girls’ and

Boys’ Weight Related Health Behaviors and Cognition: Association with Reputation and Peer

Status.” [17] A larger body shape was linked with small intensities of supposed social acceptance.

[4] Therefore, women show a strong association between thin body and being attractive to men. [2]

Female adolescents being perceived as attractive are more probable to involve themselves in

weight preoccupation behaviors in comparison to those female adolescent rated as “less

attractive.” [4]

In the article, adolescent girls showed to have higher intensities of body displeasure than

boys.[12] Hence, girls are more likely to participate and take part in extreme eating patterns to

decrease their heaviness.[1] Moms and best female friends’ feedback were the most important

forecasters of figure appearance importance and body change strategy in adolescent girls.” [11] In

addition, “A Prospective Study of Pressure from Parents, Peers, and the Media on Extreme

Weight Change Behaviors Among Adolescents”[3] also supports the fact that “female girls were

mostly influenced by their mothers and same sex peers, when it comes to body weight change

concerns. Perceived messages from these individuals play an important role in shaping strategies

to lose weight.” [10,3]

Moreover, the association between skinny ideal internalization and body discontent was detailed

in “The role of social comparison and body surveillance.” [6] Results of this study shows that

increased body monitoring/body observation leads to advanced levels of body dissatisfaction. [6]

In addition, “implicit internalization of the thin ideal as a predictor of increases in weight, body

dissatisfaction and eating disorder.” [9] Therefore, women who are constantly troubled about their

body figure and body appearance are more likely to develop eating illnesses. [6,9] This idea is

also supported in the study “Socio-cultural factors in the Development of Anorexia Nervosa:” in

this study researchers found that Anorexia Nervosa is more common in modelling and dance

students than in other similar age women. Therefore, individuals who increase their focus on

their body appearance are more expected to develop Anorexia Nervosa or other eating disorders.

[7] A population of 183 professional dancers and 56 modeling students were included in the study

Researchers chose to focus on this population since modeling and dancing are activities highly

associated with increased control and attention over weight and body shape. At the beginning of

the freshman year, females are more susceptible to adopt the thinness as the ultimate body shape,

which puts them at higher risks of eating disorders due to body image dissatisfaction. [9]

Therefore, the adolescence years is a critical period for girls, in which the primary source of

appraisal is peers. [1,2,9,10]

Wrapping up everything that we studied, all studies being chosen in this literature review were

addressing the role of sociocultural influences and the thin-internalization idea in women during

the adolescence years. Although the sample’s characteristics and data collection questionnaires

varied in each study, the general purpose of all articles was to study the association of social

comparison, stress to be skinny, body disappointment, thin internalization ideal and usage of

extreme weight loss strategies-method in young girls.

In addition, eight of these studies were cross-sectional design studies that were not able to draw

conclusions about causality. [1,3,6-8,11,12,17] However, even though the two articles left are

considered cohort studies, [9,10] inaccuracy of data collected due to the self-reported method

used,[10] presence of a homogeneous sample size of undergraduate women from one university

that are not representative of the general population,[10] and short time period to effectively

obtain realistic and accurate results[9] are some limitations of these cohort design studies.

Discussion

Social attractiveness or “sociocultural pressure to be thin” is believed to negatively affect

women’s body image. [1-5,12] Studies advise that self-comparison is related with an increase in

external shame in society and predicted the drive for thinness. [4] Moreover, body discontent has

a direct consequence on the effort for slimness. [4] Articles used in this review support the notion

that eating/exercise comparison is motivated by the thin ideal set by society. [5] In addition, there

is an inconsistency between what a lady presently appears like and what she would preferably

like to look. [5]A lack of self-compassion might explain the link that exits between body

dissatisfaction and tendency to control body weight by inadequate eating behaviors (via dieting).

[4] Nevertheless, excessive body surveillance/body concern also leads to body dissatisfaction:

[6,8,9] When women monitor their body size and shape, they might realize that there is an

inconsistency between how they look and their preferable ideal body weight, which in turn

indicates to an amplified risk for the expansion of eating sicknesses and increased body

unhappiness.[1-3,12] In other words, eating disorders serve as a tool to regulate sociocultural

threats, feeling safe in the society group, and avoid being judged by one’s body shape and

weight. [4] Society does not only influence the pathology of eating disorders by promoting thin-

ideal body weight, but also, social support has been found to have significant association with

the expansion of eating conditions: Individuals with eating sicknesses report lower levels of

perceived social support. [10] Moreover, maladaptive social relationships have also been

associated with increased bulimic symptoms. [1] In addition, messages from parents, best friends

and same sex peer influences person’s tactics and methods to try to lose weight or the

intensification of muscles during adolescence, [1,10,12,17] and sociocultural comments from peers,

friends and family are more likely to influence body dissatisfaction amongst girls with a high

Body Mass Index (BMI). Therefore, BMI is another significant predictor of body satisfaction

and positive body appearance development among adolescents. [2] It is concluded that girls that

feel a great pressure to please others in society are more expected to progress eating illnesses,

since they are more vulnerable to social clues such as: ideal weight, and shape (two components

related to body dissatisfaction). [2] In other words, restrictive diet and excessive exercise are

strategies used by females in an attempt to achieve the desired thin ideal body. [12] In addition,

educations have originated a noteworthy association between parents’ remarks about their

children’s weight and the children’s weight apprehensions. [4]

Moreover, only one study, from all selected research studies, found a weak relationship amongst

social media and both body discontent and body change strategies, but a resilient connotation

between social media and body image concern. [17] Hence, there is an existing gap between body

image concern and body dissatisfaction which leads to a desire to lose weight and achieve the

ideal body shape: “there are other factors contributing to eating and exercise behaviors (e.g self-

esteem, late maturation).” [12] On the other hand, other researches did support the fact that media

provides an appropriate foundation of evidence regarding specific attractiveness and societal

standards, and it has a significant impact in the developing of eating disorders. “Appearance

television” was exceedingly interconnected with the internalization of specify beauty

stereotypes. [6,8,9] In addition, media has caused an increased desire to lose weight and body

image concern, coupled with eating behavior.”[10,12] In study “Weight preoccupation as a

function of observed physical attractiveness”, girls aged 9-14 years old who reported an effort to

like an X-same sex media figure were more expected to advance in their weight anxieties and

become future weightwatchers. [3] Perceived messages of ideal body shape transmitted by the

media, has its highest impact on girls during their adolescent period.[10] The internalization of the

skinny perfect body weight produces disappointment in women since these standards are almost

unrealistic to achieve in a healthy way. Nevertheless, this is why is it important health concern

for adolescents since body image concerns during childhood have important implications not

only in a the possible development of eating disorders but for the formation of unfortunate body

image, self-esteem and psychological functioning.

However, “Excessive concern about weight is more prevalent among young adolescent. These

young women are more likely to engage in detrimental food and exercise behaviors to achieve

the ideal thin body weight.”[1] Therefore, as mentioned before, peer influence on thin-idealization

ideas and its impact of the development of eating disorders varies through age, and has its

highest impact when girls are 13-14 years, then it gets reduced. There is an existing relationship

between body mass and peer status: larger bodies are associated with lower levels of peer

reported popularity, and popularity is associated with dieting after accounting for body

dissatisfaction and body image concern. [17] Nevertheless, it is argued that it is not puberty what’s

really causing body image concerns and desire to lose weight: “puberty during adolescence

showed to have no significant influence on body image concern, eating, and weight loss.”\\

To sum up that point, our culture has recently shifted to an aesthetic ideal promoting thinner

body shapes in woman. In addition, thinness is nowadays being endorsed as a representation of

attractiveness and success. There has also been an substantial intensification in diet articles in

women’s magazines.[6] Eating disorders may be viewed as multifactorial disorders with family,

individual and cultural predisposition factors. (Refer to figure 1 and figure 2).

Even though all articles listed before, support the notion that culture and society plays an

essential role in the developing of eating disorders by the promotion of thinness as an ideal body

weight, no study has shown the effect of social economic status, income, education, etc. as

possible mediators of this association. These relationships need to be determined in order to find

if they also mediate the association between culture/thinness and eating disorders.

Conclusion

Eating disorders cause severe psychological, medical and social consequences that could be

lethal if not adequately treated. [13,14] Real suffering exists not only on those who suffer from the

disease, but also on those who care for them. Additional research is needed to continue studying

this multifactorial disease so that we can better understand and respond to this serious condition.

By understanding the sociocultural and psychological issue surrounding body weight concern

and body image dissatisfaction, research and healthcare practitioners can develop future

recommendations for weight control, maintenance, and the treatment of eating disorders.[6] This

literature review proves that the essential influence that sociocultural perception of attractiveness

plays on the development of eating disorders is immense. The research suggests that there is a

desire for adolescents to fit in society by being physically attractive. Following society beauty

standards of “social attractiveness” is linked to weight preoccupation, especially during the

adolescent period. [6,9,12] In addition, reading magazines at a younger age is associated with

engaging in more frequent dieting and excessive exercising behaviors, as well as the use of diet

pills, laxatives or other restrictive dieting methods.[3] It is concluded that body image is a

combined concept determined by body image concerns and body dissatisfaction; those two terms

combined lead to the development of decreased self-esteem and a negative perception of their

bodies. Dieting behaviors and body size are associated with peer popularity, in a style that could

lead to challenging exercise and eating manners. [17] Moreover, the adolescent years is a critical

period for girls in which the primary source of their appraisal is coming from their peers. In

addition, media and family promoting thin ideal body shape might be also reinforced by the

group of friends and hence, be associated with peer popularity.[17] The thin internalization idea

plays an imperative part in the etiology of eating disorders.[6,8,9] Girls presented to be internalized

at an early stage; and preoccupied with the sociocultural messages of what the ideal body weight

for a woman was. [3] Therefore, we suggest and recommend that there be intervention strategies

to modify cognition about ideal body weight and they be implemented at an early stage in order

to avert the expansion of eating disorders amongst young women.

Appendix

PUB-MED research

38 articles

5 articles that clearly addresses how thin

internalization idea set by society leads

to body image dissatisfaction and desire

to lose weight in adolescent girls

4 articles that were commonly

addressing how pressure from parents,

friends, peers and best friend lead to

desire to change body weight and shape

17 total selected

articles

1 additional article that

addresses puberty vs

sociocultural factors as possible

developers of eating disorders

7 articles chosen as background

information that were commonly

addressing culture as a strong

determinant for weight concern and

social interaction.

Figure 1. Process of identifying scientific articles for the literature review “Sociocultural

perception of attractiveness and development of eating disorders among female adolescent”

Figure 2: explaining how sociocultural factors influence the development of Eating Disorders by promoting

dieting, weight loss and “thin- ideal body weight”. [7]

Figure 3: Summary of relationship investigated between biological variables, sociocultural influences,

individual psychological variables, and body image. [2]

Figure 4: An elaborated sociocultural model of disordered eating. Social comparison and body surveillance are

conceived as mediators of the thin-ideal internalization-body dissatisfaction link. [3]

Clark L, Tiggemann M. Sociocultural and individual psychological predictors of body image in young girls: A

prospective study. Dev Psychol 2008;44(4):1124.

Table summarizing main articles

Author Year

Characteristic of the

sample

Methods Results

Type

Of

Study

Bell C, Cooper

MJ

2006

18 girls between 14-15 years out

of 83 sample size successfully participated in the study. The

mean age was 15. Sample size

was recruited from 2 mainstream

schools in the UK; girls were

chose to volunteer in this study once their mothers signed a

confirming form.

Questionnaire packs were sent

home and the researchers were the ones responsible for collecting

them after a week. *“Eating

Attitude Test”

* “Eating Disorder Belief

Questionnaire” * “Sociocultural Attitude Towards

Appearance Questionnaire”

*self-reported weight and height

Peer and media influence the

development of eating

disorder’s symptoms in young

girls. However, individual

cognitions about body image add to this relationship.

Cross-sectional

McCabe MP,

Ricciardelli LA,

Finemore J.

2001

1185 adolescents: 527 boys and 598 girls enrolled in grades 7

and 8 in six schools located in

Melbourne, Australia

5 scales of

-“Body Image and Body change

inventory”,to determine:

*body dissatisfaction, *body image

importance, *strategies being implemented to

reduce weight.

-“media scale”.

-Pubertal Development scale -the“Self-descriptive questionnaire

II”

Adolescents both boys and girls perceived that they

should respond and conform

to the sociocultural pressure

to have the ideal weight

according to their gender. However, consistent with

others research, adolescent

girls showed to have a higher

level of dissatisfaction that

boys. Girls are more likely to adopt extreme eating patterns

to decrease weight.

Cross-sectional

McCabe MP,

Ricciardelli LA.

2004

compromises 246 girls who

completed the questionnaire in

all 3 times. All participants

where chose from 6 public and private schools in Australia

Scales from the Body Image and

Body Change Questionnaire. These

scales assessed levels of body

dissatisfaction, image importance, strategies used to lose weight. In

addition, 5 subscales from the

“sociocultural influences on body

change questionnaire” were also

implemented in order to measure social pressure from parents, peers,

media and best friend.

Nevertheless, weight and height

were self-reported by the

participants

Weight change behaviors are shaped by biological,

psychological and social

factors.

Social factors include

perceived pressure from peers, parents and media to

change weight and shape.

Perceived messages from

these individuals (peers and

parents) play an important role in shaping strategies to

lose weight

Female girls were mostly

influenced by their mothers

and same sex peers, when it comes to body weight change

concerns.

Cohort

Garner DM,

Garfinkel PE 1980 441 adolescent is grade 11 and

12

Data was collected by self-reported

weight, height, dietary behavior,

peer perceived popularity and peer likeability.

Eating Attitudes Test: in order to

measure symptoms of Anorexia

Nervosa

There is a significant association between social reputation and dietary intake. Thinness is associated with peer popularity. A

larger body shape was associated with small levels of perceived social popularity. In addition,

girls show a stronger level of body dissatisfaction than boys. Individuals with increased focus

on slim body shape are at risk for anorexia nervosa.

Cross-sectional

Fitzsimmons-

Craft EE, Harney

MB, Koehler LG,

Danzi LE,

Riddell MK,

Bardone-Cone

AM.

2012

which 265 women with a mean

age of 19, who were attending Southwestern University, were

recruited through “Introduction

to Psychology course” offered at

the university

These results were calculated using

correlation measurements between

scale results of computer based

questionnaires with a timeframe of 45 min. Body Surveillance

subscale, Iowa-Netherlands

comparison orientation measure

and the internalization appearance

questionnaire-3 were the scales used for data collection

Increase body monitoring/ body observation leads to

higher levels of body

dissatisfaction.

Cross-Sectional

Juarascio AS,

Forman EM,

Timko CA,

Herbert JD,

Butryn M, Lowe

M

2011

By 80 freshman women within a 18-25 age range. Recruitment

and baseline data collection took

place at the first month of

college; the study lapse time was

7.8 months.

Body shape questionnaire to assess

body image satisfaction, Eating Attitude Test to measure disordered

eating behavior, and Sociocultural

Attitude Towards appearance scale

to test for the level of

internalization of the thin ideal

At the beginning of the freshman year, women are

more susceptible to

internalize the thinness as the

ideal body shape, which puts

them at higher risks of eating disorders due to body image

dissatisfaction.

In addition, body image

surveillance is highly

influenced by the internalization of the ideal

thin body weight-

sociocultural standard.

Cohort

Homan K. 2010

231 women students who were

attending art classes at a private liberal art college. Data was

collected in 2 times. Time 1 took

place during the first month of

the academic year; after 7

months’ time 2 data collection took place

“Athletic subscale of the

sociocultural attitudes towards

appearance questionnaire 3”, “the

internalization subscale of the sociocultural attitude towards

appearance questionnaire”,

“Multidimensional body -self

relations questionnaire”,

“Obligatory Exercise Questionnaire” and “Dutch

Restrained Eating Scale”

Thin internalization idea

predicted changes in body

dissatisfaction, dieting and

compulsive exercise

Cohort

McCabe MP,

Ricciardelli LA

2003 800 adolescent (423 boys and

377 girls) students from 6 high schools in Melbourne, Australia

the “Body Image and Body Change

Inventory” during a single class

period. This scale measured body

image dissatisfaction, importance,

strategies to decrease weight, strategies to increase weight,

strategies to increase muscle, binge

eating and supplement intake

Mother and best female

friend’s feedback were more

important predictors of body image importance and body

change strategies.

Cross-sectional

Colabianchi N,

Ievers-Landis CE,

Borawski EA

2006 4324 females adolescents in

grades 8-12 with normal BMI

were

Data source from this report comes

from the National Longitudinal Study of Adolescent Health.

Researches used questionnaires to

test for these variables: weight

preoccupation, dieting and exercise

to lose weight, thinking they were overweight and engaging in

inappropriate dieting behavior.

Physical beauty function as a

risk factor for weight preoccupation and therefore,

for the development of eating

disorders among adolescent

girls.

Thinness and attractiveness are a great concern for self-

identity among adolescent

girls.

Cross-sectional

Wang SS,

Houshyar S,

Prinstein MJ

2006 183 professional dancers and 56

modeling students

Perceived Body Size: using the Ideal Body Subscale-Female.

Body Related Cognition: To test for

frequency of adolescent’s cognition

about their body appearance and

size. Dieting: To test for food behaviors

Peer-rated social preference and

social reputation.

Girls reported higher levels of

body image concern and

obesity cognition than boys.

Ideal body shape and dieting

are associated with higher levels of peer popularity.

Cross-sectional

References

1. Bell C, Cooper MJ. Socio-cultural and cognitive predictors of eating disorder symptoms in young girls. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity

2005;10(4):e97-e100.

2. Clark L, Tiggemann M. Sociocultural and individual psychological predictors of body image in young girls: A prospective study. Dev Psychol 2008;44(4):1124.

3. Colabianchi N, Ievers-Landis CE, Borawski EA. Weight preoccupation as a function of

observed physical attractiveness: Ethnic differences among normal-weight adolescent females. J Pediatr Psychol 2006 Sep;31(8):803-12.

4. Ferreira C, Pinto-Gouveia J, Duarte C. Self-compassion in the face of shame and body image

dissatisfaction: Implications for eating disorders. Eating Behav 2013;14(2):207-10.

5. Fitzsimmons-Craft EE, Bardone-Cone AM, Bulik CM, Wonderlich SA, Crosby RD, Engel SG. Examining an elaborated sociocultural model of disordered eating among college women: The roles of social comparison and body surveillance. Body Image 2014;11(4):488-

500.

6. Fitzsimmons-Craft EE, Harney MB, Koehler LG, Danzi LE, Riddell MK, Bardone-Cone AM. Explaining the relation between thin ideal internalization and body dissatisfaction among

college women: The roles of social comparison and body surveillance. Body Image 2012;9(1):43-9.

7. Garner DM, Garfinkel PE. Socio-cultural factors in the development of anorexia nervosa.

Psychol Med 1980;10(04):647-56.

8. Homan K. Athletic- ideal and thin-ideal internalization as prospective predictors of body dissatisfaction, dieting, and compulsive exercise. Body Image 2010;7(3):240-5.

9. Juarascio AS, Forman EM, Timko CA, Herbert JD, Butryn M, Lowe M. Implicit internalization of the thin ideal as a predictor of increases in weight, body dissatisfaction,

and disordered eating. Eating Behav 2011;12(3):207-13.

10. McCabe MP, Ricciardelli LA. A prospective study of pressures from parents, peers, and the media on extreme weight change behaviors among adolescent boys and girls. Behav Res

Ther 2005;43(5):653-68.

11. McCabe MP, Ricciardelli LA. Sociocultural influences on body image and body changes among adolescent boys and girls. J Soc Psychol 2003;143(1):5-26.

12. McCabe MP, Ricciardelli LA, Finemore J. The role of puberty, media and popularity with peers on strategies to increase weight, decrease weight and increase muscle tone among

adolescent boys and girls. J Psychosom Res 2002;52(3):145-53.

13. Nasser M. Eating disorders across cultures. Psychiatry 2006;5(11):392-5.

14. Nezlek JB. Body image and Day‐to‐Day social interaction. J Pers 1999;67(5):793-817.

15. Rodin J. Cultural and psychosocial determinants of weight concerns. Ann Intern Med

1993;119(7_Part_2):643-5.

16. Sepúlveda AR, Calado M. Westernization: The role of mass media on body image and eating disorders. INTECH Open Access Publisher; 2012. .

17. Wang SS, Houshyar S, Prinstein MJ. Adolescent girls' and boys' weight-related health

behaviors and cognitions: Associations with reputation-and preference-based peer status. Health Psychology 2006;25(5):658