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Specific Sociocultural Risk Factors

It is widely agreed that experimental or prospective data are needed to establish a characteristic or experience as a risk factor (Kraemer et al., 1997). Such data are available for media, parent, and peer influences on body image and disordered eating, although they are much more commonly found for media than for parental or peer factors. Thus, an empirical basis exists for arguing that these sociocultural factors play a role in the development and maintenance of body dissatisfaction, disordered eating, and EDs, although fewer data are available regarding their relationship with EDs.


Media is a broad term referring to television, magazines, Internet sites, and sometimes toys and games. If the media influence peoples body image, then the evidence must suggest that Americans use media and absorb their messages (Levine & Murnen, 2009). Research has continued to indicate that Americans are exposed to television beginning in infancy and the preschool years. Most Americans watch television daily. For example, American children ages 8 years and younger watch about 1 hour and 44 minutes of television daily, and teens watch nearly 3.5 hours (Media Literacy Clearinghouse, 2012). Children age 8 years and younger play on the computer 25 minutes per day, and teens use either the computer or video games more than 1.5 hours daily (Media Literacy Clearinghouse, 2012). By early adolescence, at least 60% of girls are reading teen magazines that feature articles on being thin and sexy to attract boys (Field et al., 1999; Ward, 2003). Media use, then, is multifaceted, with the various sources (television, Internet, video games, magazines) reinforcing each other's messages. Moreover, use is common and extensive, beginning in early childhood.

Media images are unrealistic. Women are disproportionately portrayed as thin, tall, young, and White (Levine & Murnen, 2009). Such portrayals are evident even in media aimed at young children (e.g., Klein & Shiffman, 2006). Women in the media are also often sexually objectified, that is, presented as objects to be looked at and enjoyed by men for mens sexual pleasure (Murnen & Smolak, 2012; Stankiewicz & Rosselli, 2008). Women are encouraged to buy diet products, exercise programs, anti-aging products such as Botox, makeup, and other products to try to achieve this ideal. Thus, women (and men) are consistently given the impression that the ideal is not a fantasy but is rather an attainable reality for those who simply invest enough time, energy, effort, and money. The message is that women can control their appearance, and women with EDs may take this message very seriously.

Furthermore, heavier women are actively punished by the media. For example, Fouts and Burgraff (2000) found that heavier women were more likely to be disparaged in situation comedies, whereas female characters who are thinner than average receive more positive comments. In addition, heavier women make more negative comments about their own bodies and weight. These messages reflect and reinforce womens desire not to be fat. However, mens bodies are portrayed more diversely in the media, with some featured male actors being heavy and others quite thin. Many fall in the average size range. However, it is increasingly clear that lean muscularity is the ideal shape (McCreary, 2011). Indeed, entertainment magazines and television shows routinely feature male celebrities with six-pack abs.

Does exposure to these unrealistic media body ideals actually affect attitudes or behaviors? Several meta-analyses have documented small to moderate relationships between media use and various aspects of disordered eating attitudes and behavior among women. For example, Grabe, Ward, and Hyde (2008), examining 77 different studies, found significant relationships between media exposure and thin-ideal internalization, body dissatisfaction, and eating behaviors and beliefs (such as anorectic cognitions, dieting, and purging) among girls and women. The relationship between media exposure and body dissatisfaction was particularly consistent across studies. In another meta-analysis, girls and women with preexisting levels of body dissatisfaction were more susceptible to media effects in experimental studies (Want, 2009). Both the Grabe et al. and the Want (2009) meta-analyses found adolescent and adult women to be similarly influenced by the media in terms of appearance satisfaction. Furthermore, prospective research has found that girls as young as 5 years old may experience greater appearance dissatisfaction when they watch more appearance-oriented television (Dohnt & Tiggemann, 2006).

Exposure to such a consistent message starting at such a young age may lead people to assume that the content is normative (cultivation theory; Gerbner, Gross, Morgan, & Signorelli, 1994). In other words, girls and boys who grow up on thin-ideal messages come to believe that most women are thin and sexy and that virtually all women could look this way. They do not critique or even question this message. When women internalize this sexually objectified thin ideal and adopt it as a standard for judging themselves, their self-esteem is endangered and they are at increased risk of developing eating pathology and depression (Moradi & Yu-Ping, 2008). This image, then, becomes part of how girls and women process social and personal information. For example, innocent comments from parents and peers might be interpreted as indicative of how close a girl is to the ideal.

Men and boys are not immune to media effects. At least two relevant relationships between media and body image among boys and men deserve attention. First, boys see the same images of women that girls see. Thus, these images may contribute to boys' impression of what girls should look like; indeed, adolescent boys prefer thinner girls (Paxton, Norris, Wertheim, Durkin, & Anderson, 2005). Such exposure to the thin ideal might also increase the likelihood of peer teasing of girls by boys.

Second, media exposure to the ideal lean and muscular male body type has negative effects on men's and boys' body image. A meta-analysis of both experimental and correlational studies has indicated a significant relationship between media exposure and negative body image (Barlett, Vowels, & Saucier, 2008). The effect might be larger for college-age men than for teenage boys. Furthermore, exposure to the muscular ideal is associated with poorer self-esteem, more depression and EDs, and greater use of problematic body-change strategies such as taking food supplements or dieting (Barlett et al., 2008).

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