Media Psychology, 13:387–416, 2010
Copyright © Taylor & Francis Group, LLC
ISSN: 1521-3269 print/1532-785X online
DOI: 10.1080/15213269.2010.525737
Influence of Mass Media on Body Image and
Eating Disordered Attitudes and Behaviors in
Females: A Review of Effects and Processes
GEMMA LÓPEZ-GUIMERÀ
Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, Spain
MICHAEL P. LEVINE
Department of Psychology, Kenyon College, Gambier, Ohio
DAVID SÁNCHEZ-CARRACEDO
Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, Spain
JORDI FAUQUET
Department of Psychobiology and Methodology of Health Sciences,
Universitat Autònoma de Barcelona, Spain
This article reviews research on the effects of television and magazines on body image and on disordered eating attitudes and
behaviors in females. Evidence from different types of studies in
the fields of eating disorders, media psychology, health psychology, and mass communication indicates that mass media are an
extremely important source of information and reinforcement in
relation to the nature of the thin beauty ideal, its importance,
and how to attain it. Although considerable research remains
to be done, evidence is accumulating that repeated exposure to
media and to both direct and indirect (via media’s effects on
peers, parents, coaches, physicians, etc.) pressures from media
to be thin constitute risk factors for body dissatisfaction, concerns over weight and disordered eating behaviors in adolescent
girls and young women. To guide further research, as well as
the prevention and treatment of disordered eating, we present
a figural summary of media effects that integrates moderating
and mediating factors such as internalization of the thin beauty
Address correspondence to Gemma López-Guimerà, Department of Clinical and Health
Psychology, Edifici B, Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallés)
08193, Spain. E-mail: Gemma.Lopez@uab.cat
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ideal, social comparison, and activation of the thinness schema.
We argue that risk factor research, prevention, and treatment
will benefit from systematic research designed to clarify how the
impact of various mass media is shaped by source and receiver/
perceiver factors.
Media are among the principal social agents in many societies around the
world. Television, magazines, newspapers, radio, cinema, advertising, the
Internet, and other so-called ‘‘new media’’ or ‘‘new technologies’’ occupy—
if not invade—much of our leisure time, and indeed our working time.
Mass media transmit the ideas, values, norms, attitudes, and behaviors that
socialize and construct the social reality of those who use them for a wide
variety of reasons (Bryant & Oliver, 2009). The processes of media selection, media use, and media effects are particularly important for children
and adolescents because the powerful, insistent, market-driven media have
become serious rivals to the family and school with regard to education and
socialization (Bercedo Sanz et al., 2005). In developed countries, television
has become (after sleep) children’s primary activity (American Academy of
Pediatrics, 2001). A recent study in Spain found that adolescents consume
an average of 3 hours to 3.2 hours a day of television on weekdays and
weekends, respectively (Bercedo Sanz et al., 2005). These figures approach
those currently available for the Spanish adult population, who, according
to an official survey, spend on average 3.8 hours a day watching television
(Estudio General de Medios, 2009). A recent report of the Kaiser Family
Foundation, in United States, shows that the average amount of time spent
watching television content among all 8–18 year olds is 4.29 hours in a
typical day (Rideout, Foehr, & Roberts, 2010). Magazines aimed at females,
and especially adolescents, have increased in number and availability in
recent years. An estimated 33 million 12–19 year olds spend upward of $175
billion annually on these magazines (Kaiser Family Foundation, 2004).
Television, magazines, films, billboards, and the like frequently offer a
distorted vision of the world (Bercedo Sanz et al., 2005; Shrum, 2009), and
it may be difficult for children and adolescents to distinguish whether what
they see is real or not, so that they are more vulnerable to the messages
transmitted (American Academy of Pediatrics, 2001). In a classic content
analysis of prime-time television, Kaufman (1980) concluded that television
was obsessed with thinness, and the most prevalent and salient content of
magazines aimed at adolescent females was focused on appearance (Kaiser
Family Foundation, 2004). Undeniably, a substantial portion of media content
consumed by children and adolescents is replete with unhealthy messages
about the beauty ideal, body size, food, weight control, and the gender roles
of women and girls, as well as use of alcohol, tobacco, and other substances
for managing one’s emotions and self-presentation (see, e.g., Greenberg,
Influence of Mass Media on Body Image
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Rosaen, Worrell, Salmon, & Volkman, 2009; see also reviews by Levine &
Harrison, 2004, 2009). People are often unaware—and mass media work hard
to keep it that way—of the extent to which, and just exactly how mass media
play an important role in promoting consumerism, body objectification, and
internalization of the current beauty ideal. Similarly, various components of
the media, including critics and other commentators, tend to avoid discussion
of how often the fashion industries use digital technology to manipulate
images (Engeln-Maddox, 2006). These are the images that set the current
standards of beauty and sexuality that are seen (experienced) as ‘‘real’’ and
‘‘normative’’ but are actually impossible to attain (Levine & Harrison, 2004,
2009; Levine & Murnen, 2009; Thompson, Heinberg, Altabe, & Tantleff-Dunn,
1999; Thompson & Stice, 2001; Toro, 2004; Utter, Neumark-Sztainer, Wall, &
Story, 2003).
For these and other reasons, many researchers argue that mass media
are one of the principal factors behind body dissatisfaction, concerns about
weight, and disordered eating behavior (see, e.g., Levine & Murnen, 2009).
The purpose of this article is to review, in a critical but necessarily selective
fashion, current research on the effects of the media on body image and
on disordered eating attitudes and behaviors. This analysis helps to clarify
the empirical status of media effects, to identify the most vulnerable types
of individuals, and to raise specific questions and suggestions about the
implications of this work for causal models, for treatment, and for prevention.
Although there is a growing literature examining the Internet (see, e.g.,
Bardone-Cone & Kass, 2007) and the impact of media on adolescent boys
and young adult men (see, e.g., Bartlett, Vowels, & Saucier, 2008), the main
focus of studies to date has been centered on adolescent girls and female
undergraduates and how they are influenced by television and magazines,
which are in fact the media most widely consumed by adolescents (Estudio
General de Medios, 2006; Roberts, Foehr, & Rideout, 2005).1
There are many ways to segment and organize the data on media
effects (see, e.g., Levine & Harrison, 2009; Levine & Murnen, 2009). We
have chosen to group the studies according to methodology because different designs have been employed for analyzing how exposure to media images and other messages influence females’ perceptions, attitudes,
and behaviors. Furthermore, we review those moderators and mediators
of media effects that to date have the strongest empirical support. Several recent reviews have addressed either the effects of media exposure
on body image and disordered eating (see, e.g., Grabe, Ward, & Hyde,
2008) or processes such as internalization of the slender beauty ideal that
moderate and/or mediate those effects (see, e.g., Cafri, Yamamiya, Brannick, & Thompson, 2005). However, to the best of our knowledge, this
is the first critical review to consider the nature and implications of media
effects as a function of both research design and the psychological processes
involved. Additionally, we present a figural summary that synthesizes the
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relationships among constructs as discussed in our review and in recent
meta-analyses.
CROSS-SECTIONAL STUDIES
Cross-sectional studies explore the concurrent association between exposure
to television (certain programs in particular) or fashion magazines and variables such as concerns about weight, body dissatisfaction, and disordered
eating behaviors. Magazines often show underweight models juxtaposed
with articles about how to lose weight and how to change body shape (Dohnt
& Tiggeman, 2006a; Harrison, 2000). Field, Cheung, et al.’s (1999) survey of
548 preadolescent and adolescent girls found that 69% acknowledged that
images in magazines had influenced their conception of the ideal body, while
47% reported that they wanted to lose weight after seeing such images. Interestingly, for regular readers of fashion magazines, the probability of going on
a diet or doing physical exercise to lose weight in accordance with the recommendations of a magazine article was two to three times greater than the
probability of similar weight management behaviors in non-regular readers.
The tendency of magazine articles and advertisements to activate weight
concerns and weight management behavior was also demonstrated in a
survey study of 4,746 adolescent boys and girls conducted by Utter et al.
(2003). Compared to girls who did not usually read fashion and glamour
magazines, girls who frequently read articles about diets and issues related
to weight loss were seven times more likely to practice a range of unhealthy
weight control behaviors and six times more likely to engage in the most
extreme unhealthy weight control behaviors (e.g., taking diet pills, vomiting,
using laxatives, and using diuretics). The data suggested that these articles
had a direct effect on unhealthy weight management behavior. Although
girls who read ‘‘diet articles’’ were indeed more likely to have low selfesteem, greater body dissatisfaction, and more depressive mood than the girls
who did not read them, none of these variables mediated the relationship
between reading diet-related material in magazines and unhealthy weightcontrol behaviors. It is important to stress, however, that the magazines
in question also appear to have a positive influence in promoting physical
activity (Field, Cheung, et al., 1999) and a balanced diet (Utter et al., 2003).
In general, cross-sectional studies show that the average amount of time
adolescent girls spend viewing appearance-focused media such as fashion
and glamour magazines, soap operas, and music videos is positively and
modestly correlated with body dissatisfaction, drive for thinness, internalization of the thin ideal, endorsement of surgery to attain a bust size that
is neither small nor too large, and bulimic symptomatology (Levine & Murnen, 2009). Yet, there is substantial variability in the survey-based empirical
findings, and there is conflicting evidence as to whether these relationships
Influence of Mass Media on Body Image
391
apply to non-White as well as White girls. The issue is difficult to resolve
because most studies are conducted with samples in which the vast majority
of participants are White women and girls (DeBraganza & Hausenblas, 2010;
Levine & Harrison, 2009; Levine & Murnen, 2009; Murnen, Levine, Smith, &
Groesz, 2007).
Thus, it is important to acknowledge, for example, that some studies of
adolescent samples have found no relationship between weight and appearance concerns and the variables of exposure to television, in general, as well
as to other electronic media. However, these same studies have found effects of exposure to certain genres of television programming. Borzekowski,
Robinson, and Killen’s (2000) study of 837 adolescent girls explored the
relationship between use of electronic media (watching television, watching
videos, playing on the computer and watching music videos) and both
perceived importance of one’s appearance and preoccupation with one’s
weight. The only statistically significant relationship was a weak association,
mediated by level of body fat and ethnicity, between hours spent watching
music videos and concerns about appearance and weight; this association
was strongest among the Black girls. In a study of nearly 100 Australian
adolescents ages 15 and 16, Tiggemann and Pickering (1996) failed to find
a significant association between amount of television watched and either
body dissatisfaction or drive for thinness. But amount of time spent watching
soap operas and movies was correlated significantly with body dissatisfaction, while time spent watching music videos was associated with drive for
thinness. These results are not surprising because music videos promote
high levels of sex-role stereotyping and feature attractive women while
focusing on physical appearances characterized by thin ideal and provocative
clothing.
In contrast to studies with adolescents, studies with children more consistently find a relationship between exposure to television and both disordered eating and preoccupation with physical appearance. For example, in
a study of 303 boys and girls with an average age of 7.45 years, Harrison
(2000) found that extent of television exposure was positively correlated
with disordered eating in both sexes. In addition, the greater the exposure
to television, the more likely that boys would negatively stereotype fat girls,
but not fat boys. Harrison (2000) concluded that both girls and boys, but
especially boys, can learn to denigrate fatness before learning to idealize
thinness.
It appears that television and magazines have different effects, perhaps
as a function of age and outcome variable (Grabe et al., 2008; Levine &
Harrison, 2009; Levine & Murnen, 2009). Tiggemann (2003) analyzed the
correlates of television and magazine exposure separately in a sample of
104 female Australian university students. As Tiggemann expected, extent
of reading fashion and beauty magazines was related to internalization of
the thin beauty ideal, which mediates the relationship between reading
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magazines and body dissatisfaction; both Stice’s (1994) Dual Pathway model
and Thompson, van den Berg, Roehrig, Guarda, and Heinberg’s (2004) Tripartite model of sociocultural influences also predicted such findings. In
contrast, the amount of television watched was directly related to body
dissatisfaction, with no evident relationship to internalization of the thin
beauty ideal; these results are consistent with those obtained in Harrison’s
(2000) study of children.
It seems that the underlying processes linking magazine reading to
body image are different from those linking television watching to body
image (Harrison 2000; Tiggemann, 2003). The complexity of this matter is
illustrated in a recent study by Dohnt and Tiggemann (2006a) that explored
peer and media influences on body image concerns and dieting awareness
in 128 girls ages 5 to 8 years old. Awareness of the thin ideal and the ways
of achieving this thin ideal occurs at early ages; 6 years of age was identified
as the likely age of onset for the desire for thinness. Those young girls
who spent more time looking at magazines aimed at adult women reported
greater dissatisfaction with their appearance. As important, the greater the
level of engagement with music television shows and appearance-focused
magazines, the stronger the level of dieting awareness.
More research is needed to verify and clarify the potentially important
distinction between television and magazine effects. Grabe et al.’s (2008)
meta-analysis did not find a difference in effect size for the relationship
between internalization of the thin ideal and magazine exposure (d D 0.37,
k D 14; see the note for Table 1 to interpret the effect size) versus television
exposure (d D 0.39, k D 7) or composite measures of media exposure (d D
0.33, k D 2), but this heterogeneity analysis did not distinguish between
survey-based (correlational) and experimental studies. Tiggemann’s (2003)
data are, however, consistent with Murnen et al.’s (2007) meta-analytic finding that the strongest relationship across media and criterion variables was
that between exposure to fashion magazines and internalization of the thin
beauty ideal, with moderate effect sizes (d D 0.42). Murnen et al. found
smaller but still statistically significant correlations (d’s D 0.04 to 0.18) for the
relationship between television exposure in general and criterion variables
categorized as thin-ideal internalization, body dissatisfaction, weight and
shape control, and disordered eating.
In summary, the weight of evidence from individual cross-sectional
studies and from meta-analyses (see Table 1) indicates that greater use of
the mass media—specifically fashion magazines and television music video
shows—is significantly correlated (with small to moderate effect sizes), with
higher levels of body dissatisfaction and with higher scores on eating disorder
components in females. Of course, such correlations do not legitimize any
conclusions about causality, although it is worth remembering that lack of
correlation means lack of a causal relationship. Consequently, we turn our
attention to experimental and longitudinal, prospective studies.
TABLE 1 Published Meta-Analyses Reviewing the Effects of Media Exposure and Media Influence on Body Image and Disordered Eating in Females
Objective
Main characteristics
of studies revised
Main results
Cafri et al.
(2005)
To assess the relationship between
three sociocultural factors—
Internalization of a thin ideal (I),
awareness of a thin ideal (A),
and perceived pressures to be
thin (PP)—and body image
22 correlational studies; 7,079
participants for (I); 4,742
for (A); and 1,998 for (PP).
Average age ranged from
10.25 to 26.50. Time
period: 1990 to 2005
Effects on body image of:
! Internalization of a thin ideal: Moderate to large effect.a Age and ethnicity had nonsignificant
effects as a moderators
! Awareness of a thin ideal: Moderate effect.a Age and ethnicity had nonsignificant effects as a
moderators
! Perceived pressures to be thin: Moderate to large effect.a
Grabe et al.
(2008)
To examine experimental and
correlational studies testing the
links between media exposure
and three criteria: women’s body
dissatisfaction, internalization of
the thin ideal, and eating
behaviors and beliefs
77 studies; 15,047
participants. Time period:
1975 to January 2007
Effect of media exposure on:
! Body image dissatisfaction: Small effect.a Moderator analyses were not warranted.
! Internalization of the thin ideal: Small effect.a Larger effects were found in the correlational
literature than in the experimental literature, and for studies published in the 2000s compared
with those in the 1990s. Type of media exposure was nonsignificant as moderator.
! Eating behaviors and beliefs: Small effect.a Slightly stronger effects were found for adults (age
>19) than for adolescents (age 10–18), and for generalized media use as opposed to television
or magazine use. Much stronger effects found for published versus unpublished manuscripts.
Groesz et al.
(2002)
To assess the effect of experimental
manipulations of the thin beauty
ideal, as portrayed in the mass
media, on females’ body image
25 experimental studies;
2,292 participants. Time
period: 1983 to 2000.
Effect of media exposure on:
! Body image was significantly more negative after viewing thin media images than after viewing
images of either average size models, plus size models, or inanimate objects. Small effecta.
Stronger effects were observed for participants who were vulnerable to activation of a thinness
schema versus who were not, and for participants less than 19 years of age versus 19 and over.
Holmstrom
(2004)
To examine the effects of media on
body image
34 studies (21 experimental
and 13 correlational); 5,843
participants. Average age
ranged from 9 to 26.5.
Time period: 1990 to
January 2002.
Effect of media exposure on:
! Body image: Null effect.a,b There was virtually no difference in effect size between
experimental and survey studies. Effects of possible moderators as media measures (magazine,
photo, television, mass media, movies, and computer), comparison stimuli in experimental
studies (average weight women, overweight women, nonhuman images) or length of exposure
in experimental studies were conducted, but the small number of studies in each category calls
into question their validity.
Study
393
a Criteria
proposed by Cohen (1988) for evaluation of effect sizes: 0.2 (d) or 0.1 (r) indicates a small effect; 0.5 (d) or 0.3 (r) a moderate effect; and 0.8 (d) or 0.5 (r) a large effect.
Groesz et al. (2002) review was conducted exclusively with experimental research; reviews by Grabe et al. (2008) and by Holmstrom (2004) combined experimental and cross-sectional
research. Of the 77 studies included in Grabe et al. (2008), 18 overlapped with the 25 studies included in Groesz et al. (2002) review (72% overlapping)—both found a significant association
and the final average effect size was similar, suggesting a robust finding. In contrast, Holmstrom’s (2004) review of 34 studies failed to replicate this association. In this review, 24 studies
(70.5%) overlapped with Grabe et al. (2008) and 16 (65%) with Groesz et al. (2002). Interestingly, Holmstrom’s review (the only one of the four that did not support a solid association
between media, body image, and disordered eating) came from the mass communication research field.
b
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G. López-Guimerà et al.
EXPERIMENTAL STUDIES
Reviews of Laboratory Research
Groesz, Levine, and Murnen (2002) carried out a meta-analysis of 25 experimental studies that assessed the effects on ‘‘state’’ body satisfaction in girls
and women of controlled exposure to portrayals of the thin beauty ideal
in media photographs or video (e.g., television commercials). In general,
immediate ratings of body satisfaction become significantly lower after a
female sees images of the thin beauty ideal than after she sees images of
women with average weight, women with fat bodies, or inanimate objects.
The effect sizes found were low to moderate (d D 0.31), becoming moderate
to high (d D 0.50) in the samples of adolescent girls and women with a
previous history of body dissatisfaction or eating disorders. The effect was
also slightly more pronounced in girls under age 19 (d D 0.36).
A recent meta-analysis by Grabe et al. (2008) located an additional 19
experimental studies of magazine-based images, as well as 8 more experimental studies of the immediate effects of controlled presentations of images
from television shows and commercials. The extent of the effect size for the
now larger sample of experimental studies has to be inferred, however, for
the following reason: Grabe et al. reviewed a total of 77 studies and in their
analysis considered the type of design (experimental vs. correlational) as
a moderator variable. The effect size for the relationship between media
and body dissatisfaction for all studies (correlational and experimental) was
d D 0.28 (k D 90). However, because significant heterogeneity was not
present, moderator analyses, including study design, were not warranted.
Grabe et al. also reported that, although there was substantial heterogeneity,
the ds for experimental effects (across magazines, television, and media in
general) on internalization and on eating behaviors and beliefs were 0.21
and 0.36, respectively. With respect to heterogeneity of media effects, it is
worth noting also that, in several experimental studies with samples of high
school girls and college women, a significant minority of females who were
exposed to images of attractive models from magazines exhibited an increase
in state body satisfaction. In this regard, one meta-analysis of a mixture of
experimental and cross-sectional studies failed to find a relationship between
media exposure to thin images and body image (Holmstrom, 2004).
External Validity
Experimental designs implemented in laboratory contexts are open to the
criticism of having low external validity in part because the typical experiment arranges for only brief exposures to the target stimuli, followed
by assessment of short-term (‘‘state’’) effects. Thus, researchers conducting
experiments are, typically, only able to speculate about the cumulative,
Influence of Mass Media on Body Image
395
‘‘dispositional’’ effects of media influence over the long term. To address
this concern, Hargreaves and Tiggemann (2003) examined the long-term
effects of exposing a group of 17-year-old Australian girls to 20 television
commercials (30 seconds each) that showed actresses representative of current thinness and beauty ideals. Those girls who had the highest levels of
‘‘state’’ body dissatisfaction immediately after seeing the ads tended to have
the highest levels of ‘‘trait’’ body dissatisfaction and of desire for thinness
2 years later. Hargreaves and Tiggemann argued that the negative shortterm effects observed in laboratory contexts may represent a marker for
subsequent vulnerability to sociocultural pressure to be thin. These findings
are indeed consistent with sociocultural models of disordered eating, but
they need to be replicated with larger and varied samples and so should be
interpreted with caution, as the sample size was small.
The important issue of external validity was also addressed by Stice,
Spangler, and Agras (2001). These researchers constructed an unusual naturalistic experiment for assessing long-term effects of exposure to media
images of the thin beauty ideals on body dissatisfaction, negative affect,
internalization of the thin beauty ideal, restrictive dieting, and bulimic symptoms. Capitalizing on the design of a separate risk factor study, Stice et al.
randomly assigned 219 adolescent girls to a condition in which each received
a prize of a subscription to a fashion magazine for 15 months, or to a
nonsubscription condition. At 20-month follow up, there were no significant differences between the experimental and control conditions in any
of the dependent variables. However, those girls who received the fashion
magazine and who initially reported lower levels of social support showed
a significant increase in body dissatisfaction, dieting, and bulimic symptoms.
These findings may reflect the interaction, or transaction, between the immediate social environment—family and peers—and the impact of mass media
on internalization of the thin beauty ideal and, in turn, on body dissatisfaction
(see Levine, Smolak, & Hayden, 1994; Smolak & Levine, 1996). As Stice et al.
(2001) suggest, ‘‘perhaps exposure to thin ideal images does not produce
negative effects for adolescents who feel accepted in their immediate social
environment’’ (p. 285).
Another naturalistic study relevant to external validity was conducted
by Becker, Burwell, Gilman, Herzog, and Hamburg (2002), who examined
the impact of television on disordered eating attitudes and behaviors in a
sample of adolescent girls from the Pacific islands of Fiji.2 These researchers
observed that 3 years after television reception became widespread, 11.3%
of girls reported having vomited with the aim of controlling their weight,
compared to 0% before the advent of television on the islands. Likewise,
the percentage of girls with high levels of disordered eating attitudes more
than doubled during this period, rising from 13% to 29%. Further, once
television had been introduced, 74% of girls reported ‘‘feeling fat,’’ and those
with television at home were three times more likely to present disordered
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G. López-Guimerà et al.
eating attitudes. It is interesting to note that the traditional Fijian cultural
aesthetic reflects a preference for robust bodies, and certainly does not
endorse individual efforts to shape the body through diet or exercise. Becker
et al.’s study strongly suggests that mass media, and especially television,
not only have a substantial impact on adolescents, but exert their influence
within a short space of time, despite the traditional values of a given culture
(see also Bilunka & Utermohlen, 2002, for an example in the Ukraine).
In brief, findings from experimental studies indicate that exposure to
images of the thin beauty ideal featured in the media—and particularly
in magazines, television shows and commercials—increases body dissatisfaction, internalization of thin ideal, and disordered eating behaviors and
beliefs. Effect sizes are small to moderate. However, there are some factors
that seem to moderate this effect. These include prior body dissatisfaction
and internalization of the slender beauty ideal, as well as low social support
from peers and family, and age. To further summarize and organize the
principal findings from both cross-sectional and experimental studies, Table 1
presents the findings of the four published meta-analysis to date that have
reviewed the effects of media exposure on body image and disordered eating
in females (see Barlett et al., 2008, for a parallel review of media effects in
males). Three publications examined the specific effects of media exposure
on body image (Grabe et al., 2008; Groesz et al., 2002; Holmstrom, 2004),
whereas the other (Cafri et al., 2005) examined the impact of individual
variables that mediate the effects of media, most notably internalization of a
thin ideal. In general, the effect sizes reported by Cafri et al. are larger than
the others, highlighting the great importance of moderating variables and of
individual variables and mediator processes in how body image is influenced
by media (see also Dittmar, Halliwell, & Stirling, 2009). We will return to the
issue of mediators and moderators of media effects in the sections addressing
‘‘processes’’ and moderators, including ethnicity.
Media Literacy
If media exposure and its potential effects are a causal risk factor, then
experimental use of ‘‘media literacy’’ techniques and programs to reduce
or eliminate negative media influences should eventually reduce or prevent
negative body image and other processes that eventually result in eating
disorders. Literature on the nature of media literacy and on its effects has
recently been reviewed in detail elsewhere (see, e.g., Levine, 2009; Levine
& Murnen, 2009; Levine & Smolak, 2006, ch. 13). Briefly, the findings of laboratory studies, both brief, in vivo interventions and longer, more intensive
programs, are promising but inconclusive. To date, there have been no direct,
well-controlled, long-term studies of whether media literacy in particular can
prevent development of negative body image and the spectrum of disordered
eating. We can with confidence state that (a) brief training in media literacy as
Influence of Mass Media on Body Image
397
a critical social perspective can mitigate the immediate (or ‘‘state’’) negative
effects of exposure to the thin ideal; and (b) more systematic, intensive
interventions over days or weeks can significantly reduce one important
dispositional risk factor: internalization of the thin beauty ideal.
LONGITUDINAL PROSPECTIVE STUDIES
If X (e.g., media exposure) is a variable and causal risk factor for criterion
variable Y (e.g., negative body image), then two criteria should be met:
X should precede Y, and X (at Time 1) should predict subsequent changes
in level of Y (i.e., the level of Y at Time 2, controlling for level of Y at Time 1;
Kraemer et al., 1997; Stice, 2002). In other words, longitudinal prospective
studies are a very important aspect of exploring the causal status of a possible
risk factor, especially given the necessity (for the required statistical power)
of a large sample and a long follow up (Field, 2004). However, very few
studies in this field have approached fulfillment of such conditions. Given
the relevance of this type of design, Table 2 presents the main characteristics
and findings of the most important longitudinal studies.
Over a period of 3 years, The McKnight Investigators (2003) assessed
potential risk factors for eating disorders in a sample of 1,103 girls who
were initially ages 10–15. The self-reported influence of mass media, which
formed part of a multidimensional factor called ‘‘thin body preoccupation
and social pressure,’’ predicted the onset of eating disorders in young girls
3 years later, when all were in high school (note that ethnicity moderated
this relationship, depending on the study site; see Table 2). This finding is
supported by a more recent longitudinal study. In a sample of over 1,300 girls
in middle school and high school, those who ‘‘sometimes’’ or ‘‘often’’ read
‘‘magazine articles in which dieting or weight loss are discussed’’ (p. 32)
were twice as likely to be engaged in unhealthy weight-control behaviors
and three times as likely to be engaged in extreme weight-control behaviors
5 years later, even when initial weight-control behaviors, weight importance,
demographic features, and body mass index were statistically controlled (van
den Berg, Neumark-Sztainer, Hannan, & Haines, 2007).
A research team that included one of the principal McKnight investigators (C. B. Taylor) conducted three longitudinal studies with a sample of
nearly 7,000 girls aged 9 to 14 (Field, Camargo, Taylor, Berkey, & Colditz,
1999; Field, Camargo, Taylor, Berkey, Roberts, et al., 2001; Field, Javaras,
et al., 2008). Regardless of initial age and BMI level, at one-year followup girls who consciously tried to look like the female ideal presented on
television, in films, or in magazines were 1.6 to 1.9 times more likely to have
concerns about their weight, to be continually dieting, and/or to be ‘‘hooked’’
on purging behaviors. At 7-year-follow-up females of all ages who were
trying to look like females in the media were 1.5 times more likely to start
TABLE 2 Representative Prospective Studies of Media Effects on Body Image and Disordered Eatinga
Study
N
Age range
(mean at baseline)
Follow up
Media type
Main results
218 girls
16–18
9 months
Television and
magazines
Media social reinforcement prospectively did not predict the onset of binge eating and
purging. Media modeling of abnormal eating behavior was not associated with
concurrent bulimic symptoms and did not predict the onset of binge eating and purging.
Field,
Camargo,
et al. (1999)
USA
6982 girls
9–14
1 year
Television, movies
and magazines
Independent of age development, trying to look like females on television, in movies, or
in magazines was predictive of beginning to purge at least monthly.
Field et al.
(2001) USA
6770 girls
5287 boys
9–14
1 year
Television, movies
and magazines
Independent of age and body mass index, both girls and boys who were making a lot of
effort to look like same-sex figures in the media were more likely than their peers to
become very concerned with their weight.
Girls who were making greater efforts to look like females in the media were more likely
than their peers to become constant dieters.
MartínezGonzález
(2003) Spain
2862 girls
12–21
18 months
Television, girls’
magazines, radio
Frequently reading girls’ magazines or listening to radio programs was related to a higher
risk of eating disorder onset at the beginning of follow up. No association was found for
television viewing.
The McKnight
Investigators
(2003) USA
1103 girls
6th–9th grade
(11–15)
3 years
‘‘Media modeling’’
in general
Higher scores on the multidimensional factor thin body preoccupation and social pressure
measuring concerns with weight, shape, and eating (including media modeling, social
eating, dieting, and weight teasing) significantly predicted onset of eating disorders in
young women.
Being Hispanic moderated the onset of eating disorders at the Arizona but not the
California site.
In the Hispanic sample, a risk factor for new-onset eating disorders cases was thin body
preoccupation and social pressure.
In the non-Hispanic sample, only thin body preoccupation and social pressure was
significantly related with new-onset eating disorders cases.
398
Stice (1998)
-Study 2USA
(continued)
TABLE 2 (Continued)
Study
N
Age range
(mean at baseline)
Follow up
Media type
Main results
399
Presnell et al.
(2004) USA
293 girls
238 boys
16–19 (17)
9 months
Media in general
Elevations in perceived pressure to be thin from media did not predict increases in body
dissatisfaction.
McCabe &
Ricciardelli
(2005)
Australia
236 girls
207 boys
8–12 (9.24 girls/
9.26 boys)
16 months
Television
Perceived pressures from the media to lose weight predicted body dissatisfaction only
among boys.
Perceived media messages to lose weight predicted strategies to decrease weight only for
boys.
The media played the strongest role in shaping strategies to increase muscle among girls,
with perceived media messages to lose weight in the long term predicting strategies to
increase muscle.
Dohnt &
Tiggemann
(2006b)
Australia
97 girls
5–8 (6.91)
1 year
Appearance-focused
television shows
(or magazines)
Watching appearance-focused television programs (but not reading appearance-focused
magazines) prospectively predicted appearance satisfaction.
Harrison &
Hefner
(2006) USA
257 girls
2nd–4th grade
(8.72)
1 year
Television and
magazines
Controlling for age, race, perceived body size, and body ideals and disordered eating
measured at Time 1, television viewing at Time 1 (but not reading health and fitness
magazines, fashion magazines, or sports magazines) predicted increased disordered
eating and a thinner future body ideal at Time 2.
None of the media variables predicted a thinner current body ideal at Time 2.
van den Berg
et al. (2007)
USA
1386 girls
1130 boys
7th–12th grade
(12–18)
5 years
Magazines
For females adolescents, independent of weight-control behaviors, weight importance,
body mass index, and demographic covariates, the most frequent readers (compared
with those who did not read) of magazine articles about dieting and weight loss were at
significantly higher risk for engaging in unhealthy and extreme weight-control
behaviors. Being a frequent reader of these magazines was not associated prospectively
with binge eating in either girls or boys.
Those females who ‘‘sometimes’’ or ‘‘often’’ read ‘‘magazine articles in which dieting or
weight loss are discussed’’ were twice as likely to be engaged in unhealthy
weight-control behaviors five years later, even when initial behaviors, demographic
features, and body mass index were statistically controlled.
There were no significant associations for either weight-control behaviors or psychological
outcomes for male adolescents.
Field et al.
(2008) USA
6916 girls
5618 boys
9–15
7 years
Television, movies
and magazines
Trying to look like persons in the media was a predictor of starting to purge and binge
eating among females of all ages, but not among boys.
a This
table presents only results pertaining to media effects on body image and disordered eating. For more detailed results related with other variables studied, see the original studies.
400
G. López-Guimerà et al.
purging and 2.2 times more likely to binge eat (Field, Javaras, et al., 2008).
This is one of the few studies published in the field of eating disorders that
collected data over a very long period of time and in a very large sample.
Similarly, a study of almost 3,000 Spanish girls and young women ages 12
to 21 assessed over a period of 18 months found that frequent readers of
fashion magazines for adolescents were 2.1 times more likely to develop
an eating disorder (Martínez-González et al., 2003). Interestingly, although
no significant relationship was found between the number of hours they
watched television and risk of an eating disorder, a significant relationship
was indeed observed between listening to the radio for more than an hour
a day and the risk of developing such disorders. Martínez-González et al.
noted, as a possible explanation of these results, that radio programs transmit
many messages, primarily through advertising, in relation to ‘‘the perfect
figure’’ and how to achieve it.
In contrast to the findings in Martínez-González et al.’s (2003) survey of
adolescents and young adults, early exposure to thin-ideal television appears
to predict subsequent increases in body image problems. In a study of
Australian girls ages 5–8, Dohnt and Tiggemann (2006b) found that the
number of appearance-focused television programs (but not appearancefocused magazines) viewed predicted a decrease in appearance satisfaction
one year later. A one-year longitudinal study with 257 preadolescent girls
(Mage D 9 years) found that exposure to television, but not to magazines,
predicted a significant increase in disordered eating (Harrison & Hefner,
2006). According to the researchers, the fact that children watch far more
adult-oriented television than they read adult-oriented magazines helps explain why studies carried out in preadolescent populations (although these
are extremely scarce) yield a different pattern of results than do studies
of adolescent and young adult populations, for whom magazines are the
media format that most influences the internalization of the thin beauty
ideal. It is also very likely that adolescents and young adult females, for
various developmental reasons, are more inclined to engage in the important
mediating process of social comparison (Levine & Smolak, 1996; Thompson,
Heinberg, et al., 1999; Tiggemann, Polivy, & Hargreaves, 2009; Trampe,
Stapel, & Siero, 2007).
In thinking about media influences, it is important to note that longitudinal, prospective studies with much smaller samples (typically around 300
preadolescent and adolescent girls) suggest that the messages transmitted
by parents (especially mothers) and by friends (primarily same-sex friends)
have more influence on awareness and internalization of the thin beauty
ideal and on body dissatisfaction and unhealthy weight-control behaviors
than do mass media (McCabe & Ricciardelli, 2005; Presnell, Bearman, &
Stice, 2004; Stice, 1998). In terms of social cognitive theory, this may be
due to the fact that proximal messages transmitted directly and indirectly
by people who are important to these girls (e.g., mothers and friends)
Influence of Mass Media on Body Image
401
are given priority over more distal images and messages; that is, women
in mass media are seen as more symbolic and may not be as personally
significant for these girls. These ‘‘models’’ are not as ‘‘immediate a presence’’
or are dissimilar in ways that lower their value for observational learning and
as ‘‘standards’’ for social comparison (Levine & Smolak, 1996, 2006; Sands
& Wardle, 2003; but see Jones, Vigfusdottir, & Lee, 2004). However, this
explanation does not exclude the influence, albeit indirect, of the media,
since messages conveyed and reinforced by communications from peers
and family probably reflect messages they have assimilated from the media
(Levine & Harrison, 2009).
In summary, longitudinal studies indicate that the greater exposure to
the messages conveyed by media, particularly those that transmit messages
in relation to thin ideal and how to achieve it from magazines, television, and
radio, the more likely females are to develop disordered eating behaviors
and concerns about weight (see Table 2). As is the case for cross-sectional
(correlation-based) and experimental studies, effects appear to depend to
some extent on the type of media in interaction with age. Specifically,
television has a stronger effect on children, whereas magazines are more
influential for adolescent and adult females. Peers and family also appear to
act as moderating variables of this effect.
PROCESSES
Research on the effects of the media on body satisfaction and on eating
attitudes and behaviors has increased substantially in recent years, yet much
work remains to be done in order to clarify the processes through which
media exercise their influence (see Dittmar, 2009; Harrison & Hefner, 2008;
Levine & Harrison, 2009; Levine & Murnen, 2009; Tiggemann & McGill, 2004).
We do know that the process as a whole is not subliminal, although certain
aspects (e.g., activation of social comparison and of self-target discrepancies)
may be automatic (Levine & Harrison, 2009). Tiggemann and colleagues in
Australia (e.g., Tiggemann & Slater, 2004) have shown that music videos,
which are saturated with salient (supraliminal ) visual images and auditory
cues pertaining to appearance, gender, sexuality, and objectification, are
particularly potent activators of body dissatisfaction. A considerable amount
of data indicates that the negative impact of media images depends on the
conscious and, in many instances, cumulative processing of unambiguous,
direct, and ‘‘attractive’’ social messages (Harrison & Hefner, 2008; Levine &
Harrison, 2009).
In the fields of body image and eating disorders, it is postulated that
there are at least three processes that mediate the relationship between the
media, body dissatisfaction, and disordered eating behaviors and moderate
media effects on these variables. These processes are: internalization of the
402
G. López-Guimerà et al.
thin beauty ideal; social comparison; and activation of the thin-ideal schema
(Dittmar et al., 2009; Halliwell & Dittmar, 2005; Levine & Harrison, 2009;
Tiggemann et al., 2009; Trampe et al., 2007). Even so, and despite the
fact that progress is being made (see, e.g., Dittmar et al., 2009; Vartanian,
2009), knowledge is still lacking on the number and the time sequence of
major processes, their order of importance, and how they mediate as well as
moderate the impact of various sociocultural factors, including mass media.
Two new processes, the ‘‘activation of weight-shape-related self-ideal discrepancy’’ (Dittmar et al., 2009; Harrison & Hefner, 2008) and ‘‘self-concept
clarity’’ (Vartanian, 2009), are being considered as possible mediating and
moderating processes, and preliminary evidence indicates that these are
deserving of further research attention.
Internalization of the Thin Beauty Ideal
Stice’s (1994; Stice, Nemeroff, & Shaw, 1996) Dual-Pathway Model of bulimia nervosa and Thompson et al.’s (2004) Tripartite Model of disordered
eating both propose that internalization of the thin beauty ideal mediates
the relationship between exposure to the media (and other sociocultural influences) and resultant body dissatisfaction and disordered eating symptoms
(see also Thompson & Stice, 2001). In this regard, it is noteworthy that several
experimental studies in Great Britain and the United States have found that
only ‘‘high internalizers’’ experience heightened body dissatisfaction (Dittmar
et al., 2009; see Levine & Murnen, 2009, for a review).
Consistent with these sociocultural models, a study of 14- to 16-yearold Swiss girls by Knauss, Paxton, and Alsaker (2007) found that perceived
pressure from the media, internalization of the thin beauty ideal, and body
dissatisfaction were highly inter-correlated (all r s > .60). Jones et al.’s (2004)
cross-sectional study of adolescents ages 11–14 revealed that girls, as compared with the boys, were more invested in appearance-oriented magazines, were more likely to internalize the beauty ideals in them, and had
greater body dissatisfaction. In fact, for girls, exposure to appearance-related
magazines and to appearance conversations by peers each predicted body
dissatisfaction through the mediator of internalization of the thin beauty ideal.
The path analytic model for girls explained 48% of the variance in body
dissatisfaction.
These studies reflect a robust finding. Cafri et al.’s (2005) meta-analysis
(see Table 1) of 31 effect sizes from 18 studies found an r of .50 (d D 1.15) for
the correlation between thin-ideal internalization and negative body image
(see also Stice, 2002). This is considered a large effect according to Cohen’s
(1988) criteria, and it is significantly greater than the r of .29 (d D 0.61, based
on 25 effect sizes) for awareness of the thin ideal. Engeln-Maddox (2006)
found that young women who have a clear and strong expectation that
looking like a media ideal would transform their lives in multiple, positive
Influence of Mass Media on Body Image
403
ways, and who have internalized the media ideal of thin beauty tended to
have greater levels of body dissatisfaction.
Krones, Stice, Batres, and Orjada (2005) have argued that internalization
of the thin beauty ideal promotes body dissatisfaction specifically through
the process of social comparison. Along similar lines, research assessing
Thompson et al.’s (1999, 2004) tripartite influence model has found that both
internalization of the thin beauty ideal and social comparison mediate the relationship between sociocultural influences (parents, peers, and media) and
body dissatisfaction and disordered eating behaviors (Shroff & Thompson,
2006; van den Berg, Thompson, Obremski-Brandon, & Coovert, 2002). However, it remains unclear whether the two processes operate simultaneously
or whether one precedes the other.
Two provocative studies in this regard were recently conducted by
Vartanian (2009). American college females who reported an unstable, poorly
defined sense of self were more likely to report internalization of the thin
beauty ideal and, in turn, greater levels of negative body image and dieting
concerns. Moreover, as predicted, it appears that such low ‘‘self-concept
clarity’’ makes young women more prone to public self-consciousness and
conformity to social norms. Although it remains to be tested, it follows from
Vartanian’s (2009) work that low self-concept clarity would predispose one
to both heightened social comparison processes and internalization of the
thin beauty ideal, acting, possibly, as a moderator of the effect of media
exposure.
In two recent, well-controlled studies, Dittmar et al. (2009) demonstrated
that young women who had already internalized the thin beauty ideal were
the only participants to exhibit increased negative affect concerning their
bodies following exposure to the thin beauty ideal. Not only was internalization of this ideal a potent moderator of the classic contrast effect, this effect
was fully mediated by activation of weight-related self-ideal discrepancy and
was not dependent on whether the context of exposure emphasized the
thinness of the models. The latter finding was consistent with previous research by Dittmar and colleagues (reviewed in Dittmar et al., 2009) indicating
that internalizers will activate concerns about the self-ideal discrepancy even
when they are not paying a great deal of attention to slender models.
Social Comparison Processes
Social comparison theory, originally formulated by Festinger (1954), refers to
people’s tendency to compare themselves to others with respect to certain
attributes, especially when the characteristics (e.g., beauty or sexiness) are
important and the relevant standards or criteria for evaluation are ambiguous
(Trampe et al., 2007). Applied to the context of media, self-perception of
attractiveness, and body image, social comparison denotes the process in
which women compare themselves with the idealized, symbolic images, and,
404
G. López-Guimerà et al.
on finding that they ‘‘fail’’ to meet the social and cultural standards, show increased body dissatisfaction. For example, Hargreaves and Tiggemann (2004)
exposed Australian girls ages 13–15 to a long series of television commercials
depicting either idealized images or performers of ‘‘normal’’ appearance. As
predicted, girls who viewed images of the thin ideal were significantly more
likely than girls in the control condition to compare their own appearance
to that of the women in the commercials and to react to the images with
negative feelings. Experiments conducted in Great Britain by Dittmar and
Howard (2004) and by Halliwell and Dittmar (2004) demonstrated that it
is the thinness of fashion models, not their attractiveness, that accounts for
thin-ideal media’s immediate negative effects on body image in girls.
There is apparently a very complex interplay between the potential standard for comparison (i.e., the social stimulus), the perceiver’s self-concept,
the inclination toward and process of social comparison, and the impact of
mass media, as well as other sociocultural factors (see Levine & Smolak,
1996; Tiggemann et al., 2009; Vartanian, 2009). For example, a marketing
research study by Richins (1991) found that if consumers, specifically women,
consider professional models as a separate category, there were no changes
in their conception of beauty after seeing the ads. On the other hand, if
female consumers considered the professional models to represent in some
way the possibilities for a majority of women (Thompson & Heinberg, 1999),
then they showed the standard post-exposure contrast effect (see Grabe
et al., 2008; Groesz et al., 2002), at least temporarily, in the way they more
negatively judged themselves and the rest of the population (Richins, 1991).
Women and adolescent girls who tend to compare themselves with
the beauty ideals represented in the media—and in peers, family, and even
strangers—are more likely to show greater body dissatisfaction and disordered eating behaviors than those who tend not to involve themselves in
the process of social comparison, especially if the tendency is to compare
oneself ‘‘upward’’ against people whom society would tend to consider more
attractive (O’Brien et al., 2009; Thompson, Heinberg, et al., 1999). A recent
series of studies by Trampe et al. (2007) focused on undergraduate women
who were already dissatisfied with, and presumably self-conscious about,
their own bodies. As predicted, these women tended to compare their appearance to a wide range of body-shape standards, including other students,
fashion models, and celebrities. Further, relative to women who tended to be
more satisfied with their own bodies, the women with high levels of body
dissatisfaction were, as predicted, negatively affected by exposure to and
comparison with thin, physically attractive people, whether that person was
portrayed as a model or not. In fact, the women with negative body image
reported increased (‘‘state’’) body dissatisfaction after seeing a drawing of a
thin vase versus a fatter, rounded vase. It is possible that these women have
a poorer self-concept—and lower self-concept clarity (Vartanian, 2009)—
underlying their negative body image.
Influence of Mass Media on Body Image
405
Trampe et al.’s (2007) findings suggest that the tendency of women
with higher levels of body dissatisfaction to make broad and unhealthy social
comparisons reflects the fact that their body-relevant self-schema (Hargreaves
& Tiggemann, 2002), or their self-schema (self-consciousness) in general
(Vartanian, 2009), is activated more readily. However, ‘‘the process through
which girls and boys determine the need to make social comparisons, select
the targets, make the comparisons and assess the information available, is
an area of great importance for future research on the effects of the media’’
(Levine & Harrison, 2004, p. 700; see also Trampe et al., 2007).
Schema Activation
Social cognitive and cognitive behavioral theorists have cataloged the various
direct and indirect ways that people receive information—from the media,
parents, peers, coaches, to name but a few—about beauty, food, eating,
weight control, and other aspects related to physical appearance. In the
process of making meaning and of learning predictive relationships, such
information is distilled and arranged into a schema, that is, a mental structure
that helps people to organize their interactions with the world in a stable
and consistent fashion (see Levine & Smolak, 2006, ch. 6). Based on media
messages, gender socialization research, and studies of the psychopathology
of eating disorders, Smolak and Levine (1994, 1996; Levine & Smolak, 1996,
2006) have proposed that, beginning as early as middle childhood, girls form
a ‘‘thinness schema.’’ This cognitive structure, which is certainly connected
to and affected (cathected) by emotion-inducing memories and conclusions,
is a combination of information and beliefs referring to the self and one’s
self-worth, and to information extracted from sociocultural influences.
According to this schema theory, to a greater or lesser degree, females
are likely to embrace beliefs, memories, assumptions, and feelings revolving
around ‘‘ideas’’ such as (a) beauty constitutes the primary goal in a woman’s
life; (b) a slim body is a fundamental component of beauty, physical health,
success, and happiness; (c) by nature, women feel anxiety, shyness and
shame in relation to their bodies; (d) women can transform and renew
themselves thanks to the technology of fashion, dieting, and exercise; and
(e) fatness reveals a loss of personal control and is a sign of failure (see
Levine & Smolak, 2006). Mass media are presumed to play a role in both the
constitution of the schema and its activation once it is formed. As Dittmar
et al. (2009) indicate, the results of their study of ‘‘internalizers’’ and weightrelated self-discrepancies can be interpreted in terms of schema activation.
Images of slender models activated self-focused, negative thoughts about
the gap between one’s self-perceived body image and the cultural ideals
(see also Harrison & Hefner, 2008). In a self-perpetuating but ultimately selfdefeating process, internalizers of the thin beauty ideal are cognitively and
emotionally predisposed to ‘‘think ideal, feel bad,’’ and yet still ‘‘think ideal.’’
406
G. López-Guimerà et al.
One aspect of the ‘‘thinness schema’’ that is recognized by the American Psychiatric Association’s (2000) criteria for an eating disorder is the
‘‘undue influence of weight and shape on self-evaluation’’ (see Criterion C,
p. 589; and Criterion D, p. 594). In a study of Australian girls, ages 15
through 18, Hargreaves and Tiggemann (2002) found that, compared to
control conditions, appearance-focused commercials did indeed produce
greater activation of appearance-related self-schema. With regard to schema
as a moderator, these commercials also generated more overall appearance
dissatisfaction for those girls who began the study with a more extensive,
emotionally charged, appearance-related self-schema. With respect to mediation, the negative (contrast) effect of the thin beauty ideal on girls’ appearance satisfaction was partially mediated by schema activation.
CONCLUSIONS
Based on this review and other, related analyses (see, e.g., Harrison &
Hefner, 2008; Hogan & Strasburger, 2008; Levine & Harrison, 2004, 2009;
Levine & Murnen, 2009; Thompson & Heinberg, 1999; Thompson et al.,
1999) we can state the following with a fair degree of confidence: Mass
media are an extremely important source, if not the principal source, of
information and reinforcement in relation to the nature of the thin beauty
ideal, its importance, and how to attain it. Figure 1 provides a visual synthesis
of the relationships between the constructs discussed in this review. Our
intent is to stimulate further modeling of media effects and to summarize
potential causal pathways that have a theoretical basis, that are supported
by empirical findings, and that have meaningful implications for prevention
and perhaps treatment.
There is still a good amount of research remaining, but evidence is
accumulating that repeated exposure to media and to both the direct and
indirect (via media’s effects on peers, parents, physicians, etc.) pressure from
media to be thin constitute a risk factor for body dissatisfaction, concerns
over weight, and disordered eating behaviors in adolescent girls and young
women. Relatively little research has addressed the intersection of sociocultural factors, but it appears that a confluence of media, family, and peer
factors increases the substantial risk posed by media alone (Levine et al.,
1994; Jones et al., 2004).
The impact of media depends on a number of source and receiver/
perceiver factors, including, most prominently, ethnicity and as yet poorly
understood developmental factors. Research to date indicates fairly consistently that, relative to watching television in general (except music video
shows), reading fashion and ‘‘glamour’’ magazines seems to have a greater
influence, for adolescent girls and young women, on internalization of the
thin beauty ideal, on body dissatisfaction, and on disordered eating behav-
Influence of Mass Media on Body Image
407
FIGURE 1 Model of the mass media as a risk factor for body dissatisfaction, weight
concerns and disordered eating behaviors. Variables that appear to moderate are age (and/or
developmental status), self-esteem, ethnicity, parents, peers, and media type. Variables that
appear to mediate are contained under ‘‘Processes.’’ The processes in bold have considerable
empirical support, whereas the process in italics and in smaller text has some support but is
in need of further investigation.
iors. Conversely, in children, television in general appears to have more
influence than magazines, probably because children watch more adultoriented television (and movies) than they read adult-oriented magazines and
are more able and motivated to process (and internalize) the salient messages
about gender, weight, shape, and such, that television so readily provides
(Harrison & Hefner, 2008; Levine & Murnen, 2009). Internalization of the
thin beauty ideal, social comparison, and activation of the thinness schema
are clearly among the processes which mediate the effects of the media on
body dissatisfaction, weight concerns and disordered eating behaviors.
Furthermore, there are some variables that seem to moderate media
effects. Girls and women who already show greater internalization of the thin
beauty ideal, who already tend to compare themselves with ideal figures,
who have formed the thinness schema and, therefore, show greater body
dissatisfaction or disordered eating, are more likely to respond negatively
to the media content we have been discussing. Sadly, they also appear to
be more motivated to seek out mass media for guidance and inspiration
408
G. López-Guimerà et al.
and self-evaluation. This paradox is particularly important when thinking
about the resources of the World Wide Web, including pro-anorexia Web
sites and the efforts of the diet industry (Bardone-Cone & Cass, 2006, 2007;
Harshbarger, Ahlers-Schmidt, Mayans, Mayans, & Hawkins, 2009). Other
potentially important moderating variables that warrant further research are
age (girls under 19 appear to be more vulnerable to the influence of the
media than older girls and women) and low self-esteem and low self-concept
clarity (girls with low self-esteem appear to be more vulnerable to the adverse
effects of the media). Moreover, parents and peers play an important role
in the transmission, reinforcement, and modeling of the thin beauty ideal
and disordered eating behaviors and beliefs or—in an opposite sense, their
social support could be a protective factor from the adverse effects of the
media.
Ethnicity as a Moderator
A meta-analytic review by Roberts, Cash, Feingold, and Johnson (2006) found
that, in general, Black women have higher levels of body satisfaction and
weight satisfaction than White women. Moreover, although actual evidence
from content analyses is lacking, it appears that the vast majority of females
who constitute the cultural ideals of beauty, sexiness, and desirability in the
mass media and other avenues of social influences are White, or at least
not dark Black. This suggests that Black women are affected differently by
the pervasive, (pre)dominant images of female physical attractiveness in the
mass media.
The research evidence pertaining to this matter is both woefully sparse
and, perhaps not surprisingly, equivocal (see Harrison & Hefner, 2008, and
Levine & Smolak, 2010, for reviews). On the one hand, a set of studies
provides evidence that Black girls and women are just as vulnerable to
effects of images represented in the media too (see, e.g., Borzekowski et al.,
2000; Botta, 2000; Gordon, 2008). On the other hand, another set of studies
indicates that Black girls are not negatively affected (or not as negatively
affected) by the ideal most often represented in the media because they do
not compare themselves (as often) with these ‘‘White image’’ (DeBraganza
& Hausenblas, 2010; Frisby, 2004; Jefferson & Stake, 2009; Milkie, 1999;
Schooler, Ward, Merriwether, & Caruthers, 2004). For example, Frisby found
that, regardless of their initial levels of body esteem, young Black college
students did not report a decline in state body satisfaction following experimental exposure to White models in advertisements. However, those Black
students who had low initials levels of self-esteem and who saw Black models from ads did show a significant decline in state body satisfaction. Recently,
an experiment conducted by DeBraganza and Hausenblas found evidence
that mirrors, to some extent, that reported by Frisby. These researchers
showed that ethnicity moderates the expected effects of viewing model ideals
Influence of Mass Media on Body Image
409
on body dissatisfaction. Young Black college students showed no significant
changes in body dissatisfaction after exposure to the White ideals, whereas
White women reported significantly lower body dissatisfaction scores.
The findings of Frisby (2004), DeBraganza and Hausenblas (2010), and
others (e.g., Jefferson & Stake, 2009; Wood & Petrie, 2010) are consistent with
the tenets of social comparison theory (Festinger, 1954), which argues that
people tend to make social comparisons with those who are similar to themselves (e.g., similar skin color and similar attitudes, values, or personality). As
Milke (1999) and others have argued, perhaps Black girls and young women
are insulated from the cumulative impact of exposure to the dominant White
ideals because of their dissimilarity and, thus, their disinclination to make
destructive upward social comparisons. Moreover, despite the fact that Black
youth report that they consume more hours of media in comparison to White
youth (Roberts et al., 2005), it also appears to be the case that the beauty
ideal presented in programs targeted at Black audiences and promoted in
the Black community include a broader range of body sizes than those
targeted at the general population (Schooler et al., 2004; Tirodkar & Jain,
2003). Although social comparison theory is clearly an important contributor
to our understanding of media effects (see, e.g., Trampe et al., 2007), much
more research is needed to clarify the role of the Black–White distinction,
various ethnicities, and ethnic identity (Wood & Petrie, 2010) in moderating
media effects (Levine & Smolak, 2010).
A Final Reflection
Despite nearly 35 years of concern about the relationship between mass
media and eating disorders, there remains a strong need for both basic and
applied research on the processes and mechanisms that constitute risk and
protective factors in regard to the effects of the media on attitudes and
behaviors related to body image and eating behavior in females (Dittmar,
2009; Harrison & Hefner, 2008; Levine & Harrison, 2004; 2009; Levine &
Murnen, 2009). Developmental factors, ethnicity (including level of ethnic
identity and acculturation), cross-cultural differences and similarities (Levine
& Smolak, 2010), and the impact of new(er) media are all areas in need
of substantial clarification. There is also a need for refinements and greater
consensus in research methodology. Lack of agreement in the assessment of
key variables is particularly troublesome; Grabe et al.’s (2008) meta-analysis
reveals 14 different scales used by various studies to assess body dissatisfaction. We applaud initiatives such as those adopted by Cafri et al. (2005)
to review only studies that used measures with demonstrated reliability and
validity. Finally, there is a clear need for models (see, e.g., Figure 1) that
provide a foundation for studies to determine whether the processes studied
are definitely mediating and/or moderating variables in the contexts and
pathways that constitute media effects.
410
G. López-Guimerà et al.
NOTES
1. Unless otherwise noted, all research samples are from the United States of America, and
all measures are self-reports.
2. Technically, this well-known study by Becker et al. (2002) is not an experiment or quasiexperiment, but rather a statement of correlation between the variables being assessed and
the coming of television to Fiji, especially since other social and economic changes related
to the institution of mass media may be contributing to the phenomena of interest.
REFERENCES
American Academy of Pediatrics. (2001). Children, adolescents, and television. Committee on Public Education. Pediatrics, 107, 423–426.
American Psychiatric Association (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev; DSM-IV-TR). Washington, DC: Author.
Bardone-Cone, A. M., & Cass, K. M. (2006). Investigating the impact of pro-anorexia
websites: A pilot study. European Eating Disorders Review, 14, 256–262.
Bardone-Cone, A. M., & Cass, K. M. (2007). What does viewing a pro-anorexia
website do? An experimental examination of website exposure and moderating
effects. International Journal of Eating Disorders, 40, 537–548.
Barlett, C. P., Vowels, C. L., & Saucier, D. A. (2008). Meta-analyses of the effects
of media images on men’s body-image concerns. Journal of Social & Clinical
Psychology, 27, 279–310.
Becker, A. E., Burwell, R. A., Gilman, S. E., Herzog, D. B., & Hamburg, P. (2002).
Eating behaviours and attitudes following prolonged exposure to television
among ethnic Fijian adolescent girls. British Journal of Psychiatry, 180, 509–
514.
Bercedo Sanz, A., Redondo Figuero, C., Pelayo Alonso, R., Gómez del Río, Z.,
Hernández Herrero, M., & Cadenas González, N. (2005). Consumo de los medios
de comunicación en la adolescencia. [Use of mass media in adolescence]. Anales
de Pediatría, 63, 516–525.
Bilunka, O. O., & Utermohlen, V. (2002). Internalization of Western standards of appearance, body dissatisfaction and dieting in urban educated Ukrainian females.
European Eating Disorders Review, 10, 120–137.
Borzekowski, D. L. G., Robinson, T. N., & Killen, J. D. (2000). Does the camera
add 10 pounds? Media use, perceived importance of appearance, and weight
concerns among teenage girls. Journal of Adolescent Health, 26, 36–41.
Botta, R. A. (2000). The mirror of television: A comparison of Black and White
adolescents’ body image. Journal of Communication, 50, 144–159.
Bryant, J., & Oliver, M. B. (Eds.). (2009). Media effects: Advances in theory and
research (3rd ed.). New York: Routledge.
Cafri, G., Yamamiya, Y., Brannick, M., & Thompson, J. K. (2005). The influence
of sociocultural factors on body image: A meta-analysis. Clinical Psychology:
Science and Practice, 12, 421–433.
Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.).
Hillsdale, NJ: Erlbaum.
Influence of Mass Media on Body Image
411
DeBraganza, N., & Hausenblas, A. H. (2010). Media exposure of the ideal physique
on women’s body dissatisfaction and mood: The moderating effects of ethnicity.
Journal of Black Studies, 40, 700–716.
Dittmar, H. (Ed.). (2009). Mass media, body image, and eating behaviours [Special
issue]. Journal of Social and Clinical Psychology, 28(1).
Dittmar, H., Halliwell, E., & Stirling, E. (2009). Understanding the impact of thin
media models on women’s body-focused affect: The roles of thin-ideal internalization and weight-related self-discrepancy activation in experimental exposure
effects. Journal of Social and Clinical Psychology, 28, 43–72.
Dittmar, H., & Howard, S. (2004). Thin-ideal internalization and social comparison
tendency as moderators of media models’ impact on women’s body-focused
anxiety. Journal of Social and Clinical Psychology, 23, 768–791.
Dohnt, H., & Tiggemann, M. (2006a). Body image concerns in young girls: The role
of peers and the media prior to adolescence. Journal of Youth and Adolescence,
35, 135–145.
Dohnt, H., & Tiggemann, M. (2006b). The contribution of peer and media influences
to the development of body satisfaction and self-esteem in young girls: A
prospective study. Developmental Psychology, 42, 929–936.
Engeln-Maddox, R. (2006). Buying a beauty standard or dreaming of a new? Expectations associated with media ideals. Psychology of Women Quarterly, 30, 258–
266.
Estudio General de Medios (EGM). (2009). Resumen general abril de 2008 a marzo
de 2009. Asociación para la investigación de medios de comunicación (AIMC).
[General summary April 2008 to March 2009. Association for Media Research].
Retrieved September 15, 2009, from http://www.aimc.es.
Festinger, L. (1954). A theory of social comparison processes. Human Relations, 7,
117–140.
Field, A. E. (2004). Risk factors for eating disorders: An evaluation of the evidence.
In J. K. Thompson (Ed.), Handbook of eating disorders and obesity (pp. 17–
32). Hoboken, NJ: Wiley.
Field, A. E., Camargo, C. A., Taylor, B., Berkey, C. S., & Colditz, G. A. (1999).
Relation of peer and media influences to the development of purging behaviours among preadolescent and adolescent girls. Archives of Pediatrics and
Adolescent Medicine, 153, 1184–1189.
Field, A. E., Camargo, C. A., Taylor, B., Berkey, C. S., Roberts, S. B., & Colditz,
G. A. (2001). Peer, parent, and media Influences on development of weight
concerns and frequent dieting among preadolescent and adolescent girls and
boys. Pediatrics, 107, 54–60.
Field, A. E., Cheung, L., Wolf, A. M., Herzog, D. B., Gortmarker, S. L., & Colditz,
G. A. (1999). Exposure to the mass media and weight concerns among girls.
Pediatrics, 103, 36–41.
Field, A. E., Javaras, K. M., Anjea, P., Kitos, N., Camargo, C. A., Jr., Taylor, C. B.,
& Laird, N. M. (2008). Family, peer, and media predictors of becoming eating
disordered. Archives of Pediatric and Adolescent Medicine, 162, 574–579.
Frisby, C. M. (2004). Does race matter? Effects of idealized images on African American women’s perceptions of body esteem. Journal of Black Studies, 34, 323–
347.
412
G. López-Guimerà et al.
Gordon, K. M. (2008). Media contributions to African American girls’ focus on
beauty and appearance: Exploring the consequences of sexual objectification.
Psychology of Women Quarterly, 32, 245–256.
Grabe, S., Ward, L. M., & Hyde, J. S. (2008). The role of the media in body image
concerns among women: A meta-analysis of experimental and correlational
studies. Psychological Bulletin, 134, 460–476.
Greenberg, B. S., Rosaen, S. F., Worrell, T. R., Salmon, C. T., & Volkman, J. E. (2009).
A portrait of food and drink in commercial TV series. Health Communication,
24, 295–303.
Groesz, L. M., Levine, M. P., & Murnen, S. K. (2002). The effect of experimental
presentation of thin media images on body satisfaction: A meta-analytic review.
International Journal of Eating Disorders, 31, 1–16.
Halliwell, E., & Dittmar, H. (2004). Does size matter? The impact of model’s body
size on women’s body-focused anxiety and advertising effectiveness. Journal
of Social and Clinical Psychology, 23, 104–122.
Halliwell, E., & Dittmar, H. (2005). The role of self-improvement and self-evaluation
motives in social comparisons with idealized female bodies in the media. Body
Image, 2, 249–261.
Hargreaves, D., & Tiggemann, M. (2002). The effect of television commercials on
mood and body dissatisfaction: The role of appearance-schema activation. Journal of Social and Clinical Psychology, 21, 287–308.
Hargreaves, D., & Tiggemann, M. (2003). Longer-term implications of responsiveness
to ‘‘thin-ideal’’ television: Support for a cumulative hypothesis of body image
disturbance? European Eating Disorders Review, 11, 465–477.
Hargreaves, D., & Tiggemann, M. (2004). Idealized media images and adolescent
body image: ‘‘Comparing’’ boys and girls. Body Image, 1, 351–361.
Harrison, K. (2000). Television viewing, fat stereotyping, body shape standards,
and eating disorder symptomatology in grade school children. Communication
Research, 27, 617–640.
Harrison, K., & Hefner, V. (2006). Media exposure, current and future body ideals,
and disordered eating among preadolescent girls: A longitudinal panel study.
Journal of Youth and Adolescence, 35, 153–163.
Harrison, K., & Hefner, V. (2008). Media, body image, and eating disorders. In
S. L. Calvert & B. J. Wilson (Eds.), The handbook of children, media, and
development (pp. 381–406). Boston: Blackwell.
Harshbarger, J. L., Ahlers-Schmidt, C. R., Mayans, L., Mayans, D. & Hawkins, J. H.
(2009). Pro-anorexia websites: What a clinician should know. International
Journal of Eating Disorders, 42, 367–370.
Hogan, M. J., & Strasburger, V. C. (2008). Body image, eating disorders, and the
media. Adolescent Medicine, 19, 521–546.
Holmstrom, A. J. (2004). The effects of the media on body image: A meta-analysis.
Journal of Broadcasting and Electronic Media, 48, 196–217.
Jefferson, D. L., & Stake, J. E. (2009). Appearance self-attitudes of African American
and European American women: Media comparisons and internalizations of
beauty ideals. Psychology of Women Quarterly, 33, 396–409.
Jones, D. C., Vigfusdottir, T. H., & Lee, Y. (2004). Body image and the appearance
culture among adolescent girls and boys: An examination of friend conversa-
Influence of Mass Media on Body Image
413
tions, peer criticism, appearance magazines, and the internalization of appearance ideals. Journal of Adolescent Research, 19, 323–339.
Kaiser Family Foundation (2004). Tweens, teens, and magazines: Fact sheet.
Retrieved April 15, 2010 from http://www.kff.org/entmedia/upload/TweensTeens-and-Magazines-Fact-Sheet.pdf
Kaufman, L. (1980). Prime-time nutrition. Journal of Communication, 30(3), 37–
46.
Knauss, C., Paxton, S. J., & Alsaker, F. D. (2007). Relationships amongst body
dissatisfaction, internalization of the media body ideal and perceived pressure
from media in adolescent girls and boys. Body Image, 4, 353–360.
Kraemer, H., Kazdin, A, Offord, D., Kessler, R, Jensen, P., & Kupfer, D. (1997).
Coming to terms with the terms of risk. Archives of General Psychiatry 54, 337–
343.
Krones, P. G., Stice, E., Batres, C., & Orjada, K. (2005). In vivo social comparison
to a thin-ideal peer promotes body dissatisfaction: A randomized experiment.
International Journal of Eating Disorders, 38, 134–142.
Levine, M. P. (2009). Aportaciones desde el campo de la prevención: Implicaciones
para la educación en comunicación [Lessons from the field of prevention:
Implications for media literacy programs]. Aula de Innovación Educativa [Educational Innovations for the Classroom], 178, 14–18.
Levine, M. P., & Harrison, K. (2004). The role of mass media in the perpetuation and
prevention of negative body image and disordered eating. In J. K. Thompson
(Ed.), Handbook of eating disorders and obesity (pp. 695–717). Hoboken, NJ:
Wiley.
Levine, M. P., & Harrison, K. (2009). Effects of media on eating disorders and body
image. In J. Bryant & M. B. Oliver (Eds.), Media effects: Advances in theory and
research (3rd ed., pp. 490–515). New York: Routledge.
Levine, M. P., & Murnen, S. K. (2009). ‘‘Everybody knows that mass media are/are
not [pick one] a cause of eating disorders’’: A critical review of evidence for
a causal link between media, negative body image, and disordered eating in
females. Journal of Social and Clinical Psychology, 28, 9–42.
Levine, M. P., & Smolak, L. (1996). Media as a context for the development of
disordered eating. In L. Smolak, M. P. Levine & R. Striegel-Moore (Eds.), The
developmental psychopathology of eating disorders (pp. 235–257). Mahwah, NJ:
Erlbaum.
Levine, M. P., & Smolak, L. (2006). The prevention of eating problems and eating
disorders: Theory, research, and practice. Mahwah, NJ: Erlbaum.
Levine, M. P., & Smolak, L. (2010). Cultural influences on body image and the eating
disorders. In W. S. Agras (Ed.), Oxford handbook of eating disorders (pp. 223–
246). New York: Oxford University Press.
Levine, M. P., Smolak, L., & Hayden, H. (1994). The relation of sociocultural factors
to eating attitudes and behaviors among middle school girls. Journal of Early
Adolescence, 14, 471–490.
Martínez-Gonzalez, M. A., Gual, P., Lahortiga, F., Alonso, Y., Irala-Estévez, J., &
Cervera, E. (2003). Parental factors, mass media influences, and the onset of
eating disorders in a prospective population-based cohort. Pediatrics, 111, 315–
320.
414
G. López-Guimerà et al.
McCabe, M. P., & Ricciardelli, L. A. (2005). A longitudinal study of body image
and strategies to lose weight and increase muscles among children. Journal of
Applied Developmental Psychology, 26, 559–577.
The McKnight Investigators. (2003). Risk factors for onset of eating disorders in adolescent girls: Results of the McKnight Longitudinal Risk Factor Study. American
Journal Psychiatry, 160, 248–254.
Milkie, M. (1999). Social comparisons, reflected appraisals, and mass media: The
impact of pervasive beauty images on Black and White girls’ self-concepts.
Social Psychology Quarterly, 62, 190–210.
Murnen, S. K., Levine, M. P., Groesz, L., & Smith, J. (2007, August). Do fashion
magazines promote body dissatisfaction in girls and women? A meta-analytic
review. Paper presented at the 115th meeting of the American Psychological
Association, San Francisco, CA.
O’Brien, K. S., Caputi, P., Minto, R., Peoples, G., Hooper, C., Kell, S., & Sawley,
E. (2009). Upward and downward physical appearance comparisons: Development of scales and examination of predictive qualities. Body Image, 6, 201–
206.
Presnell, K., Bearman, S. K., & Stice, E. (2004). Risk factors for body dissatisfaction in
adolescent boys and girls: A prospective study. International Journal of Eating
Disorders, 36, 389–401.
Richins, M. L. (1991). Social comparison and idealized images of advertising. Journal
of Consumer Research, 18, 71–83.
Rideout, J., Foehr, U. G., & Roberts, D. F. (2010). Generation M2 . Media in the
lives of 8- to 18-year-olds. Menlo Park, CA: Kaiser Family Foundation. Retrieved
April 15, 2010, from http://www.kff.org/entmedia/upload/8010.pdf
Roberts, A., Cash, T. F., Feingold, A., & Johnson, B. T. (2006). Are Black–White
differences in females’ body dissatisfaction decreasing? A meta-analytic review.
Journal of Consulting and Clinical Psychology, 74, 1121–1131.
Roberts, D. F., Foehr, U. G., & Rideout, V. (2005). Generation M: Media in the lives
of 8–18 year-olds. Menlo Park, CA: Kaiser Family Foundation. Retrieved August
27, 2009, from http://www.kff.org/entmedia/7251.cfm
Sands, E. R., & Wardle, J. (2003). Internalization of ideal body shapes in 9–12-years
old girls. International Journal of Eating Disorders, 33, 193–204.
Schooler, D., Ward, L. M., Merriwether, A., & Caruthers, A. (2004). Who’s that girl:
Television’s role in the body image development of young White and Black
women. Psychology of Women Quarterly, 28, 38–47.
Shroff, H., & Thompson, J. K. (2006). Peer influences, body-image dissatisfaction,
eating dysfunction and self-esteem in adolescent girls. Journal of Health Psychology, 11, 533–551.
Shrum, L. J. (2009). Media consumption and perceptions of social reality: Effects and
underlying processes. In J. Bryant & M. B. Oliver (Eds.), Media effects: Advances
in theory and research (3rd ed., pp. 50–73). New York: Routledge.
Smolak, L., & Levine, M. P. (1994). Critical issues in the developmental psychopathology of eating disorders. In L. Alexander & B. Lumsden (Eds.), Understanding
eating disorders (pp. 37–60). Washington, DC: Taylor & Francis.
Smolak, L., & Levine, M. P. (1996). Developmental transitions at middle school
and college. In L. Smolak, M. P. Levine, & R. H. Striegel-Moore (Eds.), The
Influence of Mass Media on Body Image
415
developmental psychopathology of eating disorders: Implications for research,
prevention, and treatment (pp. 207–233). Hillsdale, NJ: Erlbaum.
Stice, E. (1994). Review of the evidence for a sociocultural model of bulimia nervosa
and an exploration of the mechanisms of action. Clinical Psychology Review,
14, 633–661.
Stice, E. (1998). Modeling of eating pathology and social reinforcement of the thinideal predict onset of bulimic symptoms. Behaviour Research and Therapy, 36,
931–944.
Stice, E. (2002). Risk and maintenance factors for eating pathology: A meta-analytic
review. Psychological Bulletin, 128, 825–848.
Stice, E., Nemeroff, C., & Shaw, H. (1996). A test of the dual pathway model of bulimia nervosa: Evidence for restrained-eating and affect regulation mechanisms.
Journal of Social and Clinical Psychology, 15, 340–363.
Stice, E., Spangler, D., & Agras, S. W. (2001). Exposure to media-portrayed thin-ideal
images adversely affects vulnerable girls: A longitudinal experiment. Journal of
Social and Clinical Psychology, 20, 270–288.
Thompson, J. K., & Heinberg, L. J. (1999). The media’s influence on body image
disturbance and eating disorders: We’ve reviled them, now can we rehabilitate
them? Journal of Social Issues, 55, 339–353.
Thompson, J. K., Heinberg, L. J., Altabe, M., & Tantleff-Dunn, S. (1999). Exacting
beauty: Theory, assessment, and treatment of body image disturbance. Washington, DC: American Psychological Association.
Thompson, J. K., & Stice, E. (2001). Internalization of the thin-ideal: Mounting
evidence for a new risk factor for body image disturbance and eating pathology.
Current Directions in Psychological Science, 10, 181–183.
Thompson, J. K., van den Berg, P., Roehrig, M., Guarda, A. S., & Heinberg, L. J.
(2004). The Sociocultural Attitudes Toward Appearance Scale-3 (SATAQ-3):
Development and validation. International Journal of Eating Disorders, 35,
293–304.
Tiggemann, M. (2003). Media exposure, body dissatisfaction and disordered eating:
Television and magazines are not the same! European Eating Disorders Review,
11, 418–430.
Tiggemann, M., & McGill, B. (2004). The role of social comparison in the effect of
magazine advertisements on women’s mood and body dissatisfaction. Journal
of Social and Clinical Psychology, 23, 23–44.
Tiggemann, M., & Pickering, A. S. (1996). Role of television in adolescent women’s
body dissatisfaction and drive for thinness. International Journal of Eating
Disorders, 20, 199–203.
Tiggemann, M., Polivy, J., & Hargreaves, D. (2009). The processing of thin ideals in
fashion magazines: A source of social comparison or fantasy? Journal of Social
and Clinical Psychology, 28, 73–93.
Tiggemann, M., & Slater, A. (2004). Thin ideals in music television: A source of social
comparison and body dissatisfaction. International Journal of Eating Disorders,
35, 48–58.
Tirodkar, M. A., & Jain, A. (2003). Food messages on African American television
shows. American Journal of Public Health, 93, 439–441.
Toro, J. (2004). Riesgo y causas de la anorexia nerviosa [Risk and causes of anorexia
nervosa]. Barcelona: Ariel.
416
G. López-Guimerà et al.
Trampe, D., Stapel, D. A., & Siero, F. W. (2007). On models and vases: Body dissatisfaction and proneness to social comparison effects. Journal of Personality
and Social Psychology, 92, 106–118.
Utter, J., Neumark-Sztainer, D., Wall, M., & Story, M. (2003). Reading magazine articles about dieting and associated weight control behaviors among adolescents.
Journal of Adolescent Health, 32, 78–82.
van den Berg, P., Neumark-Sztainer, D., Hannan, P. J., & Haines, J. (2007). Is dieting
advice from magazines helpful or harmful? Five-year associations with weightcontrol behaviors and psychological outcomes in adolescents. Pediatrics, 119,
30–37.
van den Berg, P., Thompson, J. K., Obremski-Brandon, K., & Coovert, M. (2002). The
tripartite influence model of body image and eating disturbance a covariance
structure modeling investigation testing the mediational role of appearance
comparison. Journal of Psychosomatic Research, 53, 1007–1020.
Vartanian, L. (2009). When the body defines the self: Self-concept clarity, internalization, and body image. Journal of Social and Clinical Psychology, 28, 94–
126.
Wood, N. A. R., & Petrie, T. A. (2010). Body dissatisfaction, ethnic identity, and
disordered eating among African American women. Journal of Counseling Psychology, 57, 141–153.
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