The Happy American Body 2.0: Predictors of affective body satisfaction in two U.S. national internet panel surveys
Introduction
The first major national study of body image was conducted in 1972, when Berscheid, Hatfield [Walster], & Bohrnstedt (1973) created the 109-item Body Image Satisfaction Scale and published it in the magazine Psychology Today. Readers completed the survey and the results were summarized a survey report entitled “The Happy American Body” in Psychology Today (Berscheid et al., 1973) and later in more detail in an academic journal article (Frederick, Bohrnstedt, Hatfield, & Berscheid, 2014). Most people were satisfied with their overall body appearance and about half of men (55 %) and women (45 %) reported being quite-to-extremely satisfied. A minority of men and women reported being somewhat-to-extremely dissatisfied with their overall body appearance (15 % vs. 23 %), weight (35 % vs. 48 %), and general muscle tone/development (25 % vs. 30 %). This study was followed by two additional surveys conducted decades apart that were also reported in Psychology Today. The results showed increasing levels of body dissatisfaction, but different methods were used each time, precluding direct comparisons of change in body image over time (Cash, Winstead, & Janda, 1986; Garner & Kearney-Cooke, 1996).
Large-scale national studies of body image among adults have been rare in the body image literature (for reviews, see Fiske, Fallon, Blissmer, & Redding, 2014; Frederick, Jafary, Daniels, & Gruys, 2012). Due to differences in sampling techniques and operational definitions of body image, however, the estimated prevalence of body dissatisfaction ranges dramatically from 8 % to 61 % for men and 11%–72% for women (Fiske et al., 2014). Particularly lacking is an understanding of the affective aspects of body image on the national level – people’s feelings of satisfaction or dissatisfaction with aspects of their bodies and appearance (Cash & Pruzinsky, 2004). Fiske et al. (2014) identified only seven relevant articles at the time of their review, only four of which had been published in peer-reviewed journals.
Much of what is known about the U.S. national prevalence of affective body dissatisfaction across the past twenty years is drawn from three sources. The first source is a series of five surveys including over 200,000 visitors to popular news websites such as NBCNews.com who completed a series of one-item measures of body image (Frederick, Forbes, & Berezovskaya, 2008; Frederick & Essayli, 2016; Frederick, Lever, & Peplau, 2007; Frederick, Sandhu, Morse, & Swami, 2016; Frederick, Peplau, & Lever, 2006; Lever, Frederick, & Peplau, 2006; Lever, Frederick, Laird, & Sadeghi-Azar, 2007; Peplau et al., 2009).
The second source includes several large-scale studies of Mechanical Turk users that have relied on validated measures of body image. These include the National Body Project I which analyzed 11,620 Mechanical Turk users to examine the prevalence and demographic predictors of body dissatisfaction (Frederick et al., 2019). Body dissatisfaction was also examined in a study of 1893 Mechanical Turk users (Fallon, Harris, & Johnson, 2014).
Third, the National Physical Activity and Weight Loss Survey examined body satisfaction using one-item measures in a sample of 10,201 adults as part of a population-based telephone survey (Kruger, Lee, Ainsworth, & Macera, 2008). Additionally, several researchers have also examined the prevalence of negative evaluations of appearance in relatively large online samples from classified advertisement websites (Study 1 N = 2512, Peplau et al., 2009) and in relatively large studies of college students in specific regions of the U.S. (e.g., N = 2206, Frederick, Forbes, Grigorian, & Jarcho, 2007).
The current study builds on this existing research by examining the prevalence and predictors of body image satisfaction in three Internet panel studies. We use our data to provide a modern update to the original question asked by Berscheid et al. (1973): Are Americans happy with their bodies? Our two surveys advance our understanding of body image by recruiting national samples of single, partnered, and married adults in the United States. Triangulating on the prevalence and predictors of body dissatisfaction using multiple different measures and samples is important because the combination of sampling errors, measurement errors, and variance in methods make any one estimate imprecise, even in nationally representative studies.
Furthermore, the current studies allowed us to focus on the prevalence of body dissatisfaction across key demographic groups, including by gender, ethnicity, relationship status, age, and/or sexual orientation. People who are dissatisfied with their bodies experience a wide array of negative mental health outcomes such as increased anxiety and depression (Kamody et al., 2018; Wilson, Latner, & Hayashi, 2013), desire for some forms of cosmetic surgery (Ching & Xu, 2019; Frederick, Lever et al., 2007; Matera, Nerini, & Stefanile, 2018; Sarwer, 2019; Slevec & Tiggemann, 2010), avoidance of seeking healthcare (Mensinger, Tylka, & Calamari, 2018) and exercise (More, Phillips, & Colman, 2019), discomfort with sexual activities (Gillen & Markey, 2018), psychological distress (Griffiths et al., 2016; Mitchison et al., 2017), anabolic steroid use (Griffiths, Murray, Dunn, & Blashill, 2017), skin cancer risk behaviors such as tanning (Klimek, Lamb, Nogg, Rooney, & Blashill, 2018), binge eating (Mehak, Friedman, & Cassin, 2018), and proneness to developing disordered eating patterns (Stice & Shaw, 2002). Understanding variation in body image is important because it draws attention to groups that are at risk for experiencing disordered eating patterns and psychological distress.
People who are satisfied with their bodies perceive that their feelings about their bodies have a host of positive psychological benefits (Cash & Fleming, 2002). In response to recent calls to focus on positive body image and the factors that promote thriving and general well-being, we bring attention to the prevalence of body satisfaction in addition to the prevalence of body dissatisfaction (Alleva, Paraskeva, Craddock, & Diedrichs, 2018; Homan & Tylka, 2015, 2018; Tylka & Piran, 2019; Tylka & Wood-Barcalow, 2015). This focus on positive body image is important because people feel appreciation for their bodies experience a wide variety of benefits, including great feelings of sexual agency (Grower & Ward, 2018).
The current project allowed us to examine gender, sexual orientation, age, relationship status, and ethnic differences in body affective body image. Furthermore, consistent with the original Happy American Body study and to make the results broadly accessible, we present findings in easily interpretable formats (e.g., percentages dissatisfied), along with an emphasis on effect sizes for when examining differences between groups (e.g., Cohen’s d). Below we review existing literature on associations between demographic factors and body image before turning to the findings of the current study.
Men and women face pressures to modify their bodies in ways that conform to hegemonic norms of masculinity and femininity. Many women want to be thinner (Swami et al., 2010), which is linked to disordered eating patterns (Rodgers, DuBois, Frumkin, & Robinaugh, 2018). Women are routinely exposed to popular media and social messages emphasizing that the ideal body is thin (Spitzer, Henderson, & Zivian, 1999), thin and toned (Watson & Murnen, 2019), or relatively slender but with a low waist-to-hip ratio (i.e., hour-glass shaped; Sypeck et al., 2006). When women are exposed to these images in an experimental setting, roughly half of the images made them feel worse about their weight (50 %), stomach (57 %), muscle tone (46 %), and overall appearance (50 %) (Frederick, Daniels, Bates, & Tylka, 2017).
These pressures come not only from traditional media, but also from interacting with social media. Social media posts often contain sexually objectifying images (Wick & Harriger, 2018) and encourages attention on one’s own appearance through taking selfies (Lonergan et al., 2019; Mills, Musto, Williams, & Tiggemann, 2018) and viewing other people’s selfies (Fardouly & Rapee, 2019; Vendemia & DeAndrea, 2018). Further emphasis is drawn to appearance through comments and feedback from social media followers about these selfies (Tiggemann & Barbato, 2018; Tiggemann, Hayden, Brown, & Veldhuis, 2018). Online communities encouraging focus and attention on appearance have formed such as #thinspiration where people share and seek encouragement to become and stay thin (Tiggemann, Churches, Mitchell, & Brown, 2018) and where members share eating concerns where disordered eating behaviors are often praised (Sowles et al., 2018). Social media, however, also enables the formation of communities that promote positive body image (Cohen, Irwin, Newton-John, & Slater, 2019)
The tripartite model of influence proposes that sociocultural pressures, such as peers and media, lead people to internalize (accept and embrace) these ideals, which then impacts body dissatisfaction. Consistent with this model, many women internalize these ideals (Schaefer et al., 2015), which is linked to body dissatisfaction and disordered eating (Girard, Rodgers, & Chabrol, 2018; Hazzard et al., 2019; Thompson, Heinberg, Altabe, & Tantleff-Dunn, 1999; Tylka & Hill, 2004; Uhlmann, Donovan, Zimmer-Gembeck, Bell, & Ramme, 2018). Similarly, social media use is linked to disordered eating symptoms (Griffiths, Castle et al., 2018; Griffiths, Murray, Krug, & McLean, 2018) and can lead to increases in state body image dissatisfaction (Hogue & Mills, 2019).
These pressures exist in a culture where women are sexually objectified, which causes women to monitor how their appearance is viewed by others (Fredrickson & Roberts, 1997). This surveillance of appearance is tied to internalization of appearance ideals (Vangeel, Vandenbosch, & Eggermont, 2018), seeking out appearance-related validation by posting self-objectifying images on social media (Bell, Cassarly, & Dunbar, 2018), and poorer body image (Frederick, Forbes et al., 2007; Moya-Garófano & Moya, 2019; Schaefer et al., 2018).
In contrast to the thin-ideal, men are routinely exposed to media promoting athletic, toned, and muscular bodies as ideal (Dafferner, Campagna, & Rodgers, 2019; Frederick, Fessler, & Haselton, 2005). This emphasis on the value of muscularity is promoted to material consumed by children and young men, including comic book superheroes (Burch & Johnsen, 2019) and animated movies (Harriger, Serier, Luedke, Robertson, & Bojorquez, 2018). Many men internalize this muscular/athletic ideal (Grammas & Schwartz, 2009; Karazsia & Crowther, 2009).
Pressures to be athletic and muscular come from potential dating partners. Many women express heightened attraction to relatively muscular (Frederick & Haselton, 2007), formidable (Snyder et al., 2011), and stronger men (Sell, Lukazsweski, & Townsley, 2017). Not coincidentally, appearing powerful and formidable is an important part of some men’s conceptions of their masculinity and male gender roles (Frederick, Buchanan et al., 2007; Griffiths, Murray, & Touyz, 2015; McCreary, Saucier, & Courtenay, 2005).
Given the differences in social pressures faced by men and women, the extent to which men and women differ in satisfaction with their bodies likely varies depending on whether they are thinking about their overall appearance, weight, or muscle tone with differences being smaller for overall physical appearance and larger for weight.
Across 76 studies, women reported lower physical appearance-related self-esteem than men, although the difference was only small to moderate in size (d = −0.35; Gentile et al., 2009). Past research on visitors to news websites found that fewer men than women felt unattractive (11 % vs. 21 %; Frederick, Lever et al., 2007) or dissatisfied with their overall physical appearance (22 % vs. 26 %; d = 0.15; Frederick, Sandhu et al., 2016). A similar gender difference in dissatisfaction with overall appearance was found among Mechanical Turk users (9 % vs. 13 %; d = 0.13; Fallon et al., 2014).
Several national and college samples have examined gender differences in “appearance evaluation,” a measure that assesses people’s feelings of attractiveness and satisfaction with their appearance (Brown, Cash, & Mikulka, 1990; Cash, 2000). In the National Body Project I, slightly fewer men than women reported low (negative) evaluations of their appearance (30 % vs. 36 %, d = 0.15, Frederick et al., 2019); there was no statistically significant difference in another study of Mechanical Turk users (23 % vs. 26 %, d = 0.03; Fallon et al., 2014).
Gender differences in weight concerns have consistently been found in past research. Among visitors to news websites, fewer men than women felt they were too heavy (41 % vs. 61 %) and more men than women felt they were too thin (7 % vs. 2 %; Frederick, Lever et al., 2007), but another sample found small differences in overall dissatisfaction with weight (40 % vs. 45 %; Frederick, Sandhu et al., 2016). Among Mechanical Turk users, Fallon et al. (2014) found that 39 % of men versus 46 % of women were dissatisfied with their weight (d = 0.15).
Men are less likely to report higher scores in “overweight preoccupation” (Brown et al., 1990; Cash, 2000), a measure that includes items on concerns about body weight and also attempts to lose weight through dieting. In the National Body Project I, fewer men than women reported high overall overweight preoccupation (15 % vs. 30 %, d = 0.47; Frederick et al., 2019), a pattern also found among Mechanical Turk users (9 % vs. 18 %; d = 0.45, Fallon et al., 2014).
Interest in being more muscular begins at a young age for many boys (McLean, Wertheim, & Paxton, 2018). In college samples, many men want to be more muscular (Frederick et al., 2017; Gray & Frederick, 2012), and indicate they desire increased muscularity because they want to be more attractive, healthy, strong, and physically dominant (Frederick et al., 2017). On the Drive for Muscularity Scale which assesses dissatisfaction with different aspects of the body and drive to engage in muscle building behaviors, men report higher drive for muscularity than women (d = 0.88; McCreary et al., 2005). This gender difference also emerges on items focusing specifically on cognitions such as feeling it is important to look athletic (63 % vs. 42 %; d = 0.49).
This gender difference in attitudes towards muscularity, however, was no longer found in one study when items assessed concerns with muscle tone rather than muscle size (Kyrejto, Mosewich, Kowalski, Mack, & Crocker, 2008). An item-level analysis of the Drive for Muscularity Scale found no gender difference on items measuring concerns that one’s legs or arms are not muscular enough (McCreary, Sasse, Saucier, & Dorsch, 2004). Among Mechanical Turk users, fewer men than women reported dissatisfaction with muscle tone (23 % vs. 34 %, d = .30; Fallon et al., 2014). These findings suggest that achieving a “toned-ideal” is an additional pressure women face beyond the thin-ideal.
Gay men are notably overrepresented among males with disordered eating patterns (for a review, see Murray et al., 2017). A meta-analysis of existing research found that gay men reported lower body satisfaction than heterosexual men (d = 0.29; Morrison, Morrison, & Sager, 2004). The average sample size, however, was only 49 gay men per study.
In an overview of five national surveys of visitors to popular news websites that included large samples of gay men (total N = 4398) and heterosexual men (total N = 111,958), gay men were more likely to report dissatisfaction with their physical appearance (29 % vs. 21 %; d = 0.17) and muscle size/tone (45 % vs. 30 %; d = 0.34), but not weight (44 % vs. 39 %, d = 0.10; Frederick & Essayli, 2016). Across the five studies and 11 body image items, all but two differences were smaller than d = |0.20|, with the largest differences being in dissatisfaction with muscle tone and size. Gay men were, however, much more likely to report sociocultural pressures such as feeling pressure from the media to look attractive (Frederick & Essayli, 2016) along with more sex-life related body image discomfort such as hiding aspects of their body during sex (Frederick & Essayli, 2016; Peplau et al., 2009)
In the aforementioned meta-analysis, lesbian women reported slightly higher body satisfaction than heterosexual women. The effect sizes were small, whether all studies were included (d = 0.12) or whether analyses were limited to samples where the two groups had similar body mass indexes (d = 0.22). The average sample size, however, was only 91 lesbian women per study. Few large-scale studies have compared affective body image in lesbian, gay, and heterosexual men and women simultaneously. These studies typically find that heterosexual men report better body image than most other groups, but patterns for other groups vary by study and measure. In an online sample of 2512 adults, low appearance evaluation was identified in 24 % of heterosexual men, 32 % of gay men, 38 % of heterosexual women, and 35 % of lesbian women (Peplau et al., 2009; Study 1). High overweight preoccupation was least common among heterosexual men (12 %) and most common among heterosexual women (40 %) with gay men (25 %) and lesbian women (26 %) falling in between.
Even rarer have been studies that also include bisexual men and women. The National Body Project I included 194 gay men, 194 bisexual men, 213 lesbian women, and 598 bisexual women (Frederick et al., 2019). This study found that heterosexual men reported higher appearance evaluation than gay (d = 0.23) and bisexual men (d = 0.33), and less overweight preoccupation than gay (d = 0.38) and bisexual men (d = 0.16). All differences among women in appearance evaluation and overweight preoccupation were less than d = |0.20|, except bisexual women reported more overweight preoccupation than lesbian women (d = 0.23). In a study of visitors to news websites, there were no differences in physical appearance satisfaction or weight satisfaction across sexual orientations among men and women, except that heterosexual men reported slightly higher satisfaction with physical appearance than gay men (d = 0.11; Frederick, Sandhu et al., 2016).
Past research has generally found that age is not strongly related to overall body satisfaction (Cash & Henry, 1995; Tiggemann, 2004; Tiggemann & Lynch, 2001). In the National Body Project I, age was generally unrelated or only weakly related to different measures of weight and dissatisfaction, even after controlling for BMI (Frederick et al., 2019). In a national study of visitors to news websites, women ages 50–65 were more likely than women ages 18–34 to report feeling unattractive (27 % vs. 18 %) and feeling uncomfortable with their body to the point that they avoid wearing a swimsuit in public (39 % vs. 18 %). There were no age differences, however, in feeling self-conscious about weight (Frederick et al., 2006).
The links of romantic relationship status to body image has generally received minimal attention. Some research finds that people in relationships generally experience less body image-related self-consciousness during sex (Sanchez & Kiefer, 2007; Steer & Tiggemann, 2008; Wiederman, 2000).
Single men and women may be at greater risk for body dissatisfaction because they face evaluation of their appearance on the mating market. Many people consider physical attractiveness important when seeking a romantic partner (Buss, 1989; Fales et al., 2016) and express preferences for a variety of specific physical traits (Frederick, Hadji-Michael, Furnham, & Swami, 2010; Gallup & Frederick, 2010; Swami et al., 2010), placing additional appearance-related pressures on men and women.
Experiences within romantic relationships are related to body image satisfaction as well as dissatisfaction (Goins, Markey, & Gillen, 2012; Markey & Markey, 2006, 2011, 2014; Markey, Markey, & Birch, 2001; Markey, Markey, & Birch, 2004). Overall, being in a romantic relationship promotes body image for many people, especially if they receive positive feedback on their appearance from partners. There is also a possible selection effect – people who more closely match the appearance ideals valued on the mating market will be presented with more solicitations for dates and relationships, which increases the likelihood that they are dating or in a relationship at any given time point. This selection effect would result in higher body image satisfaction among people currently in relationships (at least to the extent that people who are judged more attractive by others also have higher body satisfaction).
Past research has focused on the protective factors that promote body satisfaction among Black women (Watson, Lewis, & Moody, 2019). A meta-analysis examining ethnic differences in body dissatisfaction among women found that White women were more dissatisfied than Black women (d = 0.29); all other differences among Black, White, Asian, and Hispanic women were less than d = |0.20|. A national study of Mechanical Turk users with over 200 women in each of these ethnic groups found that, compared to Black women, White women reported lower appearance evaluation (d = 0.37), higher overweight preoccupation (d = 0.19), and more negative effects of body image on quality of life (d = 0.28; Frederick et al., 2019). White women and Hispanic women also reported greater overweight preoccupation than Black and Asian women (ds = 0.19–.31). Compared to White women, Black women report lower appearance related pressures from peers and media (Ordaz et al., 2018).
Several studies of young women in California and Hawaii have also found lower appearance evaluation among Asian women compared to White women; whether these differences are replicable remains to be seen (d = 0.38, Frederick, Buchanan et al., 2007; d = 0.50, Frederick, Kelly, Latner, Sandhu, & Tsong, 2016).
Examinations of ethnic differences among men have been less common. In a national study of Mechanical Turk users with over 250 men in each of the aforementioned ethnic groups, Black men reported higher appearance evaluation and more positive effects of body image on their quality of life than White, Hispanic, and Asian men (ds = 0.17–0.49; Frederick et al., 2019). All differences in overweight preoccupation were less than d = |0.20|.
Based on previous research, we hypothesized that positive body image would be more common among: men than women; heterosexual men than gay men; Black men and women than White men and women; people dating or in relationships than people not involved with others. In general, we expected differences to be small-to-moderate in size. We also expected either no link, or only weak links, between age and body image. Furthermore, we expected no links or weak links between sexual orientation and body image among women. Other analyses, such as comparisons among other ethnic groups, were exploratory.
Section snippets
Method
We describe the methods for both studies below rather than separating the article into two separate study sections. We combined them because it was more efficient to report the findings for the one body image item in the first study and the four body image items in the second study together in the results section. We first describe the recruitment and samples for the Singles in America Survey, then the K-Y Touch Survey, followed by the five body image measures and the data analysis plan.
Singles in America survey
As shown in Table 1, consistent with the hypothesis, there was a significant gender difference, with more men than women reporting somewhat-to-very happy with their appearance in not only the singles sample (71 % vs. 65 %; d = 0.18) but also the married sample (81 % vs. 71 %; d = 0.34). Moreover, fewer men were somewhat-to-very unhappy in the singles sample (29 % vs. 35 %) and married sample (19 % vs. 29 %).
This statistically significant gender difference was observed across all age groups in
Summary of key findings
This article provided a rare look at the prevalence of affective body satisfaction and dissatisfaction in two national samples of adults. Consistent with the hypothesis, men were less likely than women to report body dissatisfaction. The results of both surveys, however, point to the fact that there has been a sizable minority of men and women dissatisfied with aspects of their appearance for many decades. In the current study, approximately one-fifth of men (18 %) and one-fourth of women (27
Acknowledgements
This research was supported by the Kay Family Foundation Data Analytics Award for the project Applying Big Data Analytic Techniques to Understand the Predictors and Prevalence of Body Image Disturbances and Disordered Eating Patterns in National Samples. Study 1 was funded by Match.com and Study 2 was funded by K-Y.
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