Skip to main content
NCBI home page
NIHPA Author Manuscripts logoLink to NIHPA Author Manuscripts
. Author manuscript; available in PMC: 2021 Dec 1.
Published in final edited form as: Body Image. 2020 Sep 23;35:108–113. doi: 10.1016/j.bodyim.2020.08.013

Body shape concerns across racial and ethnic groups among adults in the United States: More similarities than differences

KayLoni L Olson 1,2, Jason Lillis 1,2, Emily Panza 1,2, Rena R Wing 1,2, Diane M Quinn 3, Rebecca R Puhl 4,5
PMCID: PMC7744334  NIHMSID: NIHMS1627341  PMID: 32979632

Abstract

This study evaluated the relationship between race/ethnicity and body shape concerns among adults in the U.S. and evaluated if this relationship varied by Body Mass Index (BMI) and gender.

Data were collected from U.S. adults (N=2,212) using a national online survey panel designed to approximate the US census data. Gender, age, race/ethnicity, BMI and body shape concerns (Body Shape Questionnaire) were assessed. Analysis of variance was utilized to evaluate the race/ethnicity and BSQ association and if the relationship varied by gender and BMI category.

The sample (65% White, 13% Black/African American, 16% Latino/Hispanic/Mexican American and 6% Asian/Pacific Islander) was 50% female; mean age of 44.2 years (SD=16.8); BMI of 27.4 (SD=6.7). A gender by BMI category interaction (p<.01) revealed no difference in BSQ scores by gender when BMI<18, but higher BSQ scores among women for all other BMI groups. A main effect of race/ethnicity revealed BSQ scores were equally high across racial/ethnic groups, except individuals who identified as White (M =42.0, SD=19.7) reported higher BSQ than those identified as Asian/Pacific Islander (M =37.4, SD=17.4).

Body shape concerns are common among US adults. Individuals of racial/ethnic minority status may experience similar gender- and BMI-related differences in body shape concerns as White individuals.

Keywords: Body image, body shape concerns, race, ethnicity, gender, body mass index

Introduction

The relationship between race and ethnicity and body image is complex, with much that remains to be understood about how one’s cultural environment or identity relates to personal feelings about one’s body (Holmqvist & Frisen, 2010). Historically, negative body image was believed to be a problem that only impacts young, White females (i.e., the ‘Golden Girl’ problem; Smolak & Striegel-Moore, 2001) particularly in the context of eating disorders (Brown, Cachelin, & Dohm, 2009). In the last few decades, the scope of body image research has expanded beyond the eating disorder field and to more diverse samples. It has become evident that negative body image occurs outside the context of eating disorders and is associated with numerous health risks (Bornioli et al., 2019; Bucchianeri & Neumark-Sztainer, 2014; Grogan, 2006). With a larger scope, it has also become clear that body image disturbances impact a range of individuals across the lifespan (Bailey et al., 2016; Peat et al., 2008), men as well as women (Frederick et al., 2007; Quittkat et al., 2019), individuals of racial/ethnic minority status (Brown et al., 2009), and individuals of varying body weights (Weinberger et al., 2016).

While it is now more widely recognized that negative body image can impact individuals across racial and ethnic groups, the nuances of these relationships continue to be debated. Some research has suggested that White individuals continue to report higher levels of negative body image (Dye, 2016; Umstattd et al., 2011) while other findings have indicated that body image concerns are now equally high across racial/ethnic groups (Grabe & Hyde, 2006). Conclusions from the existing literature are limited by methodological factors. For example, earlier work relied on White versus non-White comparisons that aggregate distinct racial and ethnic groups into one category, and many studies focused on young (adolescent or college-aged) and primarily female samples.

In the current study, we examined body shape concerns in particular, which reflect a specific component of negative body image that captures negative thoughts, feelings, and general distress related to current body shape. More specifically, body shape concern captures whether or not a person believes that their current shape is undesirable and reports self-devaluation (e.g., shame, perceived lack of self-control) because of this (Cooper et al., 1987; Masheb et al., 2006). Compared with the more commonly studied construct of body dissatisfaction, body shape concern is considered to be more stable and associated with more negative biopsychosocial consequences (Grilo, 2013; Mond & Hay, 2011) including smoking (Copeland et al., 2016), internalized weight bias (Durso et al., 2016), unhealthy attitudes about eating (Juarascio et al., 2011), mood symptoms like depression and anxiety (Austin et al., 2017; Wilson et al., 2013), poorer self-reported sleep and nutrition, lower enjoyment from physical activity (Becker et al., 2019), and poorer adherence to weight loss treatment recommendations (Austin et al., 2017).

Based on the broader body image literature, there is reason to believe that the relationship between race and ethnicity and body shape concerns, in particular, might be further complicated by additional factors. Existing literature suggests that body image may vary as a function of gender or body size. For example findings consistently demonstrate that on average, men tend to report less negative body image than women (Fallon et al., 2014; Fiske et al., 2014). Societal standards of beauty impose a more restrictive ‘acceptable’ body size on women compared to men in the United States (Bassett-Gunter et al., 2017) and features of female body image have been shown to be more strongly associated with BMI than male body image (Algars et al., 2009). This reflects a potential interaction of gender and body size in the association for body image in general, and body shape concerns in particular. Similarly, African American, Black, and Hispanic individuals have historically reported more flexible body ideals and more acceptance of larger body sizes (Krauss et al., 2012; Kronenfeld et al., 2010). Together, these findings suggest that there might be different thresholds of BMI where women of differing racial/ethnic identities, and men in general, become vulnerable to negative body image (Swami et al., 2010). Yet prior research has typically isolated or stratified based on a subset of these features (e.g., evaluating race and a single feature of body image only among women; Homqvist & Frisen, 2010) which may fail to capture meaningful interactions that exist across body size, race and ethnicity, and gender.

Taken together, there is a need to advance this area of research by evaluating the association of race and ethnicity with body shape concerns among adults, and to determine if this relationship differs based on body size and gender. Despite the potential clinical relevance of body shape concern as a specific facet of negative body image, we are unaware of large scale investigations of diverse adults evaluating these relationships specifically. If the historical pattern in the literature remains, we would expect to see main effects of body size, gender, and race on body shape concerns. However, we hypothesized that these cross-sectional relationships are more nuanced, and thus that there would be a significant three way interaction between race/ethnicity, body size (BMI), and gender (all independent variables) in the association with body shape concerns (dependent variable). Specifically, we expected men to will report increased body shape concerns at a higher BMI level than women. We also hypothesized that hypothesize women of minority racial/ethnic identity would report increased body shape concerns at a higher BMI level than White women.

Method

We conducted a secondary analysis of a large sample of men and women who participated in an online study of weight and health (Puhl et al., 2017). Using a national online survey panel (Survey Sampling International LLC; SSI) the original sample was designed to approximate 2010 U.S. Census characteristics based on sex and race. The large sample was ideal for the goals of the current study as the sample resembled the U.S population in regard to race and ethnicity and was sufficiently large so that even groups that represent a small proportion of the population could be analyzed. Panel participants include over two million active research respondents who are identified through over 3400 sources. SSI validates demographic data of panel participants with data available through multiple databases. Data were collected in 2015 and incentives for participation in the survey included research feedback, charitable donations, and monetary and points rewards. Participants completed an online battery of self-report questionnaires, with the measures for the current study described below. The original data collection was approved by the University of Connecticut Institutional Review Board.

Participants

The original dataset included 3,088 individuals. For the current study, individuals were excluded if they did not have complete BSQ data (n=621) or if BMI was missing (n=260) or in an improbable range (<15 or >100; n=88) resulting in an additional 348 individuals being excluded. Because race was a central construct of interest, individuals who reported their race/ethnicity as ‘other’ were excluded (n=62) from the current analysis, as individuals who endorsed this category may reflect diverse racial backgrounds and/or identities that would be inappropriate to aggregate into a single group. The resulting sample included 2,212 individuals (some individuals were excluded on multiple criteria) and retained representativeness in regard to racial/ethnic diversity consistent with U.S. census data.

Measures

Demographics.

Participants self-reported demographics from forced-choice categories. Participants indicated whether they were male or female, which we conceptualized as gender within the current study. To determine race and ethnicity, participants were asked “how would you classify yourself?” and provided with the following options: 1) White, Non-Hispanic, Non-Latino, 2) Black or African American, 3) Asian or Pacific Islander, 4) Latino, Hispanic, or Mexican American, or 5) other (and provided an open comment box to specify). Participants were asked to select their age in years from a drop down menu.

Body Mass Index (kg/m2).

Participants’ self-reported height (in inches) and weight (in pounds) which were converted to meters and kilometers to calculate Body Mass Index (BMI).

Body Shape Concerns.

Body shape concerns were assessed with a 14-item version (Dowson & Henderson, 2001) of the Body Shape Questionnaire (BSQ; Cooper et al., 1987). The BSQ utilizes a 6-point response scale (1=never, 6=always) to assess how frequently in the past four weeks an individual reports experiencing negative thoughts or feelings about their body shape (e.g., “Have you felt ashamed of your body?”). Scores from all items are added for a total score ranging from 14–84. Higher scores reflect greater body shape concerns. A total value (rather than a mean value) is typically presented for the BSQ, which is what we report and use in our analyses. We also report the sample mean for reference. The measure demonstrated strong reliability in the current sample (Cronbach’s alpha=.97 for the total sample, among women only, and among men only). The 14-item version has been shown to have strong psychometric qualities compared to other short-versions of the BSQ (Pook et al., 2008) and among both men and women (Forbush et al., 2019). Further, the BSQ-14 item language captures shape concerns relevant to both men and women as it does not rely on language related to gender-specific body ideals. By asking about thoughts and feelings about one’s body shape in general, the measure does not restrict the participant to answering based on specific gendered ideals of extreme thinness, athleticism, or muscularity.

Analysis

Analyses were conducted using SAS 9.4. Mean values with standard deviations are reported for continuous variables and percentage values are reported for categorical variables. Linear models were utilized to evaluate the relationship between sex, race/ethnicity, and BMI category and BSQ scores. Participants were categorized into one of four BMI categories (BMI: 15–18 kg/m2, 18–25 kg/m2, 25–30 kg/m2, and ≥30 kg/m2; CDC, 2020). BMI was analyzed as a categorical variable to align with the BMI classification system, providing clinically meaningful categories that also aid in interpretation of the complex nature of a three-way interaction. The model included the following terms: three way interaction of race/ethnicity, BMI category, and sex, then each of the two-way interactions possible for the three variables (BMI category by sex, BMI category by race/ethnicity, race/ethnicity by sex) as well as the main effects for each of the three variables. The model was adjusted for age (a reliable correlate of body shape concerns (r=−.26, p<.001 in the current sample) but not the focus of the current study). Highest order interactions were investigated first (i.e., three-way interaction terms and then two-interaction effects) and non-significant interactions were dropped from the model and significant interactions were probed for simple effects. Otherwise, main effects were interpreted.

Results

The final sample was 50% female and the racial/ethnic breakdown of this subsample retained values approximating US census data (65% White, 13% Black or African American, 16% Latino, Hispanic, or Mexican American and 6% Asian or Pacific Islander). The average age was 44.2 years (SD = 16.8, range: 18–88 years) and the average BMI was 27.4 kg/m2 (SD = 6.7, range: 15.2 – 87.0). In regard to BMI distribution, 2% of the sample had a BMI between 15 – 18kg/m2, 39% had a BMI between 18 – 25 kg/m2, 32% with a BMI between 25 – 30 kg/m2 and 27% had a BMI greater than or equal to 30 kg/m2. Participants reported an average BSQ score of 42.1 (SD = 19.6, range: 14 – 84. Mean BSQ score = 3.0, SD = 1.4). Unadjusted means (raw scores that have not been adjusted with covariates) for the BSQ score across, racial and ethnic, BMI, and gender groups are presented in Table 1. In analyses comparing participants included versus those excluded in the final sample, BSQ scores significantly differed (46.2 SD = 19.9 versus 42.1 SD = 19.6), p < .01. Gender also differed (p < .01) with women disproportionately represented in the excluded group. BMI significantly differed between groups (p < .001) due to exclusion of participants with extreme BMI values (under 15 or over 100 kg/m2). Age did not differ (p = .21), nor did race/ethnicity (p = .07).

Table 1.

Unadjusted mean values for body shape concerns stratified by gender, race/ethnicity, and BMI categories (kg/m2).

BMI 15–18 BMI 18–25 BMI 25–30 BMI>30
Men Women Men Women Men Women Men Women
White 35.7 (19.4)
N=9		 35.7 (19.5)
N=27		 33.0 (19.2)
N=193		 40.2 (18.6)
N=364		 46.5 (17.9)
N=253		 46.5 (17.9)
N=208		 46.5 (17.9)
N=135		 56.8 (17.8)
N=249
Black/AA 61.1 (17.8)
N=5		 35.3 (19.6)
N=4		 33.9 (20.9)
N=54		 41.4 (22.4)
N=32		 44.2 (15.9)
N=65		 44.2 (15.9)
N=31		 44.2 (15.9)
N=54		 46.3 (18.3)
N=36
Asian 29.5 (12.2)
N=4		 29.0 (0.0)*
N=1		 31.0 (13.9)
N=35		 40.9 (18.3)
N=48		 48.3 (23.0)
N=19		 48.3 (23.0)
N=12		 48.3 (23.0)
N=4		 43.5 (24.7)
N=2
Hispanic 28.0 (11.3)
N=2		 56.0 (0.0)*
N=1		 35.1 (18.2)
N=72		 40.9 (19.4)
N=53		 45.5 (18.2)
N=93		 45.5 (18.2)
N=19		 45.5 (18.2)
N=91		 56.1 (16.5)
N=28
Open in a new tab

Note: Values represent unadjusted mean (standard deviation) for the Body Shape Questionnaire. BSQ scores range from 14–84 on the 14-item version used in this study.

*

indicates a subgroup with only one individual which is why the standard deviation is zero for these groups.

In the full model, the three-way interaction effect of gender, race/ethnicity, and BMI was not significant so it was dropped from the model (p = .70). In the model excluding the three-way interaction term, the gender by race (p = .13) and race by BMI category (p = .15) interactions were not significant and were dropped from the model. In the final model adjusted for age, gender, race/ethnicity, and BMI category (F (11, 2188) = 55.64, p < .001, η2 = 0.22), the gender by BMI category interaction (p <.01; partial η2 = .006) remained significant. Post hoc analyses were conducted to probe the interaction effect (see Figure 1). Due to the interaction effect, main effects of gender and BMI category were not interpreted, but Tukey’s post hoc analysis was utilized to evaluate the main effect of race/ethnicity. Individuals who identified as White reported significantly higher BSQ scores (M = 42.0, SD = 19.7) compared to individuals who identified as Asian/pacific islander (M = 37.4, SD = 17.4). However, there were no other significant differences between race and ethnicity groups (Black/African American M = 40.8, SD = 20.3; Hispanic M = 41.7, SD = 19.1).

Figure 1.

Figure 1.

Open in a new tab

Least square mean values for Total Body Shape Questionnaire scores across men and women by BMI categories (kg/m2).

Note: Men and women did not differ in BSQ scores when BMI was between 15–18 kg/m2 (men: 40±20.4, Women: 36.0±19.0, p=.31) but among those with a BMI between 18–25 kg/m2 (Men: 33.5±18.8, women: 40.4±18.8), BMI between 25–30 kg/m2 (Men: 36.0±17.5, Women: 47.8±18.1) and BMI≥30 kg/m2 (Men: 45.9±17.7, Women: 55.4±18.0) men reported significantly lower scores than women (all significant at p<.001). Further, among men only those with a BMI over 30 kg/m2 reported significantly higher BSQ scores than those with a BMI between 25–30 kg/m2 and 18–25 kg/m2. No other groups significantly differed. Among women, BSQ scores did not differ among those with a BMI less than 18 kg/m2 and those with a BMI between 18–25 kg/m2; all other BMI groups among women significantly differed.

Discussion

Among a large sample of adults in the U.S. including four different racial and ethnic groups, there are more similarities than differences in body shape concerns. While on average White individuals reported significantly higher body shape concerns compared to individuals who identified as Asian or Pacific Islander (consistent with some findings indicating lower body dissatisfaction among this group (Cachelin et al., 2002), no other groups significantly differed in body shape concerns. These findings are contrary to the historical perspective in the literature and reiterate the importance of empirically investigating these relationships rather than assuming that findings from other populations (e.g., young females with or at risk for eating disorders) are representative. Indeed, the current findings indicate that individuals of racial/ethnic minority status may be just as likely as their White counterparts to report body shape concerns in the context of higher body weight.

Minimizing the relevance of body shape concerns across racial/ethnic categories may have multiple negative consequences. This includes potential for health care providers to overlook body image as a relevant feature of physical and mental health for people of color, reduced screening and referral for treatment, underrepresentation in research, and a lack of evidence-based, culturally tailored interventions to address the relationship between race, ethnicity and body image. This is especially important given the potential for negative body image to drive negative health-related behaviors. Although negative body image is often discussed as a motivator for individuals of higher body weight to ‘become healthier’, this view conflates body size with health status and fails to account for the growing evidence that factors such as weight stigma and internalized weight bias may paradoxically contribute to body weight through a number of pathways including unhealthy behaviors resulting from body-related distress (i.e., body shape concerns; Puhl, Himmelstein, & Pearl, 2020; Tomiyama, 2016).) This is particularly important given the high prevalence of obesity, which is projected to continue to rise in coming years, driving increases in adiposity-related health concerns (Ward et al., 2019).

The results of this study indicate that the relationship between BMI and body shape concerns is different among adult men and women. While body shape concerns tended to incrementally increase for women across BMI categories, the relationship among men did not reflect a gradual pattern. Rather, there were no differences in body shape concerns among men until their BMI reached 30 or greater. This is consistent with previous findings in the literature (Bassett-Gunter et al., 2017) and highlights the importance of gender-inclusive body image research moving forward. Because gender-related differences in body image are more established in the literature, replicating this gender by body size interaction in our sample can serve to increase confidence the current sample is not exceptional or unusual in ways that impact generalizability.

The current study examined one specific element of the race/ethnicity and body image relationship—namely whether or not there are meaningful differences in body shape concerns across racial/ethnic groups. Even among groups that report very similar levels of body shape concerns, there may be differences in body ideals related to culture that contribute to body shape concerns. For example, two individuals from different cultural backgrounds may share the same level of body shape concerns, but one person may be distressed because he/she wants to be extremely thin, while the other’s concerns may stem from desires for a more curvy body shape. It will be important for future research to determine if variability in cultural ideals that drive body shape concerns is clinically relevant (Overstreet, Quinn, & Agocha, 2010). Additionally, there may be race-related differences in how body shape concerns are related to health behaviors and outcomes, in other facets of both negative and positive body image (i.e., body dissatisfaction, body appreciation), and in what approaches to body image treatment are most effective across groups. These questions were beyond the scope of the current study, but highlight important areas for future investigation.

Limitations and Future Directions

There are several limitations of the current study. This survey was conducted online and relied on self-report data, and self-reports of body weight and height can be unreliable (Powell-Young, 2012). The sample is large and diverse in order to reflect the current racial and ethnic makeup of the United States, which is a strength of the study. Yet because of this, different racial and ethnic groups are disproportionately represented across BMI categories in the current sample (see Table 1) and may have reduced power to detect meaningful interactions in the three-way ANOVA. We re-analyzed the data with BMI as a continuous variable and no interactions were upheld (all three main effects remained significant). This may be because a linear relationship is not the best characterization of the relationship between BMI and body shape concerns among men, which were better captured with BMI categories. Given the clinical utility of BMI categories, the primary analytic approach remains valuable but highlights the importance of recruiting samples with sufficient power to verify and further examine the relationships of interest. Relatedly, while the current sample was designed to be representative of the population in regard to demographic features, it was not specifically designed to represent the U.S. in regard to body size. Compared to the CDC data from 2015–2016, individuals with obesity were underrepresented in our sample (27% compared with >39% in the U.S.) Finally, it is important to recognize that there is heterogeneity within racial/ethnic groups that may be important for understanding cultural factors that influence body image (e.g., level of acculturation, the fact that Asian/Pacific Islander captures a wide range of places of origin), which we could not assess with this dataset.

Our findings clearly show that body shape concerns are present across multiple racial/ethnic groups. These results add to the growing evidence that question previous views that body image concerns are a ‘White female’ problem, or that individuals of non-White race/ethnicity are protected against body image concerns. Continued research, particularly with large and diverse samples, is warranted to help clarify the relationship between body shape concerns and racial/ethnic status in order to avoid inadvertently reducing attention to an important issue that affects individuals of diverse backgrounds, and possibly reducing their access to needed treatment and resources. This is especially true given persistent health disparities in the United States (Baciu et al., 2017). Furthermore, longitudinal work would be informative to determine whether body shape concerns are changing over time among different racial and ethnic minority groups, and what implications this may have for health. As health consequences of negative body image are better understood, it is critical to understand how race and ethnicity influence these relationships.

Highlights.

  • The relationship between race and body image remains incompletely understood

  • This large sample was racially diverse with men and women of varying body sizes

  • Findings reveal more similarities in body shape concerns across race/ethnic groups

  • The association of BMI and body shape concerns differs by gender

Acknowledgements

This Research was funded through an internal grant awarded by the University of Connecticut’s 2015 Research Excellence Program to Diane M. Quinn and Rebecca M. Puhl. The first (KLO) and third (EP) authors are funded on an NIH training grant (T32 HL076134).

Footnotes

Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

Declarations of interest: None

References

  1. Ålgars M, Santtila P, Varjonen M, Witting K, Johansson A, Jern P, & Sandnabba NK (2009). The adult body: how age, gender, and body mass index are related to body image. Journal of Aging and Health, 21(8), 1112–1132. 10.1177/0898264309348023 [DOI] [PubMed] [Google Scholar]
  2. Austin JL, Serier KN, Sarafin RE, & Smith JE (2017). Body dissatisfaction predicts poor behavioral weight loss treatment adherence in overweight Mexican American women. Body Image, 23, 155–161. 10.1016/j.bodyim.2017.08.002 [DOI] [PubMed] [Google Scholar]
  3. Baciu A, Negussie Y, Geller A, Weinstein JN, & National Academies of Sciences, Engineering, and Medicine. (2017). The state of health disparities in the United States In Communities in action: pathways to health equity. National Academies Press (US) Available from: https://www.ncbi.nlm.nih.gov/books/NBK425844/ [PubMed] [Google Scholar]
  4. Bailey KA, Cline LE, & Gammage KL (2016). Exploring the complexities of body image experiences in middle age and older adult women within an exercise context: The simultaneous existence of negative and positive body images. Body Image, 17, 88–99. 10.1016/j.bodyim.2016.02.007 [DOI] [PubMed] [Google Scholar]
  5. Bassett-Gunter R, McEwan D, & Kamarhie A (2017). Physical activity and body image among men and boys: A meta-analysis. Body Image, 22, 114–128. 10.1016/j.bodyim.2017.06.007 [DOI] [PubMed] [Google Scholar]
  6. Becker CB, Verzijl CL, Kilpela LS, Wilfred SA, & Stewart T (2019). Body image in adult women: Associations with health behaviors, quality of life, and functional impairment. Journal of Health Psychology, 24(11), 1536–1547. 10.1177/1359105317710815 [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Bornioli A, Lewis-Smith H, Smith A, Slater A, & Bray I (2019, March). Adolescent body dissatisfaction as public health issue: Effects on later risky health behaviours. Paper presented at South West Public Health Scientific Conference 2019 [Google Scholar]
  8. Brown M, Cachelin FM, & Dohm FA (2009). Eating disorders in ethnic minority women: A review of the emerging literature. Current Psychiatry Reviews, 5(3), 182–193. [Google Scholar]
  9. Bucchianeri M and Neumark-Sztainer D (2014), “Body dissatisfaction: an overlooked public health concern”, Journal of Public Mental Health, 13, 64–69. 10.1108/JPMH-11-2013-0071 [DOI] [Google Scholar]
  10. Cachelin FM, Rebeck RM, Chung GH, & Pelayo E (2002). Does ethnicity influence body- size preference? A comparison of body image and body size. Obesity Research, 10(3), 158–166. 10.1038/oby.2002.25 [DOI] [PubMed] [Google Scholar]
  11. Centers for Disease Control and Prevention (CDC, 2020). Defining Adult Overweight and Obesity. https://www.cdc.gov/obesity/adult/defining.html
  12. Cooper PJ, Taylor MJ, Cooper Z, & Fairbum CG (1987). The development and validation of the Body Shape Questionnaire. International Journal of Eating Disorders, 6(4), 485–494. [DOI] [Google Scholar]
  13. Copeland AL, Spears CA, Baillie LE, & McVay MA (2016). Fear of fatness and drive for thinness in predicting smoking status in college women. Addictive Behaviors, 54, 1–6. 10.1016/j.addbeh.2015.11.010 [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Dowson J, & Henderson L (2001). The validity of a short version of the Body Shape Questionnaire. Psychiatry Research, 102(3), 263–271. 10.1016/S0165-1781(01)00254-2 [DOI] [PubMed] [Google Scholar]
  15. Durso LE, Latner JD, & Ciao AC (2016). Weight bias internalization in treatment-seeking overweight adults: Psychometric validation and associations with self-esteem, body image, and mood symptoms. Eating Behaviors, 21, 104–108. 10.1016/j.eatbeh.2016.01.011 [DOI] [PubMed] [Google Scholar]
  16. Dye H (2016). Are there differences in gender, race, and age regarding body dissatisfaction? Journal of Human Behavior in the Social Environment, 26(6), 499–508. 10.1080/10911359.2015.1091240 [DOI] [Google Scholar]
  17. Fallon EA, Harris BS, & Johnson P (2014). Prevalence of body dissatisfaction among a United States adult sample. Eating Behaviors, 15(1), 151–158. 10.1016/j.eatbeh.2013.11.007 [DOI] [PubMed] [Google Scholar]
  18. Fiske L, Fallon EA, Blissmer B, & Redding CA (2014). Prevalence of body dissatisfaction among United States adults: Review and recommendations for future research. Eating Behaviors, 15(3), 357–365. 10.1016/j.eatbeh.2014.04.010Get rights and content [DOI] [PubMed] [Google Scholar]
  19. Forbush KT, Hilderbrand LA, Bohrer BK, & Chapa DA (2019). Test–retest reliability of common measures of eating disorder symptoms in men versus women. Assessment, 26(3), 419–431. [DOI] [PubMed] [Google Scholar]
  20. Frederick DA, Buchanan GM, Sadehgi-Azar L, Peplau LA, Haselton MG, Berezovskaya A, & Lipinski RE (2007). Desiring the muscular ideal: Men’s body satisfaction in the United States, Ukraine, and Ghana. Psychology of Men & Masculinity, 8(2), 103–117. https://doi-org.proxy.lib.ohio-state.edu/10.1037/1524-9220.8.2.103 [Google Scholar]
  21. Grabe S, & Hyde JS (2006). Ethnicity and body dissatisfaction among women in the United States: A meta-analysis. Psychological Bulletin, 132(4), 622 10.1037/0033-2909.132.4.622 [DOI] [PubMed] [Google Scholar]
  22. Grilo CM (2013). Why no cognitive body image feature such as overvaluation of shape/weight in the binge eating disorder diagnosis? International Journal of Eating Disorders, 46(3), 208–211. 10.1002/eat.22082 [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Grogan S (2006). Body image and health: Contemporary perspectives. Journal of Health Psychology, 11(4), 523–530. 10.1177/1359105306065013 [DOI] [PubMed] [Google Scholar]
  24. Holmqvist K, & Frisén A (2010). Body dissatisfaction across cultures: Findings and research problems. European Eating Disorders Review: The Professional Journal of the Eating Disorders Association, 18(2), 133–146. 10.1002/erv.965 [DOI] [PubMed] [Google Scholar]
  25. Juarascio AS, Perone J, & Timko CA (2011). Moderators of the relationship between body image dissatisfaction and disordered eating. Eating Disorders, 19(4), 346–354. 10.1080/10640266.2011.584811 [DOI] [PubMed] [Google Scholar]
  26. Krauss RC, Powell LM, & Wada R (2012). Weight misperceptions and racial and ethnic disparities in adolescent female body mass index. Journal of Obesity, 2012, 1–99 doi: 10.1155/2012/205393 [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Kronenfeld LW, Reba-Harrelson L, Von Holle A, Reyes ML, & Bulik CM (2010). Ethnic and racial differences in body size perception and satisfaction. Body Image, 7(2), 131–136. 10.1016/j.bodyim.2009.11.002 [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Masheb RM, Grilo CM, Burke- Martindale CH, & Rothschild BS (2006). Evaluating oneself by shape and weight is not the same as being dissatisfied about shape and weight: a longitudinal examination in severely obese gastric bypass patients. International Journal of Eating Disorders, 39(8), 716–720. 10.1002/eat.20311 [DOI] [PubMed] [Google Scholar]
  29. Mond JM, & Hay PJ (2011). Dissatisfaction versus over- evaluation in a general population sample of women. International Journal of Eating Disorders, 44(8), 721–726. 10.1002/eat.20878 [DOI] [PubMed] [Google Scholar]
  30. Overstreet NM, Quinn DM, & Agocha VB (2010). Beyond thinness: The influence of a curvaceous body ideal on body dissatisfaction in Black and White women. Sex Roles, 63(1–2), 91–103. 10.1007/s11199-010-9887-y [DOI] [Google Scholar]
  31. Peat CM, Peyerl NL, & Muehlenkamp JJ (2008). Body image and eating disorders in older adults: a review. The Journal of General Psychology, 135(4), 343–358. 10.3200/GENP.135.4.343-358 [DOI] [PubMed] [Google Scholar]
  32. Pook M, Tuschen-Caffier B, & Brähler E (2008). Evaluation and comparison of different versions of the Body Shape Questionnaire. Psychiatry Research, 158(1), 67–73. 10.1016/j.psychres.2006.08.002 [DOI] [PubMed] [Google Scholar]
  33. Powell-Young YM (2012). The validity of self-report weight and height as a surrogate method for direct measurement. Applied Nursing Research, 25(1), 25–30. 10.1016/j.apnr.2010.06.001 [DOI] [PMC free article] [PubMed] [Google Scholar]
  34. Puhl RM, Quinn DM, Weisz BM, & Suh YJ (2017). The role of stigma in weight loss maintenance among US adults. Annals of Behavioral Medicine, 51(5), 754–763. 10.1007/s12160-017-9898-9 [DOI] [PubMed] [Google Scholar]
  35. Quittkat HL, Hartmann AS, Düsing R, Buhlmann U, & Vocks S (2019). Body dissatisfaction, importance of appearance and body appreciation in men and women over the lifespan. Frontiers in Psychiatry, 10, 864 10.3389/fpsyt.2019.00864 [DOI] [PMC free article] [PubMed] [Google Scholar]
  36. Smolak L, & Striegel-Moore RH (2001). Challenging the myth of the golden girl: Ethnicity and eating disorders In Striegel-Moore RH & Smolak L (Eds.), Eating disorders: Innovative directions in research and practice (p. 111–132). American Psychological Association; 10.1037/10403-006 [DOI] [Google Scholar]
  37. Swami V, Frederick DA, Aavik T, Alcalay L, Allik J, Anderson D, … & Danel D. (2010). The attractive female body weight and female body dissatisfaction in 26 countries across 10 world regions: Results of the International Body Project I. Personality and Social Psychology Bulletin, 36(3), 309–325. 10.1177/0146167209359702 [DOI] [PubMed] [Google Scholar]
  38. Umstattd MR, Wilcox S, & Dowda M (2011). Predictors of change in satisfaction with body appearance and body function in mid-life and older adults: Active for Life®. Annals of Behavioral Medicine, 41(3), 342–352. 10.1007/s12160-010-9247-8 [DOI] [PubMed] [Google Scholar]
  39. Ward ZJ, Bleich SN, Cradock AL, Barrett JL, Giles CM, Flax C, … & Gortmaker SL. (2019). Projected US State-Level Prevalence of Adult Obesity and Severe Obesity. New England Journal of Medicine, 381(25), 2440–2450. DOI: 10.1056/NEJMsa1909301 [DOI] [PubMed] [Google Scholar]
  40. Weinberger NA, Kersting A, Riedel-Heller SG, & Luck-Sikorski C (2016). Body dissatisfaction in individuals with obesity compared to normal-weight individuals: a systematic review and meta-analysis. Obesity Facts, 9(6), 424–441. 10.1159/000454837 [DOI] [PMC free article] [PubMed] [Google Scholar]
  41. Wilson RE, Latner JD, & Hayashi K (2013). More than just body weight: The role of body image in psychological and physical functioning. Body Image, 10(4), 644–647. 10.1016/j.bodyim.2013.04.007 [DOI] [PubMed] [Google Scholar]

RESOURCES