EXERCISE AND QUALITY OF LIFE
Volume 7, Issue 1, June 2015
UDC 613.9:159.923.31
RELATIONSHIP BETWEEN BODY SATISFACTION AND PSYCHOPHYSICAL
HEALTH
Nevena Miučin1 and Jelena Šakotić-Kurbalija2
1Department of Psychology, Faculty of Philosophy, University of Novi Sad
2Department of Psychology, Faculty of Philosophy, University of Novi Sad
Correspondence то:
Nevena Miučin
Department of Psychology, Faculty of Philosophy
University of Novi Sad
E-mail: nevena.miuchin@gmail.com
Abstract
Body satisfaction has become immensely popular topic over the last couple of decades, and
yet, there are still so many undiscovered aspects of the phenomenon which actively influence
people’s everyday lives. In this study, we’ve been investigating the connection between body
satisfaction and self-rated symptoms of psychophysical health. Sample comprised
393
women, aged 19 to 76, with different socio-economic status. In order to determine the
differences in psychophysical health between women who are satisfied with their body and
those who are not, discriminant analysis was applied. Obtained discriminant factor was
significant
(Wilks’ lambda=0.79; p level<0.01) which indicate that there is a significant
difference in the level of psychophysical health between women who are satisfied with their
body and those who are not. Results of this study show that women who are dissatisfied with
their body appearance are more likely to experience some symptoms of poor psychophysical
health (nervousness and irritability, fatigue, anxiety, digestive problems, poor productivity,
lack of energy and depressive thoughts) compared to the women who are satisfied with their
body appearance.
Keywords: body image, ideal figure, self-perceived health, stress
20
Introduction
The first definition of body image, which circumvented hitherto exclusively
neurological perspective, and took into account a psychological view, was conceived by Paul
Schilder as: ”The picture of our own body which we form in our mind, that is to say the way
in which the body appears to ourselves.” (Schilder, 2013, p. 11). Later, this definition was
modified to: ”The picture we have in our minds of the size, shape and form of our bodies; and
our feelings concerning these characteristics and our constituent body parts.”(Slade, 1994, p.
497). Formulated in this way, it highlights the distinction between two important
components: perceptual (the degree to which one can accurately assess their own body) and
attitudinal (feelings and thoughts one has towards their own body) (Slade, 1994). In this
research, we have focused on the latter, or more precisely, body satisfaction.
Body image related topics have become immensely popular in the past few decades
among researchers as well as laymen. Cash notes that the number of publication, regarding
body dissatisfaction, has doubled in the 2000s compared to the 1990s (Cash & Smolak,
2011). This is not completely surprising, considering massive changes in the culturally
imposed ideal figure over the last couple of decades. Idealized figure of woman’s body has
become slimmer and, due to the additional digital adjustments, almost impossible to attain.
Series of studies confirmed this by comparing size and weight measures of models in
magazine Playboy and Miss America pageant contestants from 1950s to 2000s (Garner et al.,
1980; Wiseman et al., 1992; Spitzer et al., 1999).
The notion that those rigorous expectations bypass male population is just ostensible.
Through various channels of mass media, men are constantly inundated with visuals of
idealized V-shape masculine figures and therefore compelled to compare themselves to those
ideals (Leit et al., 2002; Blond, 2008).
Interestingly, the roots of these influences become apparent even after a mere glance
at the most popular children’s toys. Dittmar and colleagues report that after the exposure to
the images of Barbie dolls, girls, ages 5 to 8, reported lower self-esteem and greater desire for
thinner body (Dittmar et al., 2006). At the same time, many of the boys’ favorite action toys,
which evidently represent an idealized male body in tiny plastic figures, become even more
muscular over time (Pope et al., 1999).
According to The Sociocultural Model, permanent exposure to idealized body images,
conveyed through the media, family and peers, leads to internalization of those ideals. The
level of discrepancy between idealized picture and individual’s own appearance determines
the level of (dis)satisfaction with their own body(Cash & Smolak, 2011). Body disturbance
can lead person to engage in various unhealthy behaviours (in order to attain desired body
shape) such as: eating restraint (Lunner et al., 2000), dieting (Davis, 1992; Cooley & Toray,
2001; Davison et al., 2003; Markey & Markey, 2005), binging (Cargill et al., 1999; Carano et
al., 2006) and purging (Brown et al., 1989), reluctance to quit smoking because of the risk of
weight gaining (King et al., 2005), lower levels of physical activity and fruit and vegetable
intake
(Neumark-Sztainer et al.,
2006). These behaviors can lead to dangerous health
21
outcomes (Fielding, 1985; Barr et al., 1994; Lakka et al., 2003; Tomiyama et al., 2010).
Besides the risks to physical health, it was found that body disturbance is associated with
mental health deterioration (Archer & Cash, 1985; Ali et al., 2010), namely, stress (Johnson
& Wardle, 2005; Murray et al., 2011), depression (Rierdan & Koff, 1997; Stice & Bearman,
2001; Johnson & Wardle, 2005) and low self-esteem (Ali et al., 2010).
Despite the fact that research on body image has been proliferating over the past
couple of decades, few studies investigated the potential impact body image disturbance has
on everyday functioning in non-clinical population. The majority of research has been
focused on the issues relating to the body image in the context of obesity and eating
disorders. On the other hand, there is a substantial group of studies that investigated the
impact some physical (AIDS, cancers, physical disabilities etc.) and mental (depression,
anxiety) deteriorations have on the perception, feelings and attitudes towards one’s own body
(Noles, Cash, & Winstead, 1985; Cash, 2004; Fobair et al., 2006; Grogan, 2007). Although
the significance of the studies scrutinizing the mediating/moderating role body image has in
complex psychological and physical issues is indisputable, the consequences of low body
satisfaction on every-day functioning in otherwise healthy individuals is unduly neglected.
Bearing in mind the vague nature of complex clinical problems related to the body
concerns (eating disorders, obesity, depression etc.), it is often hard to determine the exact
pertinence each contributing factor has in those problems. Some studies have shown that
perception of one’s own body appearance, rather than actual body size/weight, has a greater
influence on individual’s life (Ter Bogt et al., 2006; Muennig et al., 2008; Atlantis & Ball,
2008). More specifically, it was argued that the stress, as an aftermath of the disturbed body
perception, is the main contributing factor to poor health (Muennig et al., 2008; Atlantis &
Ball, 2008). Nevertheless, there is no consensus on the exact ratio between psychological,
biological and social contributors in those problems. On top of that, considering the human
disposition to misjudge their actual body size/weight and classify themselves as overweight
when they’re actually normal/underweight and vice versa (Donath, 2000), the question of the
severe clinical problems in combination with disturbed body image and their consequences
on physical and psychological functioning become even more difficult to untangle.
Therefore, in order to obtain a clearer picture of the phenomenon, it is justified to investigate
body image out of those complicated issues and assess its influence on daily functioning in
non-clinical population.
In that matter, some studies investigated the relationship between body image and
various aspects of quality of life. It was shown that people who are satisfied with their body
appearance also experience a greater degree of subjective well-being (Stokes & Frederick-
Recascino, 2003), better sexual functioning (Weaver & Byers, 2006) and have more positive
perception of their life-style (Kwak et al., 2011).
Study conducted on a sample in Serbia has shown that body satisfaction has a
moderating role between obesity and subjective well-being. With BMI controlled, body
dissatisfaction was significantly correlated with higher level of emotional distress and lower
22
level of positive emotions. Authors concluded that satisfaction with one’s own body
represents more important factor for subjective well-being than a mere body weight (Brdaric
et al., 2015).
Aim of this research is to build upon the existing knowledge on body image by
illuminating its potential harmful effects on different and yet not sufficiently scrutinized
aspects of psychophysical functioning.
Considering the popularity that body related themes have among general population
(due to the omnipresence of idealized body commercials and displays) and the huge effect
that those established body ideals have on people’s perceptions of their own bodies, it is
highly relevant to investigate all possible consequences of such preoccupation. Although
there is a substantial body of work on the detrimental role body dissatisfaction has in some
serious clinical problems (obesity, anorexia, bulimia), evident is the lack of studies that tackle
those problems in otherwise healthy individuals. Purpose of this study was to determine if the
satisfaction with one’s own body appearance, as alone factor, can be a significant indicator of
their psychophysical health in non-clinical sample of women.
Method
This study was a part of larger research, conducted on the territory of Republic of
Serbia, which originally included 2206 women, aged 19-76, with different socio-economic
status. Questionnaires were administered through schools, kindergartens and gynecology
offices (which assured that women without children were included) in larger cities as well as
in villages and smaller towns. Participants took the questionnaires home, filled them out and
returned them in closed envelopes. The participation was completely anonymous and
voluntary.
For the purpose of this study, the number of included participants was reduced. In the
original research, body dissatisfaction was assessed with 5-point Likert scale, which resulted
in normally distributed data. As the main problem of this study was to determine potential
differences in psychophysical health between women who are satisfied with their body
appearance and women who aren’t, we sought for a clearer distinction between those two
groups. In order to obtain that, participants from the ”middle” were excluded and only those
who on the item: ”I have attractive body.” Answered either with ”completely correct” and
”mostly incorrect” or with
”completely incorrect” were included in the analysis. This
reduction resulted in the final sample of 393 women.
Psychophysical health was assessed with the Scale of Psychophysical Health (SPFZ;
Majstorovic, 2011) which included 23 items with 4-point Likert scale (“no, I didn’t”, “yes,
but rarey”, “yes, often”, “yes, daily”) pertaining to the self perceived level of some of the
symptoms of psychophysical health. Participants assessed how many times in the last four
23
weeks they have experienced some of the following symptoms: problems with physical
health, fear and anxiety, depressive reactions, disturbance in social functioning and fatigue.
In order to determine the difference in psychophysical health between women who are
satisfied with their body and those who are not, discriminative function analysis was applied.
Results
In order to determine whether there is a statistically significant difference in
psychophysical health status between people who are satisfied with their body appearance
and those who are not, a discriminant analysis was conducted. Significant difference in
means between groups is obtained on almost every psychophysical health status item
(p<0.05). Canonical correlation of 0.45 shows that 20% of variance between groups is
explained by the proposed model. Wilks’ lambda (0.8) with p level<0.01 indicates significant
discriminant function. In other words it suggests that there is a correlation between
psychophysical health and body satisfaction. However, the high value of Wilks’ lambda
implies that
80% variability in discriminant scores is explained with factors other than
differences in health status.
Items
Function
p124 You’ve noticed a slowdown in your work activities
.517
p117 You’ve had doubts in your work abilities
.495
p125 You’ve become impatient with others
.491
p128 You’ve noticed you quickly lose spirit
.465
p127 You’ve noticed that you’re tired without any visible reason
.464
p120 You’ve felt that what you do makes sense no more
.429
p122 You’ve had a feeling that you’re bothering others with your
.408
problems
p116 You’ve been avoiding people
.391
p123 You’ve been enjoying talking to people(r)
.-
385
p108 You’ve had stomach problems or other problems with digestive
.342
system (gastritis etc.)
p115 You’ve had troubles with usual activities in your household
.324
p119 You’ve felt that you’re worth nothing
.311
p111 You’ve been nervous and uptight
.302
Table 1. Excerpt from Structure Matrix
24
Structure matrix
(Table
1) shows bipolar discriminant function. Positive pole is
defined by the experience of different aspects of poor psychophysical health such as digestive
problems, nervousness and irritability, fatigue, anxiety, perception of poor productivity, lack
of energy and depressive thoughts. Negative pole is determined by pleasure taken in
conversation with others.
Discriminant function divides respondents by assigning negative value to the group of
people who are satisfied with their body (-.44) and positive values to the group of people who
are dissatisfied with their body (.58) (Figure 1). In other words, it suggests that people who
are satisfied with their body appearance are healthier than those who are not satisfied.
Figure 1. Distribution of discriminative scores
Classification results revealed that 71.2% of respondents were classified correctly
with cases in satisfied group
(75.4%) classified slightly more accurately than those in
dissatisfied group (65.7%).
Discussion
The results of this study suggest that there is a certain relationship between body
satisfaction and perceived psychophysical health status. Namely, it appears that people who
are satisfied with their body appearance feel better, in terms of psychophysical health,
compared to the people who are not satisfied. These findings complement earlier studies
25
which revealed the importance body satisfaction has in the context of various health-related
behaviours (Brown et al., 1989; Davis, 1992; Cargill et al., 1999; Lunner et al., 2000; Cooley
& Toray, 2001; Davison et al., 2003; Markey & Markey, 2005; King et al., 2005; Carano et
al.,
2006; Neumark-Sztainer et al., 2006) as well as in a relation to some psychological
difficulties (Archer & Cash, 1985; Rierdan & Koff, 1997; Stice & Bearman, 2001; Johnson &
Wardle, 2005; Ali et al., 2010; Murray et al., 2011).
Considering studies which investigated body dissatisfaction as an incentive for
unhealthy behaviour, it is reasonable to take that view as a possible framework for the results
of this research. In other words, we can presume that dissatisfaction with body appearance
can lead a person to take some physically and mentally exhausting actions (like eating
restraint, excessive workouts, poor diet etc.) which can consequently cause their poor
psychophysical health. At the same time, people who are satisfied with their body engage in
healthy behaviours
(to preserve that desired body image) and therefore have better
psychophysical health.
Another possible explanation may lie in the amount of stress that people who are not
satisfied with their body can experience. That stress, caused by constant preoccupation and
feeling of incongruity with the socially desirable standards of body shape/weight, may
consequently lead to poor psychophysical health (Muennig et al., 2008).
Conversely, the obtained results can be interpreted in a way that an exacerbation in
psychophysical health can produce an overall feeling of discontentment, which implies,
among other things, the discomfort in one’s own body. Also, it is possible that some people,
when experiencing some kind of psychophysical difficulty, resort to different unhealthy
behaviours, due to the lack of energy or in order to make themselves feel better (e.g.
excessive eating, sedentary activities), which can consequently lead to disturbed body image.
It should be taken into consideration that the relationship between body satisfaction
and psychophysical health might be more complicated and that some additional variables
should be included in order to get comprehensive image. Self-esteem, as hierarchical and
multifaceted phenomenon (Shavelson et al., 1976), seems like a relevant factor for the better
understanding of the results obtained in this study. On the one hand, self perception of
physical appearance is often considered as one of the facet of global self-esteem (Sonstroem
& Morgan, 1989; Fox & Corbin, 1989; Blascovich & Tomaka, 1991; Goldenberg et al.,
2000). On the other hand, some studies show that there is a solid association between self-
esteem and mental and physical health (McGee & Williams, 2000; Mann et al., 2004).
Considering those findings, it seems justified, for future studies, to investigate a particular
role that self-esteem might have in this context.
Obtained results serve as a good starting point for further examination of the
relationship between body satisfaction and psychophysical health. It would be useful for
future studies to assess the level of stress (caused specifically by poor body image) and
possibly elucidate the obtained connection between body satisfaction and psychophysical
health.
26
Although there is an impression of abundance of literature related to the body image,
results of this study show that there are still some undiscovered aspects of the phenomenon
that can strongly influence people’s lives. It is often accentuated that dissatisfaction with
body appearance has an important role in the context of obesity and eating disorders, but little
is known about its adverse impact on otherwise healthy individuals. Considering the
culturally imposed, almost unattainable ideal body figure and pervasive popularity of various
fitness programs and diets, the pressure on average person to strive toward that ideal seems
inevitable. In contrast to those ubiquitous messages, people are generally still dissatisfied
with their body shape/weight which consequently creates a great discord between reality and
desire and can lead to interior conflicts and adverse psychological outcomes. Considering
that, the phenomenon of body image should be scrutinized in more depth, in non-clinical
context, so its potential influence on different aspects of quality of life can be illuminated.
References
Ali, M. M., Fang, H., & Rizzo, J. A. (2010). Body weight, self-perception and mental health
outcomes among adolescents. The journal of mental health policy and economics, 13
(2), 53-63.
Archer, R. P. & Cash, T. F. (1985). Physical attractiveness and maladjustment among
psychiatric inpatients. Journal of Social and Clinical Psychology, 3 (2), 170-180.
Atlantis, E. & Ball, K. (2008). Association between weight perception and psychological
distress. International journal of obesity, 32 (4), 715-721.
Barr, S. I., Prior, J. C., & Vigna, Y. M. (1994). Restrained eating and ovulatory disturbances:
possible implications for bone health. The American journal of clinical nutrition, 59
(1), 92-97.
Blascovich, J. & Tomaka, J. (1991). Measures of self-esteem. Measures of personality and
social psychological attitudes, 1, 115-160.
Blond, A.
(2008). Impacts of exposure to images of ideal bodies on male body
dissatisfaction: A review. Body Image, 5 (3), 244-250.
Brdaric, D., Jovanovic, V., & Gavrilov-Jerkovic, V. (2015). The relationship between body
mass index and subjective well-being-the moderating role of body dissatisfaction.
Medicinski pregled, 68 (9-10), 316-323.
Brown, T. A., Cash, T. F., & Lewis, R. J. (1989). Body-image disturbances in adolescent
female binge-purgers: A brief report of the results of a national survey in the usa.
Journal of Child Psychology and Psychiatry, 30 (4), 605- 613.
Carano, A., De Berardis, D., Gambi, F., Di Paolo, C., Campanella, D., Pelusi, L., Sepede, G.,
Mancini, E., La Rovere, R., Salini, G., et al. (2006). Alexithymia and body image in
adult outpatients with binge eating disorder. International Journal of Eating
Disorders, 39 (4), 332-340.
27
Cargill, B. R., Clark, M. M., Pera, V., Niaura, R. S., & Abrams, D. B. (1999). Binge eating,
body image, depression, and self-efficacy in an obese clinical population. Obesity
Research, 7 (4), 379-386.
Cash, T. F. (2004). Body image: Past, present, and future. Body image, 1(1), 1-5.
Cash, T. F. & Smolak, L. (2011). Body image: A handbook of science, practice, and
prevention. Guilford Press.
Cooley, E. & Toray, T. (2001). Body image and personality predictors of eating disorder
symptoms during the college years. International Journal of Eating Disorders, 30 (1),
28-36.
Davis, C. (1992). Body image, dieting behaviours, and personality factors: A study of high-
performance female athletes. International Journal of Sport Psychology.
Davison, K. K., Markey, C. N., & Birch, L. L. (2003). A longitudinal examination of patterns
in girls’ weight concerns and body dissatisfaction from ages
5 to
9 years.
International Journal of Eating Disorders, 33 (3), 320-332.
Dittmar, H., Halliwell, E., & Ive, S. (2006). Does barbie make girls want to be thin? the effect
of experimental exposure to images of dolls on the body image of 5-to 8-year-old
girls. Developmental psychology, 42 (2), 283.
Donath, S. M.
(2000). Who’s overweight? comparison of the medical definition and
community views. The Medical Journal of Australia, 172 (8), 375-377.
Fielding, J. E. (1985). Smoking: health effects and control. New England journal of medicine,
313 (8), 491-498.
Fobair, P., Stewart, S. L., Chang, S., D'Onofrio, C., Banks, P. J., & Bloom, J. R. (2006).
Body image and sexual problems in young women with breast
cancer.Psycho- Oncology, 15(7), 579-594.
Fox, K. R. & Corbin, C. B. (1989). The physical self-perception profile: Devel- opment and
preliminary validation. Journal of Sport & Exercise Psychology.
Garner, D. M., Garfinkel, P. E., Schwartz, D., & Thompson, M. (1980). Cultural expectations
of thinness in women. Psychological reports, 47 (2), 483-491.
Goldenberg, J. L., McCoy, S. K., Pyszczynski, T., Greenberg, J., & Solomon, S. (2000). The
body as a source of self-esteem: the effect of mortality salience on identification with
one’s body, interest in sex, and appearance monitoring. Journal of personality and
social psychology, 79 (1), 118.
Grogan, S. (2007). Body image: Understanding body dissatisfaction in men, women and
children. Routledge.
Johnson, F. & Wardle, J. (2005). Dietary restraint, body dissatisfaction, and psychological
distress: a prospective analysis. Journal of abnormal psychology, 114 (1), 119.
King, T. K., Matacin, M., White, K. S., & Marcus, B. H. (2005). A prospective examination
of body image and smoking cessation in women. Body Image, 2 (1), 19-28.
28
Kwak, H.-K., Lee, M. Y., & Kim, M. J. (2011). Comparisons of body image perception,
health related lifestyle and dietary behavior based on the self- rated health of
university students in seoul. Korean Journal of Community Nutrition, 16 (6), 672-
682.
Lakka, T. A., Laaksonen, D. E., Lakka, H.-M., M¨annikk¨o, N., Niskanen, L. K., Rauramaa,
R., & Salonen, J. T. (2003). Sedentary lifestyle, poor cardiorespiratory fitness, and the
metabolic syndrome. Medicine and science in sports and exercise, 35 (8), 1279-1286.
Leit, R. A., Gray, J. J., & Pope, H. G. (2002). The media’s representation of the ideal male
body: A cause for muscle dysmorphia? International Journal of Eating Disorders, 31
(3), 334-338.
Lunner, K., Werthem, E. H., Thompson, J. K., Paxton, S. J., McDonald, F., & Halvaarson, K.
S. (2000). A cross-cultural examination of weight-related teasing, body image, and
eating disturbance in swedish and australian samples. International Journal of Eating
Disorders, 28 (4), 430-435.
Majstorovic, N. (2011). Validation of metric characteristic of The Scale of Psychophysical
Health SPFZ-1. Unpublished manuscript.
Mann, M. M., Hosman, C. M., Schaalma, H. P., & de Vries, N. K. (2004). Self-esteem in a
broad-spectrum approach for mental health promotion. Health education research, 19
(4), 357-372.
Markey, C. N. & Markey, P. M. (2005). Relations between body image and dieting
behaviors: An examination of gender differences. Sex Roles, 53 (7-8), 519-530.
McGee, R. & Williams, S. (2000). Does low self-esteem predict health compromising
behaviours among adolescents? Journal of adolescence, 23 (5), 569-582.
Muennig, P., Jia, H., Lee, R., & Lubetkin, E. (2008). I think therefore i am: Perceived ideal
weight as a determinant of health. American Journal of Public Health, 98 (3), 501.
Murray, K. M., Byrne, D. G., & Rieger, E. (2011). Investigating adolescent stress and body
image. Journal of adolescence, 34 (2), 269-278.
Neumark-Sztainer, D., Paxton, S. J., Hannan, P. J., Haines, J., & Story, M. (2006). Does body
satisfaction matter? five-year longitudinal associations between body satisfaction and
health behaviors in adolescent females and males. Journal of Adolescent Health, 39
(2), 244-251.
Noles, S. W., Cash, T. F., & Winstead, B. A. (1985). Body image, physical attractiveness,
and depression. Journal of consulting and clinical psychology, 53(1), 88.
Pope, H. G., Olivardia, R., Gruber, A., & Borowiecki, J. (1999). Evolving ideals of male
body image as seen through action toys. International Journal of Eating Disorders, 26
(1), 65-72.
Rierdan, J. & Koff, E. (1997). Weight, weight-related aspects of body image, and depression
in early adolescent girls. Adolescence, 32 (127), 615.
Schilder, P. (2013). The image and appearance of the human body (Vol. 163). Routledge.
29
Shavelson, R. J., Hubner, J. J., & Stanton, G. C. (1976). Self-concept: Validation of construct
interpretations. Review of educational research, 407-441.
Slade, P. D. (1994). What is body image? Behaviour research and therapy, 32 (5), 497-502.
Sonstroem, R. J. & Morgan, W. P. (1989). Exercise and self-esteem: rationale and model.
Medicine & Science in Sports & Exercise.
Spitzer, B. L., Henderson, K. A., & Zivian, M. T. (1999). Gender differences in population
versus media body sizes: A comparison over four decades. Sex Roles, 40 (7-8), 545-
565.
Stice, E. & Bearman, S. K. (2001). Body-image and eating disturbances prospectively predict
increases in depressive symptoms in adolescent girls: a growth curve analysis.
Developmental psychology, 37 (5), 597.
Stokes, R. & Frederick-Recascino, C. (2003). Women’s perceived body image: relations with
personal happiness. Journal of Women & Aging, 15 (1), 17-29.
Ter Bogt, T. F., van Dorsselaer, S. A., Monshouwer, K., Verdurmen, J. E., Engels, R. C., &
Vollebergh, W. A. (2006). Body mass index and body weight perception as risk
factors for internalizing and externalizing problem behavior among adolescents.
Journal of Adolescent Health, 39 (1), 27-34.
Tomiyama, A. J., Mann, T., Vinas, D., Hunger, J. M., DeJager, J., & Taylor, S. E. (2010).
Low calorie dieting increases cortisol. Psychosomatic medicine, 72 (4), 357.
Weaver, A. D. & Byers, E. S. (2006). The relationships among body image, body mass index,
exercise, and sexual functioning in heterosexual women. Psychology of Women
Quarterly, 30 (4), 333-339.
Wiseman, C. V., Gray, J. J., Mosimann, J. E., & Ahrens, A. H. (1992). Cultural expectations
of thinness in women: An update. International Journal of Eating Disorders, 11 (1),
85-89.
30