Resources for planning No. 6 - Body image

Page content: Shapes: Body image program planning guide | Best bets: Body image programs overview | Tabulated summary of evaluated prevention intervention literature | Research review of body image programs

Shapes: Body image program planning guide

Pick up a magazine, turn on the television, look at the billboards and you will see the 'body beautiful'. Magazines glamorise lean models and television stars, and ridicule signs of weight gain or 'fat'. Teasing young people about their weight is a common form of bullying. Our society has become increasingly preoccupied with 'leanness', and having a perfect face and body. At the same time levels of personal dissatisfaction with one's own body shape are increasing. Does it matter? Absolutely. There is clear evidence that strong body image concerns are linked to serious health problems. A recent edition of a popular Australian magazine was headlined 'How body image killed this plus-size model', and described an all too familiar story of obsession with body shape ending in tragedy. Poor body image is a serious matter.

The purpose of this booklet is to describe what we know about body image dissatisfaction (the problem) and the most promising strategies being used to promote positive body image. The first part of this project was a review of evaluated projects on body image (Research Review of Body Image Programs). Some of the stronger programs are described in detail in the following pages. Planning tools are provided to help you develop, promote and evaluate your own body image programs.

This publication is designed to be user friendly and practical. You will find links between health promotion theory, past intervention programs and the settings where the work needs to occur. There is a planning checklist adapted specifically for body image programs, tips on improving effectiveness and building sustainable programs, ideas for communicating body satisfaction messages, discussion of theories and suggestions about evaluation.

• Introduction
• What's the problem?
• What solutions have been tried?
• What's the next step?
• Start with planning
• Consider the big picture: frameworks and theories
• Review possible settings and approaches
• Identify the communication issues
• Evaluate with purpose
• What next?
• Appendix 1- Summary of promising strategies
• Appendix 2 - promising strategies: Four case studies

Shapes: Body image program planning guide (264kb, pdf)

Best bets: Body image programs overview

What's the problem?

Many females and increasing numbers of males and children are unhappy with their bodies. Research links body image dissatisfaction to physical and mental health concerns, especially, but not exclusively, in women. In Australia, body image concerns focus on issues about weight even in women and men who are underweight or who are healthy weights. Poor body image is linked to unhealthy weight loss practices (crash dieting, fasting, laxative misuse, vomiting etc) in people in all weight ranges. In males, dissatisfaction with one's body is less widespread, and is more likely to take the form of desiring to be larger and more muscular than to being thinner. Fear of fat is common to men and women. Australian research has documented body dissatisfaction and weight loss behaviours in adolescent girls and boys. In high school girls, 70-76% choose an ideal figure thinner than their own, and over half have tried to lose weight, while only a relatively small proportion of girls are objectively overweight. In one study of adolescent boys, a third wished to be thinner while over a third desired to be larger than their current size. A community sample of Australian adults recorded 47% and 24% of healthy weight women and men respectively believed they were overweight. Less than a quarter of young Australian women are satisfied with their weight.

• What's the problem?
• The research: what do we know about programs?
• Does poor body image matter?
• What settings and approaches work best?
• Who to focus on
• What to focus on
• What next?
• Getting started

Best bets: Body Image Programs Overview (76kb, pdf)

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Tabulated summary of evaluated prevention intervention research literature

Introduction

The following document provides a tabulated summary of the research literature examining the effectiveness of a wide range of body image dissatisfaction prevention interventions. With a few exceptions this is a review of published or in press research. While unpublished interventions are frequently valuable, they are difficult to access and often un-evaluated. I believe the literature summarised below does provide a very good indication of the “state of the art” in the prevention intervention area.

A review of this kind is never complete as new work is being conducted all the time and there are now very many evaluated programs of one kind or another. However, it is hoped that this table will be a helpful resource for those who whish to understand the research literature, and particularly the nature of the outcomes, in some depth. Commentaries have not been included in this review, but a number of helpful references of this kind are provided.

This document forms the evidence base on which the Overview of Body Image Dissatisfaction Prevention Intervention Research, the Body Image Planning Guide and Best Bets are based. The document is divided into three sections: a tabulated summary of each reviewed paper, a very similar though sometimes extended review in a non-tabulated form, and a reference section. A standard format has been used throughout to help in cross-comparisons. The research has been arranged in alphabetical order of first author. While this does mean that different types of research may be adjacent to each other, the reference list at the end with full titles and details provides a quick way to identify material that may of particular interest to you.

Full explanations of all variables assessed, abbreviations and descriptions of research details are not provided. Full detail is typically provided in the original document. With one or two exceptions, I have copies of the articles, and anyone wishing to obtain a copy is welcome to get in touch with me and I will endeavour to assist.

The Overview of Body Image Dissatisfaction Prevention Intervention Research provides an integrated overview of the findings of the research summarised below.

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Tabulated summary of evaluated prevention intervention research literature (852kb, pdf)

Research review of body image programs
An overview of body image dissatisfaction prevention interventions

Introduction

Body image dissatisfaction is increasingly being recognised as an important target for public health action (Paxton, 2000a). Research evidence links body dissatisfaction to physical and mental health concerns, especially, but not exclusively, in women. In Australian women, body dissatisfaction mainly focus on concerns about weight even in underweight and healthy weight individuals (Ben-Tovim & Walker, 1991) and is reflected in unhealthy weight loss practices (crash dieting, fasting, laxative misuse, vomiting etc) in those in all weight ranges (e.g. Wertheim et al., 1992). In males, body image dissatisfaction is less widespread but is more likely to take the form of desiring to be larger and more muscular in addition to being thinner (McCabe & Ricciardelli, 2001; Pope, Phillips & Olivardia, 2000; Ricciardelli, McCabe & Banfield, 2000).

Australian and New Zealand research has documented body dissatisfaction and weight loss behaviours in adolescent girls and boys. In high school girls, 70-76% choose an ideal figure thinner than their own (Fear, Bulik & Sullivan, 1996; Paxton, Wertheim, Gibbons, Szmukler, Hillier, Petrovich, 1991; Tiggemann & Pennington, 1990), and over half have tried to lose weight (Fear et al., 1996; Grigg, Bowman & Redman, 1996; Patton et al. 1997; Paxton et al., 1991), while only a relatively small proportion of girls are objectively overweight. In one study of adolescent boys, a third wished to be thinner while over a third desired to be larger than their current size (Paxton et al., 1991).

While there is little Australian adult epidemiological data specifically related to body image, in the United States a recent survey found 56% and 43% of women and men respectively reported body dissatisfaction (Cash, 1997). In a community sample of Australian adults, 47% and 24% of healthy weight women and men respectively believed themselves to be overweight (Paxton, Sculthorpe & Gibbons, 1994). In a representative sample of young Australian women (Kenardy, Brown & Vogt, 2001) found only 24% of healthy weight women were satisfied with their weight.

Introduction

• The Need for Prevention
• Public Health Approaches to Prevention
• Identification of Risk Factors for Body Image Dissatisfaction
• Risk Factors and Prevention Intervention Programs for Body Image Dissatisfaction
• Prevention Interventions Reviewed for the Current Report

Overview of research findings

• Settings for Interventions
• Approach and Content of Interventions
• Maintenance of Effects
• Importance of Knowledge Changes
• Selective or Targeted Prevention and Timing of Interventions
• What About Boys?
• Interventions with Parents
• Do Interventions do Harm?
• Who Shouldn't Participate in or Lead an Intervention Program?
• Conclusions
• References

Research Review of Body Image Programs (524kb, pdf)

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