Body dissatisfaction, engagement in body change behaviors and sociocultural influences on body image among Chinese adolescents
Introduction
Body image disturbance and disordered eating have typically been seen as problems affecting women living in developed Western countries, and for this reason research has tended to focus on Western female populations (Kennedy, Templeton, Gandhi, & Gorzalka, 2004). Recent reports however, have shown an increase in body dissatisfaction and disordered eating in non-Western countries such as Japan (Pike & Borovoy, 2004), Malaysia (Mellor, Ricciardelli, McCabe, Yeow, Daliza, & Binti Mohd Hapidzal, 2009), China (Chan and Owens, 2005, Chen and Jackson, 2008, Ma, 2007) and Fiji (Ricciardelli et al., 2007a, Ricciardelli et al., 2007b). In a large survey study on body image involving over 9000 Chinese children, Li, Hu, Ma, Wu, and Ma (2005) found that rates of body dissatisfaction were comparable to those reported in Western populations. Among the children classified as healthy weight only 46.5% of boys and 43.0% of girls were satisfied with their bodies, and preferences for thinner bodies increased with age (Li et al., 2005). In a recent study of 2103 young people living in China, Chen and Jackson (2008) found that 2.3% of their participants met the full DSM-IV criteria for an eating disorder or an eating disorder not otherwise specified (EDNOS). Lee and Lee (2000) believe a further 3–10% of Chinese females may suffer from disordered eating at a subclinical level. Less is known about body image disturbances and body change behaviors of Chinese males; for instance, are Chinese males influenced by the drive for muscularity that is increasingly evident among Western males or do they aspire to traditional cultural ideas of masculinity? The current study aims to investigate levels of body dissatisfaction and engagement in body change behaviors to reduce weight, gain weight and increase muscle bulk among adolescent males and females living in China.
It is generally agreed that sociocultural influences play a significant role in promoting body dissatisfaction and preoccupation with body change behaviors by perpetuating largely unattainable body image ideals. Sociocultural forms of influence include social pressure to conform to a particular body type, teasing, and comparisons with other idealised body types, with the most powerful sources of influence being one's family, friends and the media (Jackson & Chen, 2008b). Social comparison and attention to cultural standards are important means by which people evaluate their bodies (Franzoi & Klaiber, 2007). The dispositional tendency to compare one's appearance to that of others has been found to be a potent predictor of body dissatisfaction and disordered eating in Western populations (Stormer and Thompson, 1996, Thompson et al., 1999, Van den Berg and Thompson, 2007). Morrison, Kalin, and Morrison (2004) found social comparison was the best predictor of body dissatisfaction, appearance self esteem, and engagement in body change behaviors, with universalistic sources of influence (media) exerting greater influence than particularistic ones (friends and family).
Some researchers claim that sociocultural pressure to be thin is the strongest influence on the development of body image disorders. McCarthy (1990) reviewed cross-cultural data on eating disorders and concluded that “all cultures that have eating disorders have the thin ideal. Further, no culture that does not have the thin ideal has eating disorders” (McCarthy, 1990, p. 210). There is ample support for the role of sociocultural influences in determining notions about ideal body types among Western samples, particularly females (Dittmar, 2005, Halliwell and Harvey, 2006, McCabe and Ricciardelli, 2003, Paxton et al., 1999). However, there is a lack of research examining the relative importance of sociocultural influences and types of sociocultural pressures on body image in non-Western populations (Chen et al., 2007, Mellor et al., 2009). In light of this, the second aim of the current study is to investigate the sources of sociocultural influence and types of sociocultural pressure related to body image, as well as the predictive relationship between these variables and the body dissatisfaction and body change behaviors of Chinese males and females.
The source of sociocultural influence most heavily criticised for promoting body dissatisfaction and body change behaviors is Western media, with its relentless portrayal of thin female bodies and emphasis on diet and weight control (Jung & Forbes, 2007). Rising reports of body dissatisfaction and preoccupation with body change behaviors in Western males have also been attributed to the increasing value placed on the male body in Western advertising (Yang, Gray, & Pope, 2005). It has been suggested that in non-Western countries exposure to Westernised media leads to the adoption of Western beauty ideals, which in time override traditional or previously held body type ideals (Becker et al., 2002, Williams et al., 2006). This proposition is supported by evidence linking exposure to Westernised media with concurrent rises in body dissatisfaction and disordered eating in non-Western countries (Becker et al., 2002, Mellor et al., 2008, Mellor et al., 2009, Shih and Kubo, 2002).
It is likely, however, that the impact of Western media on body dissatisfaction is mediated by the cultural context in which it appears (Davidson et al., 2002, Jung and Forbes, 2007, Mellor et al., 2008, Mellor et al., 2009). As Shih and Kubo (2002) have demonstrated, both Japan and Taiwan have been heavily exposed to Western media, both populations have relatively similar body sizes, and yet Japanese college women reported much greater body dissatisfaction than their Taiwanese counterparts. In another study Xie et al. (2006) found that while both Asian and Western media were influential in the body image perceptions of Chinese adolescents, Asian media had a slightly stronger influence. The authors concluded that the Western media approach to body image may be too culturally distinct from Chinese values to impact significantly on the attitudes and behaviors of Chinese people.
Asian media has not typically been associated with body dissatisfaction, because images and advertising tend to focus on the face more than the body (Jackson & Chen, 2008b). Advertisements for cosmetics and hair products, rather than clothes, are common in magazines targeted at Asian women and depictions of women tend to be feminine and demure, rather than sexy and alluring like the images of women portrayed in Western media (Frith, Cheng, & Shaw, 2004). Yang et al. (2005) compared the images of men in Western and Taiwanese magazines and assessed levels of body dissatisfaction in Taiwanese males. They found that Taiwanese magazines depicted undressed Asian men rarely, compared to the numerous representations of undressed Western men in both Western and Asian magazines, and that Taiwanese men reported significantly less body dissatisfaction than their Western counterparts. The authors concluded that Taiwan – whose population and culture are predominantly descended from China – is less preoccupied with male body image than Western countries. However, they raise the question: can Chinese attitudes and values regarding body image withstand the influence of Western culture? (Yang et al., 2005).
It is important to recognise that the cultural, political and economic reforms in China that have allowed the introduction of Western media have also resulted in changes to dietary and lifestyle habits (Chen and Jackson, 2005, Jung and Forbes, 2007). The growing prosperity of the Chinese population has led to increases in sedentary work and high calorie, high fat diets, the result of which has been a 200% rise in obesity rates for women and a 300% rise for men between 1989 and 1997 (Bell, Ge, & Popkin, 2001). These factors provide support for Jung and Forbes’ (2007) argument that the relationship between body dissatisfaction and Western media is complex and multiply determined and highlights the importance of interpreting the influence of Western media within the context of the predominant culture. Several authors have pointed out that thinness and fragility have long been a feminine beauty ideal in Chinese culture and therefore reports of body dissatisfaction among Chinese women may not be reflective of a desire to conform to Western ‘thin-ideals’ at all (Jackson and Chen, 2008b, Jung and Forbes, 2007, Leung et al., 2001, Ma, 2007). Masculinity, in traditional Chinese culture, is more closely related to a man's character than his physique (Yang et al., 2005), though Jackson and Chen (2008a) suggest that stature, as opposed to muscularity, may be a valued body ideal. Jackson and Chen (2008a) have further suggested that collectivist values and culturally defined ideals of femininity and masculinity may lead to high levels of sociocultural pressure to conform, unrelated to Western ideals of beauty that are disseminated by the media.
The rapid economic growth and increasing Westernisation experienced by China since the adoption of the ‘Open Door Policy’ in the 1980s has resulted in a shifting cultural climate characterised by intergenerational conflict between modern and traditional values (Lee and Lee, 1996, Ma, 2007). These intergenerational differences have direct implications for relationships between children and their parents, whose upbringing was drastically different from that of the current generation of Chinese youth (Ma, 2007, Ma, 2008). While young people in China today are embracing Western values emphasising autonomy, independence and personal success, their parents were raised to value cooperation, obedience and group cohesion. These vast cultural differences are likely to impede effective communication between parents and children regarding issues of body image and diet, which are highly relevant to personal development throughout childhood and adolescence (Jung & Forbes, 2007).
In Western studies parental influence has been shown to have both a direct and an indirect impact on children's development of ideal body types, by encouraging particular diet and exercise habits, as well as by engaging in these habits themselves and discussing their own body image concerns in the presence of their children (Markey, Tinsley, Erickson, Ozer, & Markey, 2002). In particular, mother's dieting habits have been associated with body dissatisfaction and disordered eating in their adolescent daughters (Markey et al., 2002). Early studies of eating disorders in China also emphasised the role of the mother and recommended that anorexic patients should be isolated from their mothers, who were seen as a ‘toxic agent’ responsible for causing and maintaining self-starvation in their daughters (Chen, 1990, cited in Ma, 2008). This recommendation proved to be theoretically unsound and therapeutically harmful and it is now more commonly accepted that dysfunctional mother–daughter relationships are a corollary, rather than a cause of disordered eating (Ma, 2008). Several aspects of the parent–child relationship have been associated with disordered eating in Chinese adolescents and these include the need for control over one's life (particularly when parents are seen as restrictive and over controlling, a common feature in Chinese families), the dilemma between growing up and staying young, and inner conflict about whether to pursue autonomous goals or to fulfil parental expectations (Ma, 2008).
In addition, due to the ‘one child only’ policy introduced in 1979, many urban dwelling Chinese children are likely to be only children. The lack of siblings, as well as the weakening of familial bonds, may threaten traditional understandings of self that are embedded in kinship relationships (Falbo & Poston, 1993), as well as limit opportunities for social comparison with regard to body image (Tsiantas & King, 2001). Only children, particularly those who are isolated from extended family networks, may rely more heavily on peer relationships and information from the media to inform them about ideal body types. More directly, Falbo and Poston (1993) have suggested that only children may be over indulged with food, perhaps contributing to the rise in obesity rates and disordered eating in Chinese children.
The influence of peers on body dissatisfaction and engagement in body change behaviors in Chinese populations has received relatively little attention within the literature and this may reflect a belief that peers are less influential than the media or family in Chinese society (Chen et al., 2007). Studies conducted with adolescents in Western countries tend to show that peers are a powerful source of influence in promoting body image ideals and body change behaviors (Jones and Crawford, 2005, Ricciardelli and McCabe, 2003). For girls, female friends have been shown to exert pressure related to weight loss (Griffiths and McCabe, 2000, McCabe and Ricciardelli, 2001), and for boys, male friends in particular have been shown to encourage muscle building behaviors (Jones and Crawford, 2005, Ricciardelli and McCabe, 2003). Adolescents, at least in the West, are likely to discuss their appearance concerns with friends and this may reinforce the value and importance of appearance ideals (Jones & Crawford, 2005). Negative or critical feedback may further enhance poor body image in adolescents, who are particularly vulnerable to the need for acceptance among their peers. Jones, Vigfusdottir, and Lee (2004) found that boys and girls who reported more frequent conversations with friends about their appearance reported greater body dissatisfaction, however the direction of this relationship is impossible to determine in cross-sectional studies. Dissatisfaction may lead to more frequent conversations about appearance or vice versa.
In a recent study of Chinese adolescents living in Malaysia, Mellor et al. (2009) found that body dissatisfaction was predicted by perceived pressure from the family and the media, but not peers. Perceived pressure from peers did, however predict engagement in strategies to lose weight for females and to increase muscle for males (Mellor et al., 2009). Chen et al. (2007) reported that perceptions of teasing and social pressure to be thin directly predicted body dissatisfaction for Chinese males and females, however the authors used measures of ‘people in general’ with regard to teasing, and social pressure was measured using a combination of sources including significant others and the mass media. Given the lack of available research, the role of peers in influencing body perceptions and body change behaviors in Chinese youth warrants further investigation.
The current study aims to address the lack of available research on body image issues in non-Western populations by exploring levels of body dissatisfaction and engagement in body change behaviors among Chinese adolescents. Body change behaviors included efforts to lose weight, to gain weight or to increase muscle bulk. Sociocultural sources of influence related to body image among Chinese adolescents, namely pressure from adult relatives, peers and the media to either lose weight, gain weight or increase muscle bulk, were also explored and the relationship between these sociocultural pressures and body dissatisfaction and body change behaviors was examined. Because sex differences are consistently reported with regard to body dissatisfaction, engagement in body change behaviors and sociocultural sources of influence, the current study investigated males and females separately. Body mass index (BMI) is also known to influence these variables (Chen et al., 2007, Ricciardelli et al., 2003), and therefore differences between Chinese adolescents classified as either underweight, healthy weight or overweight were also considered. It was anticipated that the results of the current study would make a significant contribution to the literature regarding body image concerns and behaviors among Chinese youth and will also improve understanding and applicability of the sociocultural model of body image (Ricciardelli & McCabe, 2004) in different cultural contexts.
Section snippets
Participants
A sample of 219 males and 298 females was recruited through three schools for the current study. Two schools were in urban areas of Chengdu, and the other in a semi-urban area of Chengdu. Ages ranged from 12 to 16 years with a mean age of 14.47 years for males and 14.39 for females. Body mass index (BMI) was derived from adolescents’ self-reports of height and weight, and BMI classifications for underweight, healthy weight and overweight were calculated using Cole et al., 2000, Cole et al., 2007
Results
Data were analysed with SPSS for Windows statistical package (SPSS Inc, 2005 – SPSS for Windows: Release 15.01, Michigan, IL: SPSS Inc). Two separate MANCOVAs were conducted to examine differences with regard to sex and BMI on all the variables. Due to the tendency for BMI to correlate positively with age in adolescents, age was entered as a covariate. A chi-square test for independence indicated that there were no gender differences across the age categories of participants, χ2(1, n = 517) = .15, p
Discussion
The current study is the first to investigate body dissatisfaction, engagement in body change behaviors and sociocultural influences related to body image, as well as the relationships between these variables, in Chinese adolescents. In line with previous studies conducted in the West, as well as in other cultural contexts (Chen and Jackson, 2008, Kennedy et al., 2004, Lee and Lee, 1996, Mellor et al., 2008, Mellor et al., 2009), females were found to report greater body dissatisfaction than
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