Elsevier

Body Image

Volume 13, March 2015, Pages 67-74
Body Image

Associations between positive body image and indicators of men's and women's mental and physical health

https://doi.org/10.1016/j.bodyim.2015.01.002Get rights and content

Highlights

  • Positive body image and health indicators among men and women were examined.

  • Positive body image was associated with lower depression and higher self-esteem.

  • Positive body image was associated with less dieting and drive for muscularity.

  • Positive body image was associated with greater skin protection intentions.

  • Results suggest positive body image has health-related benefits for men and women.

Abstract

Positive body image has been found to be associated with various beneficial health-related indicators among women. Yet, less is known about its health-related correlates among men. The goal of the current study was to examine associations between positive body image and various mental and physical health-related indicators in both men and women. Undergraduate students (N = 284) from a non-residential college in the northeastern United States participated. Individuals with greater positive body image reported less depression, higher self-esteem, fewer unhealthy dieting behaviors, lower drive for muscularity, and greater intentions to protect their skin from UV exposure and damage. Gender did not moderate these associations; thus, connections between positive body image and health-related indicators were similar for women and men. Results suggest that positive body image has significant implications for health and well-being beyond objective body size. Health care providers should encourage positive body image because of its potential health benefits.

Introduction

Most research on body image assumes a risk-based perspective, failing to capture what individuals like about their bodies. This approach reflects the high prevalence of body dissatisfaction among adults in the United States (U.S.; Gillen and Lefkowitz, 2006, Yates et al., 2004). Yet, not everyone is unhappy with their looks and some may, in fact, love their bodies. According to Tylka (2011), positive body image is defined as individuals’ appreciation for, protection and acceptance of, and connection with their physical selves. It differs from negative body image in that it is a separate construct that represents more than low levels of negative affect or cognitions about the body. For example, just as happiness is more complex than the absence of depression, positive body image is more complex than the absence of body dissatisfaction. Williams, Cash, and Santos's (2004) work provides support for the distinctiveness of positive body image and low negative body image. Using cluster analysis, they identified three groups of women: those with positive, negative, and “normative discontent” body image. Women with positive body image reported a number of more healthful characteristics than women in the other two groups, such as higher optimism and self-esteem, and lower perfectionistic self-presentation. This research demonstrates that positive body image is not simply the opposite of low negative body image.

The relatively small literature on positive body image suggests that it may have important benefits for women in mental and physical health domains such as eating behavior, sexual functioning, attitudes toward cosmetic surgery, and personality (Hahn Oh et al., 2012, Satinsky et al., 2012, Swami et al., 2012, Swami et al., 2013b). However, most research on positive body image has been conducted with women, with fewer studies sampling men. Researchers should not assume that the health-related indicators associated with positive body image for men will resemble those found for women. To that end, the goal of the present investigation was to examine links between positive body image and mental and physical health-related indicators among both men and women. In the current study, positive body image was operationalized as body appreciation, a central aspect of positive body image (Tylka, 2011). Body appreciation is measured by the Body Appreciation Scale (BAS; Avalos, Tylka, & Wood-Barcalow, 2005), the most empirically supported measure of positive body image to date.

Positive body image may be associated with two important mental health indicators: depression and self-esteem. These two constructs have been frequently examined in literature on negative body image, so it is important to determine if they are associated with positive body image as well. Compared to those lower in positive body image, individuals who have higher levels of positive body image may be less prone to depression and poor self-esteem by having fewer feelings of dejection and higher self-worth: when individuals love and respect their physical selves, they may develop a respect for their emotional well-being as well. Self-care behaviors are asserted to be an outcome of positive body image (Tylka, 2011), suggesting that individuals with positive body image could more frequently take steps to protect and nurture their physical and mental health. For example, those with higher positive body image may be more likely to engage in self-care behaviors such as cardiovascular exercise, yoga, meditation, or unwinding by reading novels (Tylka, 2011). Self-compassion, a construct related to positive body image, is in fact associated with fewer depressive symptoms and higher self-esteem (Wasylkiw, MacKinnon, & MacLellan, 2012). Thus, by being proactive in caring for their bodies and being compassionate toward themselves, those with higher positive body image may have better mental health, including lower depression and higher self-esteem, compared to those lower in positive body image.

Some researchers have examined links between positive body image and depression. For example, Rubin and Steinberg (2011) created their own measure of awareness and appreciation of body functionality for pregnant women, and found that higher awareness and appreciation was associated with fewer depressive symptoms in these women. Similarly, among predominantly female medical students in Romania, individuals with higher body appreciation had lower levels of depression (Dumitrescu, Zetu, Teslaru, Dogaru, & Dogaru, 2008). In a sample of U.S. college women, Iannantuono and Tylka (2012) found inverse moderate associations between body appreciation and depressive symptoms in a bivariate, but not multivariate, context.

Links between positive body image and self-esteem are also important to investigate. Having positive feelings toward one's physical being may translate into positive feelings toward the self as a whole. In a sample of U.S. college students, for instance, body appreciation was significantly associated with self-esteem in both men and women (Tylka & Kroon Van Diest, 2013). Other work is based primarily on non-U.S. samples of male and female adults. British women with higher body appreciation tend to have higher self-esteem (Swami et al., 2009, Swami et al., 2012). Body appreciation and self-esteem have also been found to be significantly related in male and female British adults (Swami, Henry, Peacock, Roberts-Dunn, & Porter, 2013), and in Austrian adults using a German translation of the Body Appreciation Scale (Swami, Stieger, Haubner, & Voracek, 2008). Thus, it seems that positive body image is associated with lower depressive symptoms, particularly among women, and higher self-esteem in both men and women, although most of these studies have been conducted outside of the US on adults from the general population. More research on college students, for whom issues such as body image and mental health may be concerning, is needed (American College Health Association, 2009, Gillen and Lefkowitz, 2012).

Positive body image may also be associated with physical health-related indicators. Given that positive body image reflects liking, appreciating, accepting, and caring for one's physical being (Tylka, 2011), those with positive body image may be less interested in modifying their body to fit cultural norms of attractiveness, and consequently, may be less likely to harm the body in these efforts. Three bodily factors that may be relevant to positive body image are eating behavior, desire for muscularity, and intentions to protect one's skin from ultraviolet (UV) ray damage. These factors were chosen to examine because they pertain to modifying the body in particular ways to conform to cultural ideals of attractiveness including thinness, muscularity, and tan skin, respectively (Grant et al., 2014, McCreary, 2011, Murnen, 2011). Although these factors have been examined in relation to negative body image, there is little work on how they might relate to positive body image.

Eating behavior may be associated with positive body image. One eating-related construct often examined in research on positive body image is intuitive eating, an adaptive style of eating that involves consumption based largely on internal hunger cues rather than other reasons (e.g., depression, boredom; Avalos and Tylka, 2006, Tylka and Kroon Van Diest, 2013). Avalos and Tylka's (2006) model of intuitive eating (and variations of it) have gained support in multiple samples of women (Augustus-Horvath and Tylka, 2011, Iannantuono and Tylka, 2012, Hahn Oh et al., 2012). Beyond intuitive eating, it is important to investigate other eating-related issues that may relate to positive body image. For example, many people are currently trying to lose weight, and some engage in unhealthy weight loss behaviors (e.g., skipping meals, diet pills) in order to achieve this goal (Kruger, Galuska, Serdula, & Jones, 2004). Although dieting behavior has been examined extensively with regard to negative body image, there is little knowledge of how some extreme and perhaps dangerous dieting behaviors may relate to positive body image. All aspects of positive body image—love, respect, protection, acceptance, and connection with the body—suggest that individuals with higher positive body image would avoid potentially harmful dieting behaviors (Tylka, 2011). There is considerable sociocultural pressure on both women and men to have a lean body (McCreary, 2011, Murnen, 2011), yet those with higher positive body image may resist this pressure because they value the body they presently have. They may also seek to protect their bodies from any negative impacts that dieting may have such as constant hunger, malnutrition, or excessive weight loss. Some recent research supports this argument; body appreciation was found to be associated with less weight loss behavior among women (Andrew, Tiggemann, & Clark, 2014), and less disordered eating among college men and women (Tylka & Kroon Van Diest, 2013).

Like dieting behavior, the desire for muscularity may also be related to positive body image; specifically, individuals with lower drive for muscularity may have higher positive body image. The cultural body ideal for men includes leanness and muscularity; although the societal appearance ideal for women is not quite as bulky, it does feature a lean, “toned” body (McCreary, 2011, Petrie and Greenleaf, 2012). Thus, sociocultural pressure may lead both men and women to strive for more muscle mass. Individuals who have higher positive body image may resist more harmful forms of muscle building to fit sociocultural appearance ideals and instead accept their bodies as they are. In studies of college men, Tylka, 2013, Tylka, 2015 found that those with higher body appreciation were less dissatisfied with their muscles and body fat, and used pornography less frequently (pornography being a medium where the ideal male muscular body may be predominantly featured). More research is needed to understand how attitudes and behaviors pertaining to the desire for muscle mass relate to positive body image for both men and women. Although there is prior work linking muscle and body fat dissatisfaction to lower positive body image among men (Tylka, 2013, Tylka, 2015), there is no comparable research on women, and no research examining the specific construct of drive for muscularity among men or women.

Just as individuals with higher positive body image may avoid or reduce harmful behaviors that alter their weight or body shape, they may also minimize attempts to alter their skin color. Tanning is a common practice among college students; improving appearance is a critical motivator for engaging in this behavior (Hillhouse et al., 1999, Knight et al., 2002, Mosher and Danoff-Burg, 2010). Consistent with the high rates of tanning and its motivations, individuals tend to rate tan people as more attractive than non-tan people, suggesting that tanness may be part of the cultural ideal of attractiveness (Chung et al., 2010, Grant et al., 2014). Although tanning is believed to enhance appearance, it carries serious health risks. Through exposure to UV rays, tanning increases the risk for skin cancer (Rass & Reichrath, 2008), a fact that most people are aware of (Knight et al., 2002). Individuals with higher positive body image, in an effort to protect and care for the body, may have greater intentions to protect their skin from UV exposure and damage. However, it is important to recognize that skin type may confound this association because it may be linked to tanning-related attitudes and behaviors (Clarke, Williams, & Arthey, 1997). That is, individuals with more sun-sensitive skin types may engage in more protective skin behaviors and have more protective attitudes because they may recognize that their skin is more vulnerable to UV damage (Clarke et al., 1997). In fact, people with the most sun-sensitive skin types (Types I and II) are at greatest risk for skin cancer (Skin Cancer Foundation, 2014). For these reasons, skin type was included as a control variable in the current study. Tylka (2011) suggested that researchers examine whether or not positive body image is related to a greater focus on physical health, including taking more preventive measures to protect against disease. Intentions to protect the skin from skin cancer by limiting UV exposure may fit this suggestion. There is little published work on positive body image and skin cancer protection, however, with only one prior study examining this association. Specifically, Andrew et al. (2014) found that women with higher body appreciation engaged in more sun protective behaviors and skin screenings.

In sum, the goal of the present study was to examine associations between positive body image and various indicators of mental and physical health among men and women. The physical health indicators examined have rarely been previously studied in the context of positive body image but may be significant outcomes. Although there is little research on health-related indicators associated with positive body image for men, the research that does exist suggests that these associations may be similar to women's. The hypotheses are as follows: (a) men and women with higher positive body image will report lower depression and higher self-esteem (b) men and women with higher positive body image will report less unhealthy dieting behaviors, lower drive for muscularity, and greater intentions to protect their skin from UV exposure and damage.

Section snippets

Participants and Procedure

Data collection occurred at a non-residential regional college of a large university which is located in a suburban area in the northeastern U.S. Undergraduate students (N = 284, M = 20.14 years, SD = 3.39; range 18–59 years) participated in a study in exchange for course credit for one of three foundation courses in psychology. Participants were told that the purpose of the study was to learn about college students’ attitudes and behaviors related to body modification. Sixty percent of students were

Results

Among all analytic variables, 0–4.6% of data was missing. For individual scales where more than 20% of data was missing, participants’ score on that scale was eliminated from any analysis including that variable. For scales where less than 20% of data was missing, mean scores on the completed items were entered in place of the missing item(s) and a total score was then calculated. Data were screened for univariate and multivariate outliers. Several univariate and multivariate outliers were

Discussion

The purpose of the current study was to examine associations between positive body image and mental and physical health-related indicators among racially/ethnically diverse male and female college students. Results show that individuals with higher positive body image reported fewer depressive symptoms, higher self-esteem, fewer unhealthy dieting behaviors, a lower drive for muscularity, and greater intentions to protect their skin from UV exposure and damage. Interestingly, these findings

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