Media production and engagement

TV is big business, generating £10·1×10⁹ in revenue in the UK during 2004 (Ofcom, 2005). At the end of May 2005, 376 channels were broadcasting in the UK, achieving an output of >1×10⁶ h annually. Of UK households 99% have a TV and 81% of individuals live in households with two or more TV sets (Satter et al. Reference Satter, Glen and Diaper2005). Approximately 65% of households are capable of receiving multi-channel TV. Unsurprisingly, about 60% of TV viewing by <16-year-olds is directed at non-traditional channels (Ofcom, 2005). A report on children's TV viewing has estimated that in 2001 the daily viewing times of those in ‘multi-channel’ homes were 2 h 27 min, about 35 min more than those for children with access to only terrestrial channels (Atwal et al. Reference Atwal, Millwood-Hargrave and Sancho2003). However, only 30 min/d were reported to be spent by 4–15-year-olds watching children's programming; the majority was family or adult programming.

Choice is even greater when it comes to magazines. Consumer magazines, as opposed to those directed at the business and professional market, numbered 3366 UK titles in 2005 and generated £2·2×10⁹ in sales and advertising (Periodical Publishers Association, 2006). Approximately 90% of 10–14-year-old girls in the UK read a teenage magazine, and popular titles like Bliss and Sugar sell >0·25×10⁶ copies per issue (Periodical Publishers Association, 2006). It is estimated that the likely readership for each magazine is two or three times greater than the sales figures, as issues are shared or passed on between friends. Although they are targeted at females, the readership of these titles amongst teenage boys is also high. The problem pages in particular cater for and respond to both sexes. Like TV, teenagers' engagement with magazines is not exclusive to those produced for them, and the data for teenage magazine readership may represent only part of their total magazine exposure and use.

Other media are being increasingly used by adolescents. Almost all children now have a personal computer at home (ChildWise, 2006). Seven in ten 5–16-year-olds have internet access and half have broadband. The popularity of internet messaging services such as MSN mean that teenage internet users spend approximately 2 h/d on line (in addition to, or simultaneous with, the 2·5 h daily TV viewing). Advertisers are aware of this changing media use. Expenditure on advertising on the internet in the UK approximately doubled from 2004 to 2005 and, at £1·1×10⁹, surpassed for the first time that spent on advertising in consumer magazines (a mere £827×10⁶).

Depicting the female body

Not only is media access and engagement increasing, but the depiction of women's bodies in the media has altered, albeit over a longer timescale. The way that women's ideal body weight has decreased since the late 1950s is well documented (see Wiseman et al. Reference Wiseman, Gray, Mosimann and Ahrens1992). Taking magazine centrefolds and beauty contestants as metrics of changing ideals, Miss America contestants continued to decrease in body size during the 1980s while the Playboy centrefolds plateaued at an extremely low weight (Wiseman et al. Reference Wiseman, Gray, Mosimann and Ahrens1992).

Complementing this research Sypeck et al. (Reference Sypeck, Gray and Ahrens2004) have examined the models used on the covers of the four most popular American fashion magazines between 1959 and 1999 (Vogue, Mademoiselle, Glamour, Cosmopolitan). The body size of the models decreased during the 1980s and 1990s. Of equal importance was the change in body portrayal. In the first two decades studied the magazine covers depicted the models' faces or their faces and upper torso. From the mid-1980s onwards, full-body depictions became much more common. In addition, in the later editions they were much more likely to be wearing revealing clothes. So, the presentation of ideal female body shapes has become more complete (full-body) and more revealing, and is patently thin. This change is not likely to be restricted to fashion magazine covers. It is apparent in women's lifestyle magazines and in advertising, be it on TV or on public display.

Adolescent's perception of influence

A number of studies have looked at the adolescent's perception of media influence. For example, in a frequently-cited questionnaire study (Field et al. Reference Field, Cheung, Wolf, Herzog, Gortmaker and Colditz1999) 69% of the American girls who participated reported that magazine pictures influenced their idea of a perfect body shape and 47% reported wanting to lose weight because of magazine pictures. This perceived influence was shown to increase with increasing teenage age, and a positive association was found between these endorsements and the frequency of reading women's magazines.

However, these questionnaire responses fail to do justice to the depth of girls' appreciation of media influence. In a focus-group study Australian adolescents were found to be in broad agreement that the thin but perfect body appearance of models determines their views of what is normal and what everyone should look like (Tiggemann et al. Reference Tiggemann, Gardiner and Slater2000). They describe the process as automatic and instilling the belief that thinness promises happiness and success. However, a variety of other reasons were given as underpinning their desire for thinness, including: feeling more attractive and confident; receiving more attention; being able to wear and look good in fashionable clothes. It was found that wanting to be thinner is not always synonymous with being dissatisfied with current weight and shape. For some girls at least, personal distress does not drive the appeal of thinness. Indeed, the authors note the sophistication of girl's observations regarding the socio-cultural pressures on them and the ways they negotiate externally-imposed representations of body-shape ideals.

Experimental studies

Attempts at understanding the effects of exposure to media body images on self-perception have for some time used more-tightly controlled experimental investigations. Unsurprisingly, these investigations have taken many forms. However, a meta-analysis by Groesz et al. (Reference Groesz, Levine and Murnen2002) draws out some of the main issues. The authors only included studies that: used female participants; used published whole-body images; included a control or comparison group; measured body dissatisfaction or physical attractiveness as a dependent variable. Overall, twenty-five studies met these criteria, yielding forty-three effect sizes. It was found that the mean effect size was −0·30, a small but relatively consistent effect, indicating that exposure significantly decreased body satisfaction. The value of this evidence synthesis can be seen in the correlates of outcome. Body image was shown to be more negative after viewing thin media images than average- or plus-size models or non-body objects. The effect was found to be greater in between-subject designs, in participants younger than 19 years and in those with existing body dissatisfaction and body-shape concerns.

These data led to the conclusion that in experimental settings exposure to thin body images activates rather than cultivates a thinness schema. In other words, it facilitates negative body image in women who already think about themselves in terms of concerns about body shape and weight. The implication is that the existence of a thinness schema is a vulnerability in circumstances in which weight, shape and attractiveness information is salient. The authors also hypothesise that young adolescent girls are particularly vulnerable, because some girls are entering adolescence who already have body-image concerns and because self-presentation and physical appearance are common adolescent concerns.

A problem with many of these experimental studies is that they present participants with a very salient but essentially weak stimulus. Exposure to thin images rarely lasts more than a few minutes and the effects are never followed to the next days or weeks. The topic is in desperate need of longer-term laboratory or field studies of media image exposure.

The value of this approach can be seen in a study by Stice et al. (Reference Stice, Spangler and Agras2001). As an incentive to participation in a survey, 50% of a group of adolescent girls were given a 15-month subscription to Seventeen, a popular US adolescent magazine. The others were entered into a draw for book or music store gift vouchers. Although the original purpose of the study was a longitudinal survey of adolescent body image and dieting, the authors analysed the data as though it was a trial evaluating magazine exposure. Overall, no effects of prolonged exposure on body dissatisfaction, dieting or negative affect were found. However, and consistent with the notion of vulnerability mentioned earlier, those girls with initially higher body dissatisfaction were found to increase their level of negative affect over the trial. Thus, longer-term exposure to, and engagement with, body-image media may have effects on a body-image-vulnerable group in a manner not limited to body weight and shape issues. Also of relevance to issues raised later in the present paper, it was found that girls who at the trial outset rated themselves as low in peer and family support had increased in body dissatisfaction and dieting by the end of the trial. This finding suggests that any proposed vulnerability to media effects involves more than the existence of a thinness schema. Socially-isolated adolescents may use and interact with body-image media in different ways to those satisfied with their bodies and content in their peer group.

Magazines or television?

This study by Stice et al. (Reference Stice, Spangler and Agras2001) is a rarity, and it illustrates some of the problems in implementing longer-term research. The issue of a weak experimental manipulation is also apparent, and it is difficult to properly measure manipulated exposure dose against the background of other body-focused media. The same would be true of any attempt to manipulate the content of adolescent TV exposure. However, there is evidence that magazine body-image exposure has more influence than that of TV. Vaughan & Fouts (Reference Vaughan and Fouts2003) have collected information on eating-disorder psychopathology and magazine and TV exposure in a group of young adolescent girls on two occasions, 16 months apart. The girls were divided into three groups according to whether they increased, decreased or did not change in eating-disorder symptoms. It was found that those girls who with increased symptoms, increased in their exposure to fashion magazines but decreased their TV viewing, while those whose symptoms decreased, reduced their exposure to both magazine and TV media.

Although this study was longitudinal it says nothing about causal processes. Plausible directional influences could be argued for in either direction and the possible influence of a third variable such as reduced self-esteem cannot be ruled out. However, it does reinforce the idea that in this context magazine and TV engagement are functionally-different activities. Tiggemann (Reference Tiggemann2003), for example, argues that women with high body dissatisfaction may be more likely to buy and read magazines for their explicit depictions of thinness and advice on appearance enhancement. In this respect, their engagement is purposive and active, something very different from the entertainment value of TV viewing. It also mirrors the inclusion of ‘thinspiration’ sections in nearly every pro-ana (pro-anorexia) website. ‘Thinspiration’ comprises a host of images of very thin models and celebrities often wearing very revealing clothes. The purpose is to remind browsers who have disordered eating about the body shape they are striving for and to help them manage their control over eating.

This functional aspect of media engagement can also be seen in the relationship between the frequency of reading magazines and weight-loss attempts. For example, frequent readers are twice as likely to report dieting to lose weight and three times more likely to exercise to lose weight because of a magazine article (Field et al. Reference Field, Cheung, Wolf, Herzog, Gortmaker and Colditz1999). In addition, reading magazine articles about dieting or weight loss is strongly associated with unhealthy weight-control behaviours such as fasting or vomiting. Girls who often read these articles are seven times more likely to engage in these behaviours (Utter et al. Reference Utter, Neumark-Sztainer, Wall and Story2003). The most likely explanation is that most girls are motivated to diet and seek the information they are looking for, which is obviously easy to find.

Comparisons with peers and models

The process by which adolescents may use thin media images for body-comparison purposes is described by Botta (Reference Botta1999). Consulting TV or magazines, adolescents see glamorous and attractive images as representing realistic goals to achieve. Comparing themselves with these images they find themselves wanting. The focus may be on a single body feature or more generalised. The more they compare themselves, the more they strive to be thin, the more they dislike their bodies, and the more they engage in unhealthy weight-control behaviours.

This account is compelling in its simplicity but the reality is more complex. For example, media engagement is often a highly social process and media knowledge a social currency. As an illustration of this aspect Jones et al. (Reference Jones, Vigfusdottir and Lee2004) have used path analysis to examine how appearance-magazine exposure and peer relationships are associated with body dissatisfactions in a large group of adolescents. The pattern of relationships suggests that magazine images in their own right probably have limited impact on girls' body image. Rather, those more involved with appearance magazines are also engaged in friendships that focus attention on appearance concerns. It would appear that magazine content provides material for conversation that is personalised with friends. Thus, it is within this interpersonal context of interactions with friends that these thin-body media have an effect.

The functions of social comparisons with media models have been explored by contrasting them with comparisons with same-gender peers (Jones, Reference Jones2001). As previously described, social comparisons may be made across a variety of abilities or attributes, not all of which are appearance related. The results show that both models and celebrities and same-gender peers are the targets for physical and appearance comparisons. In contrast, comparisons on personal and social attributes are more directed at peers. So, social comparisons with models and celebrities are primarily for appearance self-evaluation. Interestingly, weight and shape comparisons with both models and peers were shown to be correlated with body dissatisfaction, once more suggesting that this focus for comparison is greatest in those most dissatisfied. It was also noted that girls make more social comparisons than boys across all targets and attributes. This greater frequency, especially in relation to appearance attributes, is likely to reflect the greater sensitivity and need for this information by girls.

Celebrity

A brief reference to the appeal of celebrity figures is appropriate. Looking at celebrity interest in British teenagers, Giles & Maltby (Reference Giles and Maltby2004) argue that celebrities provide adolescents with a secondary group of pseudo-friends during a time when they are becoming more autonomous, in particular separating from parents. The appearance attributes or attitudes and behaviour of a celebrity may be highly influential, providing teenagers with exemplars to mimic, aspire to or reject. So, celebrity interest meets developmental needs, and celebrities' appearance and body shape are likely to be highly influential.

Supporting this reasoning, Maltby et al. (Reference Maltby, Giles, Barber and McCutcheon2005) have found an association between celebrity interest for intense personal reasons and the importance they placed on body shape and weight. This relationship was shown to be age-related, becoming apparent at 14 years but disappearing from 17 years onwards. This outcome is consistent with the idea that adolescent girls who develop intense celebrity interest in an individual with an attractive or thin body shape develop a poor body image in themselves. However, once again there are alternative explanations. The opposite may be true. Someone with body dissatisfaction may become obsessed with an attractive or thin celebrity. Most likely, these relationships are reciprocal and alternate, inflating both body dissatisfaction and celebrity interest.

A final observation concerns the changing way that the media manages celebrity. There is great cynicism apparent in many media, and celebrity figures are not held in the exclusive high regard they once were. Distinctions are made between ‘A’ lists and ‘B’ lists, with ‘minor’ celebrities seen as in the media spotlight for money or their 15 min of fame. Women in the public eye are featured in popular magazines for praise and for ridicule. Public display enables public commentary, much of which is spiteful. Two forms are readily apparent. Popular young women's magazine covers regularly feature photographs of celebrities chosen for looking over-thin or overweight. The accompanying narrative is judgemental: too fat; too thin; has cellulite. Inside, features are on what not to wear, celebrities in bikinis and the circle of (appearance) shame poke fun at their clothes or appearance. This media coverage is not designed to inspire appearance confidence in its readership.

Social support and social contagion

The issue of social isolation as a component of an individual's susceptibility to thin media has been raised earlier in describing the study by Stice et al. (Reference Stice, Spangler and Agras2001). It is also apparent in a later study by this group. Here, perceived low social support by parents, and to a lesser extent by peers, was shown to predict body dissatisfaction (Bearman et al. Reference Bearman, Presnell, Martinez and Stice2006); the effect being weak. Participants were younger adolescents (mean 13·5 years) and from a mix of public and private schools, suggesting a more even balance of parental and peer affiliation that might be seen in later teenage years.

Peer friendship groups can make a positive or negative contribution to body image and dieting. Using a social-network analysis to identify friendship clusters or cliques, Paxton et al. (Reference Paxton, Schutz, Wertheim and Muir1999) have found higher within-group than between-group similarity for body-image concern, dieting and extreme weight-loss behaviours. In addition, groupings of 15-year-old girls scoring high in body dissatisfaction and dieting were found to show high levels of peer engagement in weight- and shape-related issues. This social-contagion model of weight concern and dieting is similar to that proposed to account for adolescent smoking and alcohol consumption. For certain groups these behaviours and accompanying attitudes become socially normative and define group identity. Group affiliation is maintained by sharing information on weight-control strategies, modelling dieting and disordered eating and participating in fat talk, i.e. discussion with peers on the negative perception of particular body areas. It should come as no surprise therefore that the number of friends dieting has been found to be a predictor of the use of unhealthy weight-control behaviours in overweight and average-weight girls (Eisenberg et al. Reference Eisenberg, Neumark-Sztainer, Story and Perry2005).

On the positive side, friendship groups less invested in weight and shape issues provide a protective environment for girls who are otherwise vulnerable. Much of the time friends can offer sensible advice and emotional support, and act as a gateway to helpful adults.

Children's views

Recently, Latner & Stunkard (Reference Latner and Stunkard2003) have conducted a replication of a very well-known study of children's perceptions of disability, originally published in the early 1960s. The task faced by 10–11-year-olds was to choose from a series of drawings the child they would most like as their friend. The pictures were of a child as physically normal, in a leg brace or crutches, in a wheelchair, with facial disfigurement, without a hand or overweight. The overweight child was found to be the last to be chosen. Some 40 years on, the overweight child was again found to be liked least and placed bottom by even more children than in the original study, especially by girls. In addition, the healthy non-disabled child was more consistently chosen first, again more so than 40 years before. So the polarisation of children's views has paralleled that of the adults around them.

An indication of the extent to which these views are socially ingrained comes from work with very young children. For example, Musher-Eizenman et al. (Reference Musher-Eizenman, Holub, Miller, Goldstein and Edwards-Leaper2004) have asked 4–6 years olds to rate three body figure drawings. Overall, the fat body shape was found to be the most negatively rated. This drawing was chosen as a friend on 16% of occasions (v. 39% and 45% of occasions for thin and average figures respectively), and as best friend only 7% of the time. Using a storyline procedure in which one child was mean, the other nice, Cramer & Steinwert (Reference Cramer and Steinwert1998) have found that 3–5-year-old children are more likely to choose a drawing of a fat figure as the mean child than a thin or average-shape figure. Furthermore, these authors report that body-size stigmatising increases with age but is clearly present in 3-year-olds. In addition, girls show more stigmatisation than boys, and while the preferred playmate of low- and average-weight children is average shaped, overweight children are more likely to choose the thin figure. Even preschool children have acquired the belief that fat is bad.

Fatness is also a target for children's bullying and victimisation; between one-quarter and one-third of adolescents report being teased by peers for reasons of weight (Eisenberg et al. Reference Eisenberg, Neumark-Sztainer and Story2003). Those teased were found to have low body satisfaction, low self-esteem and more depressive symptoms. The author's research has looked specifically at fat-teasing, i.e. being teased, bullied or called horrible names for being fat. Of the 450 12-year-olds studied, 12% of girls and 16% of boys were found to identify with the description of themselves as a fat-teased child (Hill & Murphy, Reference Hill and Murphy2000). Again, being fat-teased was found to be associated with body dissatisfaction and low self-esteem.

Personal responsibility

With a strong public health focus on obesity and governments that promise action, overweight has high visibility. The personal-responsibility approach remains prominent, fostering the idea that individual choice is the key to implementing behavioural change. The population is urged to become more physically active and to eat less. Obesity, it is implied, is a modifiable state of body (Hill, Reference Hill, Voss and Wilkin2003). However, making obesity a lifestyle disorder has helped relatively few. Instead, it has inflamed anti-fat attitudes and the prejudice directed at the obese. The messages concerning the pathology associated with obesity confirm the bleak picture. If any adolescent had a reason to dread being fat, then health professionals have provided several more. Also, of course, a fear of fatness is at the very heart of eating disorder psychopathology. Teenagers are directed to alter their nutritional behaviour not just because of their bombardment with thin ideals but for the disgrace and disease of fatness.