Perceived current and ideal body size in female ...

Eating Behaviors 18 (2015) 71–75

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Eating Behaviors

Perceived current and ideal body size in female undergraduates Lillian P. MacNeill, Lisa A. Best ⁎ University of New Brunswick, Saint John, Canada

a r t i c l e

i n f o

Article history: Received 19 August 2014 Received in revised form 10 February 2015 Accepted 19 March 2015 Available online 15 April 2015 Keywords: Perception of body size Ideal vs. current body size Disordered eating Changing perceptions

a b s t r a c t Body image dissatisfaction and disordered eating attitudes and behaviors are pervasive problems in Western society, particularly for females. The female “thin-ideal” is a potent contributor to the growing discontent with the female body and research has shown that even females who are normal or underweight, perceive themselves as overweight. The goal of the current study was to examine correlates of body image satisfaction and the perception of the female body. One hundred and sixty six female undergraduates (Mean Age = 21.40 years) completed self-report measures pertaining to disordered eating (EAT-26) and body dissatisfaction (BIQ and ABS). Body image perception and satisfaction were measured using ratings of female bodies on a weight perception scale (PFRS). Overall, disordered eating was related to a lower ideal body size and greater body dissatisfaction. In support of previous research, the most common ideal female body had a BMI categorized as underweight. Although females in the current sample reported an ideal that was smaller than their current size, participants underestimated their current body size, which, given the amount of dieting and weight pressure in present Western society, seems counterintuitive. It is possible that thin ideal portrayed in the media is increasingly different from and at odds with the average female body. © 2015 Elsevier Ltd. All rights reserved.

1. Introduction The female “thin-ideal” of Western society has become a potent contributor to the high levels of disordered eating and body image disturbance in the female population (Stice, 2002; Striegel-Moore, McAvay, & Rodin, 1986), and research suggests that women are more influenced by appearance pressures and experience more body dissatisfaction than males (i.e. Frederick, Forbes, Grigorian, & Jarcho, 2007; Hoyt & Kogan, 2002; Lokken, Ferraro, Kirchner, & Bowling, 2003; McDonald & Thompson, 1992; Mellor, Fuller-Tyszkiewicz, McCabe, & Ricciardelli, 2010; Muth & Cash, 1997; Paxton & Phythian, 1999; Stanford & McCabe, 2002). Women who internalize the “thin-ideal” of Western society develop a cognitive schema that connects thinness with positive attitudes (Tiggemann, 2002), and these cognitive schemas have been shown to be associated with greater eating disturbances and body dissatisfaction (Ahern, Bennet, & Hetherington, 2008). Body dissatisfaction is so prevalent among the Western female population, that researchers have long identified body dissatisfaction among women as a “normative discontent” (Rodin, Silberstein, & Striegel-Moore, 1985). An abundance of research has shown that, despite being normal or underweight, many women perceive themselves to be overweight (i.e. Anstine & Grinenko, 2000; Bellisle, Monneuse, Steptoe, & Wardle, 1995; Monneuse, Bellisle, & Koppert, 1997; Stock, Kücük, Miseviciene, ⁎ Corresponding author at: Department of Psychology, University of New Brunswick, 100 Tucker Park Road, PO Box 5050, Saint John, NB E2L 4L5, Canada. Tel.: +1 506 648 5562(w). E-mail address: [email protected] (L.A. Best).

http://dx.doi.org/10.1016/j.eatbeh.2015.03.004 1471-0153/© 2015 Elsevier Ltd. All rights reserved.

Petkeviciene, & Krämer, 2004; Wardle, Haase, & Steptoe, 2006), and it has been shown that this inaccurate perception extends to the bodies of others. Ahern et al. (2008) found that females rated a significant number of underweight female bodies as “normal-weight” and two normal-weight female bodies were consistently labeled as “overweight”. It is possible that with the increasing focus on the female body and an emphasis on thinness in Western society, women's perception of a “normal” female body may be shifting. Individuals who experience body dissatisfaction and concerns about their appearance frequently experience co-morbid psychological and health-related problems. Negative body image is a common precursor to disordered eating behaviors and the development of eating disorders (Cash & Deagle, 1997; Stice & Shaw, 2002). Anorexia nervosa (AN) and bulimia nervosa (BN) are both eating disorders characterized by abnormal eating behaviors, weight regulation, and distorted attitudes and perceptions about body weight and shape (American Psychiatric Association [DSM-5], 2013). Although AN and BN differ in their diagnostic criteria and prevalence rates, both disorders are based on a preoccupation with, and a fear of, weight gain (American Psychiatric Association [DSM-5], 2013). Research has shown that both AN and BN are more common in females than in males. For example, males are reported to account for 5–10% of patients with AN and 10–15% of patients with BN (i.e. Fernández-Aranda et al., 2004; Støving, Andries, Brixen, Bilenberg, & Hørder, 2011; Striegel-Moore et al., 2009). In studying body dissatisfaction, researchers often find that females report that their ideal body that is both smaller than their current body and, in general, unhealthy. For example, Swami, Salem, Furnham, and Tovee (2008) examined differences between the current,

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L.P. MacNeill, L.A. Best / Eating Behaviors 18 (2015) 71–75

acceptable, and ideal body types and reported that the most common ideal body was underweight, with a BMI ranging from 15 to 18.5 kg/m2. Further, research has indicated that normal weight females perceive themselves as being overweight (i.e. Anstine & Grinenko, 2000; Bellisle et al., 1995; Monneuse et al., 1997; Stock et al., 2004; Wardle et al., 2006), broadening the gap between the perceived ideal and perceived current body. In spite of the small ideal body size and the overestimation of current body size, Fryar, Carroll, and Ogden (2012) reported that the incidence of obesity among adolescents has increased from 5% (1976–1980) to 18.1% (2007–2008). Given the increase in the incidence of obesity, it is important to examine if the perceptions of the ideal and current body size has shifted. The current paper discusses the relationship between disordered eating, body image disturbances, and the perception of the female body. Although the link between body image and eating disorders has been largely addressed, less information exists concerning the perceptual and cognitive factors that affect body assessment. Using only female participants, we examined the relationship between eating attitudes and the ratings of female bodies on a weight perception scale. We hypothesized that: 1) Using a numerical scale, females presenting disordered eating symptoms would rate female bodies as larger than noneating disordered females; 2) Females presenting disordered eating symptoms would report a smaller ideal body size than non-eating disordered females; and, 3) Females presenting eating disordered symptoms would overestimate their current body size to a greater extent than non-eating disordered females. 2. Method 2.1. Participants One hundred and sixty six female undergraduate students, ranging in age from 18 to 54 years (M = 21.40 years, SD = 5.9), were recruited from introductory psychology classes at the University of New Brunswick, Saint John Campus. Participants received one bonus point towards their final grade in Introductory Psychology for participating in the study. All students had an alternative project made available to them by their instructor if they did not wish to participate in the study. 2.2. Materials 2.2.1. Eating Attitudes Test-26 (EAT-26; Garner, Olmsted, Bohr, & Garfinkel, 1982) The EAT-26 contains 26 items on a self-report scale that measure atypical behaviors and attitudes about eating. The test is divided into three subscale scores: dieting, which focuses on monitoring food intake and activity; oral control, which focused on restricting eating; and bulimia, which focuses on food preoccupation. The EAT-26 maintains internal consistency reliability with a reliability coefficient of r = 0.90, and is an adequate screening tool in non-clinical settings (Garner et al., 1982). 2.2.2. Attention to Body Shape Scale (ABS; Beebe, 1995) The Attention to Body Shape Scale is a 7-item self-report questionnaire with a 5-point scale ranging from 1 (definitely agree) to 5 (definitely agree). The test measures the degree of body focus for each participant. The ABS has demonstrated convergent and discriminant validity as well as internal consistency, ranging from 0.70 to 0.82, that is within acceptable limits for research (Beebe, 1995). 2.2.3. Photographic Figure Rating Scale (PFRS; Swami et al., 2008) The Photographic Figure Rating Scale contains ten photographic images of real women facing forward. The images range in BMI from 12.51 to 41.23 kg/m2, and consist of two images from each of the five established BMI categories: emaciated (b15 kg/m2), underweight (15–18.5 kg/m2), normal (18.5–24.9 kg/m2), overweight

(25.0–29.9 kg/m2), and obese (N30 kg/m2). The PFRS has greater ecological validity and re-test reliability than previous scales, with reliability coefficients ranging from 0.80 to 0.90 (Swami et al., 2008). 2.2.4. Demographics A demographic questionnaire was used to collect information about age and race. 2.3. Procedure Participants completed the study individually or in small groups of approximately 30 individuals. Each participant was first presented with, and asked to sign, an informed consent form explaining the study. The participant then completed the series of questionnaires in random order. The questionnaire package included the Eating Attitudes Test-26 (EAT-26), Attention to Body Shape Scale (ABS), and a paper copy of the Photographic Figure Rating Scale (PFRS). There were 30 photos presented in the PFRS, three copies of each photo in random order. The participants were asked to rate each photo on a scale from 1 to 10, with one being emaciated and 10 being extremely obese. Participants then identified their ideal body and the body that they thought most accurately resembled themselves from the paper photographs. 3. Results 3.1. Descriptive statistics For all participants, self-reported height in centimetres (M = 164.79, SD = 6.90) and weight in pounds (M = 139.00, SD = 30.04) were used to calculate Body Mass Index (BMI), resulting in an average BMI of 23.11 kg/m2 (SD = 4.81). Participants also reported their ideal weight (M = 127.16, SD = 17.19). Based on BMI, the participants were categorized as emaciated (N = 2), underweight (N = 15), normal weight (N = 106), overweight (N = 23) and obese (N = 15). 3.2. Eating attitudes and Body Mass Index Based on the clinical cut-off of 21 for EAT-26 scores (M = 12.49, SD = 12.36), participants were divided into symptomatic and nonsymptomatic groups. Of the 166 participants, 132 were nonsymptomatic and 34 were classified as symptomatic. EAT-26 scores were correlated with each participant's BMI and a statistically significant positive correlation was found between BMI and the dieting subscale of the EAT-26, r(166) = 0.229, p = 0.003. A significant negative correlation was found between BMI and the oral control subscale of the EAT-26, r(166) = − 0.261, p = 0.002, indicating that participants scoring higher on the dieting subscale had higher BMIs than participants scoring lower on the dieting subscale and participants scoring higher on the oral control subscale had lower BMIs than participants scoring lower on the oral control subscale. 3.3. Eating attitudes and PFRS ratings It was hypothesized that females presenting disordered eating symptoms would rate female bodies as larger than non-eating disordered females on the numerical scale. An independent samples t-test showed no significant difference between symptomatic and nonsymptomatic females in the numerical ratings of female body size. Correlational analysis revealed a statistically significant negative correlation between bulimia subscale scores and body ratings. Individuals scoring higher on the bulimia subscale of the EAT-26 rated the most obese female body as less overweight (r = − .183, p = 0.018) than those scoring lower on the bulimia scale; however, no significant correlations were found between figure ratings and total EAT-26 scores or either of the remaining subscales.


Reported BMI Perceived BMI

Underweight 17.14 16.06

Normal Weight 21.62 18.83

Overweight 26.81 22.53

27.78

22.53

Perceived BMI

34.612

In the current study it was found that the most common ideal body had a BMI which is categorized as underweight, which supports previous research (Swami et al., 2008). Glauert, Rhodes, Byrne, Fink, and Grammer (2009) suggested that women's perceptions of bodies may be altered by the frequent exposure to idealized thin bodies, as Western media portrays an ideal version of the female body that is unrealistic, but still internalized by the modern female. In accordance with previous studies, Ahern, Bennett, Kelly, and Hetherington (2011) indicated that a BMI of 20, which is at the low end of the normal weight BMI category, was reported as being most attractive. In the current study, the majority of participants had an even thinner ideal; choosing an ideal BMI of 18.5 kg/m2. It is apparent that females have a skewed perception of the ideal female body that may be getting even smaller and that most women strive to attain a physique that is considered underweight and difficult to maintain. Females categorized as symptomatic and nonsymptomatic based on the clinical cut-off for the EAT-26 did not differ in their perception of female body size or their perception of an ideal female body. This may seem counterintuitive, as research suggests that disordered eating is influenced by the excessively thin ideals of Western society, particularly for females (Çatikkaş, 2011; Frederick, Forbes, Grigorian, & Jarcho, 2007; Fredrickson & Roberts, 1997; Glauert et al., 2009; Hoyt & Kogan, 2002). It could be that the ideals of Western society are so pervasive that both eating disordered and non-eating disordered individuals are idealizing a similar body size. The current study indicates that women underestimate their current body size and that symptomatic and non-symptomatic participants do not differ with regard to the discrepancy between their perceived body size and their current BMI. Given the amount of dieting and weight pressure in present Western society, this also seems counterintuitive. It has been consistently shown that a large proportion of females are dissatisfied with their weight and report a desire to be thinner (i.e. Frederick et al., 2007; Hoyt & Kogan, 2002; Lokken et al., 2003; McDonald & Thompson, 1992; Mellor et al., 2010; Muth & Cash, 1997; Paxton & Phythian, 1999; Stanford & McCabe, 2002); however, underestimation of body size has been found in adolescent samples (i.e. Brener et al., 2004; Johnson, Cooke, Croker, & Wardle, 2008; Park, 2011; Standley, Sullivan, & Wardle, 2009), particularly among overweight and obese females. There has been little research regarding actual weight and body size misperception in the adult population. Recently, Kim and Lee (2010) examined the misperception of weight in a sample of Korean university students and found that 64.1% of participants overestimated their weight, while only 2.4% underestimated their weight. Similar results have been found using other Korean samples (Choi, Shin, & Seo, 2004; Jeon & Ahn, 2006; Oh & Yu, 2007). The current study suggests that these findings may not be generalizable to the Western female population, as participants in the current sample selected an image to represent their current body that had a BMI which was less than their reported current BMI.

26.81

21.62

16.06

17.14

Reported BMI

4. Discussion

18.83

It was also hypothesized that females presenting disordered eating symptoms would report a smaller ideal body size than non-eating disordered females. Correlational analysis revealed that ratings of ideal body size were significantly negatively correlated with total EAT scores, r(166) = − 0.187, p = 0.016 and oral control subscale scores, r(166) = − 0.265, p = 0.001, indicating the choice of smaller ideal body sizes for participants scoring higher in restrictive eating habits and overall disordered eating. ABS scores were also significantly negatively correlated with rating of ideal body size, r(166) = −0.190, p = 0.015, indicating that individuals exhibiting higher levels of body dissatisfaction report a smaller ideal body size than other participants. With regard to the clinical cut-off, an independent samples t-test revealed no significant difference between symptomatic and non-symptomatic females with regard to ideal body size. To measure body image dissatisfaction using the PFRS, a difference score was calculated by subtracting the numerical rating score of ideal body size from the numerical rating score of current body size chosen by each participant. There was a statistically significant positive correlation between difference scores and total EAT-26 scores, r(166) = 0.226, p = 0.004, as well as, a significant positive correlation between difference scores and the dieting subscale scores, r(166) = 0.309, p b 0.001. With regard to the clinical cut-off, an independent samples t-test showed a statistically significant difference in difference scores between symptomatic and non-symptomatic females, with symptomatic females reporting a larger discrepancy between their current and ideal body size, t(162) = − .205, p = .042. The majority (68.9%) of participants chose an ideal body that was smaller than their perceived current size and only 20.7% of participants actually reported being at their ideal size. The PFRS photos that represented an underweight BMI were most commonly chosen as an ideal. Overall, 88.5% of females chose an ideal female body that was underweight or emaciated. Approximately 33% of participants thought a BMI of 16.65 kg/m2 was ideal, 41% of participants thought a BMI of 18.45 kg/m2 was ideal, with 5% more of the participants choosing an ideal between these two BMI levels, which are considered lower than a healthy weight. Approximately 11% of females chose an ideal BMI which is considered a normal, healthy BMI. Only one participant chose an ideal that was considered overweight, a BMI of 26.94 kg/m2. No female participants chose an ideal body represented by the three largest figures. It was also possible to assess how accurately female participants estimated their body size by subtracting the BMI of the chosen current body from the self-reported BMI of each participant. It was hypothesized that females presenting eating disordered symptoms would overestimate their current body size to a greater extent than non-eating disordered females. An independent samples t-test revealed no significant difference between symptomatic and non-symptomatic females with regard to body perception accuracy and there were no significant correlations between eating disorder symptoms and body perception accuracy. Interestingly, the majority of participants (86.8%) perceived themselves to be smaller than their calculated BMI indicated (Fig. 1).

73

Obese 34.612 27.78

Fig. 1. Mean scores for accuracy of perceived body size in underweight, normal weight, overweight, and obese participants. Note. The emaciated and underweight categories were collapsed due to the small number of emaciated participants.

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There are several possibilities as to why females in this sample underestimated their current body size. Due to the growing amount of obesity in Western world, it is possible that women perceive their bodies as smaller because the body size that is considered normal or typical is getting larger (Ogden, Yanovski, Carroll, & Flegal, 2007; Twells, Gregory, Reddigan, & Midodzi, 2014; Wang, Beydoun, Liang, Caballero, & Kumanyika, 2008; Williams, 2011). Twells et al. (2014), for example, reported that in 2011 33.6% of Canadian adults reported being overweight (BMI 25–29.9) and 18.3% reported being obese (BMI N30), and that these numbers will continue to rise without intervention. Given these statistics, it appears that the healthy BMI is not the average BMI of women. The messages that women receive are mixed. On the one hand, the media portrays a thin ideal but, on the other hand, the size of the average woman is increasing. Thus, women who are not overweight may use unrealistic media images as they select an ideal body (Glauert et al., 2009), but when judging their current body size, women may use personal comparisons with other people they encounter during their everyday lives. In this case, women who consider themselves to be a normal weight may underestimate their size in order to stay consistent with the average (but overweight) bodies they encounter. Thus, the ideal body and the current body are at odds for all but the underweight women. This would have significant implications for women's health and obesity research, as women might perceive a larger body condition as both normal and healthy, which could contribute to the growing acceptance of obesity in Western society. Although the current study does not focus on clinical tools or a clinical population, taken together, the current results can provide both researchers and clinicians with useful information regarding critical individual differences in populations seeking clinical treatment. Although the presence of more disordered eating symptoms is related to more body dissatisfaction and a smaller ideal, females classified as symptomatic do not seem to differ from non-symptomatic females in body size perception. This suggests that the use of the EAT-26 and similar instruments may be less useful as screening tools when absolute cut-off values are used. The selection of a cut-off value suggests that a person scoring 20 on the EAT-26 is categorically different from a person scoring 21 and categorically similar to a person scoring 2. Even outside of clinical practice, the use of these cut-off values may obscure important differences among individuals displaying disordered eating attitudes and behaviors. In the current study symptomatic females displayed more body dissatisfaction but reported having similar ideals and weight perceptions. This could have important implications for disordered eating interventions. Treatment strategies for eating disorders that focus on maladaptive behaviors and self-esteem may be of more use than treatment strategies focusing on maladaptive cognitions and perceptions about body image.

5. Limitations Limitations of the current study were largely methodological. The current study utilized self-reported Body Mass Index (BMI) as an indicator of the participants' present body condition. Although BMI is widely used as an indicator of body condition, it is considered to be somewhat inaccurate because it does not take into consideration body composition, such as muscle and bone mass. A better indicator of body condition would be the use of percent body fat for each participant (Burkhauser & Cawley, 2008). Because the height and weight of each participant was self-reported, there could also be inaccuracies concerning the participant's actual body size. It would be interesting for future researchers to measure weight and height in order to examine the relationship between actual and reported BMI and body perceptions.

Role of funding sources There were no funding sources for the research submitted in this paper.

Contributors The research was conducted as Lillian MacNeill's undergraduate thesis (2010). Lisa Best was her thesis supervisor. We worked together on all aspects of the planning, conducting, and writing of the manuscript. Conflict of interest Lillian MacNeill and Lisa Best have no conflicts of interest. Acknowledgments N/A.

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