RESEARCH QUESTION

Accelerat ing t he world's research.

The role of the media in body image concerns among women: a meta- analysis of experimental and correlational studies

Solomon Kitaka

Psychological bulletin

Need to cite this paper?

Get the citation in MLA, APA, or Chicago styles

Want more papers like this?

Download a PDF Pack of related papers

Search Academia's catalog of 22 million f ree papers

Downloaded f rom Academia.edu 

See discussions, stats, and author profiles for this publication at: https://www.researchgate.net/publication/5259131

The Role of the Media in Body Image Concerns

Among Women: A Meta-Analysis of

Experimental and Correlational Studies

Article in Psychological Bulletin · June 2008 DOI: 10.1037/0033-2909.134.3.460 · Source: PubMed

CITATIONS 544

READS 36,902

3 authors, including:

Shelly Grabe University of California, Santa Cruz 34 PUBLICATIONS 1,312 CITATIONS

SEE PROFILE

All content following this page was uploaded by Shelly Grabe on 04 October 2014.

The user has requested enhancement of the downloaded file. All in-text references underlined in blue are added to the original document and are linked to publications on ResearchGate, letting you access and read them immediately.

The Role of the Media in Body Image Concerns Among Women: A Meta-Analysis of Experimental and Correlational Studies

Shelly Grabe University of Wisconsin–Madison

L. Monique Ward University of Michigan

Janet Shibley Hyde University of Wisconsin–Madison

Research suggests that exposure to mass media depicting the thin-ideal body may be linked to body

image disturbance in women. This meta-analysis examined experimental and correlational studies testing

the links between media exposure to women’s body dissatisfaction, internalization of the thin ideal, and

eating behaviors and beliefs with a sample of 77 studies that yielded 141 effect sizes. The mean effect

sizes were small to moderate (ds � –.28, –.39, and –.30, respectively). Effects for some outcome

variables were moderated by publication year and study design. The findings support the notion that

exposure to media images depicting the thin-ideal body is related to body image concerns for women.

Keywords: body image, media, advertising, human females, meta-analysis

Body dissatisfaction has reached normative levels among Amer-

ican girls and young women. Approximately 50% of girls and

undergraduate women report being dissatisfied with their bodies

(e.g., Bearman, Presnell, & Martinez, 2006; Monteath & McCabe,

1997). These perceptions develop relatively early, emerging

among children as young as age 7 years, and appear to exist across

diverse levels of body size and race (Dohnt & Tiggemann, 2006a;

Grabe & Hyde, 2006). These feelings are not inconsequential; they

have been linked to critical physical and mental health problems.

Research from prospective and longitudinal designs has identified

body dissatisfaction as one of the most consistent and robust risk

factors for eating disorders such as bulimia and as a significant

predictor of low self-esteem, depression, and obesity (Grabe,

Hyde, & Lindberg, 2007; Johnson & Wardle, 2005; Neumark-

Sztianer, Paxton, Hannan, Haines, & Story, 2006; Paxton,

Neumark-Sztianer, & Hannan, 2006; Tiggemann, 2005). Thus, in

many ways, body dissatisfaction has emerged as a core aspect of

women’s physical and mental health.

Why is it that so many girls and young women are dissatisfied

with their bodies, regardless of the size? Among the many forces

believed to play a role (in addition to parental messages and

peer-related teasing) is the increasingly thin ideal dominating the

media. Across movies, magazines, and television programs, thin-

ness is consistently emphasized and rewarded for women (e.g.,

Fouts & Burggraf, 1999), and thin television characters are over-

represented while overweight characters are underrepresented

(e.g., Fouts & Burggraf, 1999, 2000; Greenberg, Eastin, Hofschire,

Lachlan, & Brownell, 2003). Indeed, the images of women pre-

sented in the media today are thinner than past media images of

women (Silverstein, Perdue, Peterson, & Kelly, 1986), thinner than

the actual female population (e.g. Fouts & Burggraf, 1999, 2000),

and often thinner than the criteria for anorexia (Wiseman, Gray,

Moismann, & Ahrens, 1992). This ideal is pervasive, with fashion

models, cartoon characters, movie and television actresses, Play-

boy centerfolds, and Miss America Pageant winners all having

become increasingly thinner over the past decades (Garner, Gar-

finkel, Schwartz, & Thompson, 1980; Klein & Shiffman, 2005;

Morris, Cooper, & Cooper, 1989; Silverstein et al., 1986; Spitzer,

Henderson, & Zivian, 1999). Thus, media aimed at girls, adoles-

cents, and young women are replete with extremely thin models

that portray an ideal that is unattainable to most.

According to communications theories, repeated exposure to

media content leads viewers to begin to accept media portrayals as

representations of reality (e.g., cultivation theory: Gerbner, Gross,

& Morgan, 2002; social learning theory: J. D. Brown, 2002). In

this case, it is believed that the media’s consistent depiction of a

thin ideal leads women to see this ideal as normative, expected,

and central to attractiveness. However, because media presenta-

tions of women’s bodies are so skewed, showcasing an ideal that

is out of reach to most, adopting this reality may lead to decreased

satisfaction with one’s own body (e.g., Levine & Harrison, 2004)

and to behaviors aimed at meeting this ideal, behaviors such as

dieting, bingeing and purging, and skipping meals. A growing

body of research has begun to investigate these claims, testing how

both laboratory and natural exposure to the thin ideal shapes young

women’s internalization of this ideal, body dissatisfaction, and

disordered eating. Research in this area has produced more than

100 studies whose findings not only demonstrate the proposed

links but also provide evidence that body image disturbance pro-

spectively predicts eating pathology (e.g., Stice & Shaw, 2002)

Shelly Grabe and Janet Shibley Hyde, Department of Psychology,

University of Wisconsin–Madison; L. Monique Ward, Department of

Psychology, University of Michigan.

This research was sponsored in part by National Institutes of Health

Grant F32MH7197102 to Shelly Grabe.

Correspondence concerning this article should be addressed to Shelly

Grabe, Department of Psychology, University of Wisconsin–Madison,

1202 West Johnson Street, Madison, WI 53706. E-mail: grabe@wisc.edu

Psychological Bulletin Copyright 2008 by the American Psychological Association 2008, Vol. 134, No. 3, 460 – 476 0033-2909/08/$12.00 DOI: 10.1037/0033-2909.134.3.460

460

and that treatment interventions aimed at reducing body image

disturbance can produce reductions in bulimic pathology (e.g.,

Bearman, Stice, & Chase, 2003). Thus, in the following review we

focus on body image dissatisfaction and related concerns, among

which we include behaviors and beliefs about eating and dieting.

The majority of studies examining connections between media

use and women’s body image and related issues have been exper-

imental laboratory studies that examine whether exposure to thin-

ideal media increases body dissatisfaction or related concerns in

the short term (e.g., Tiggemann & Slater, 2003). These types of

designs, in which participants are randomly assigned to conditions,

are often believed to offer the most conclusive evidence regarding

media effects on psychological outcomes (C. A. Anderson et al.,

2003). However, although experiments of this type contribute

significantly to our understanding of media effects on body image

and related concerns, they also include a level of artificiality that

limits their external validity. As such, findings from laboratory

studies may be especially valuable when they are combined with

results obtained from naturalistic, correlational studies in which

participants report their actual media use. However, findings from

these correlational surveys are also limited in that they cannot

indicate whether thin-ideal media cause negative body image

outcomes, whether women with poor body image are drawn to

thin-ideal media, or whether some other factor creates both con-

ditions. Neither method, then, provides unequivocal findings re-

garding the role of the media in women’s body image concerns.

The combination of the two, however, can provide converging

evidence. Although longitudinal and prospective studies can en-

hance confidence in the conclusions drawn, this area of research is

relatively new, and therefore, the number of such studies is small.

As a result, what follows is a review of the experimental and

correlational research examining the link between media use and

women’s body image and related concerns.

Experimental Research

The majority of studies in this area have used experimental

methods to test whether women feel worse about their bodies after

exposure to thin media models than after exposure to other types

of images (e.g., Dittmar & Howard, 2004). In a typical experiment,

women are shown a series of magazine or television advertise-

ments that contain either images of the thin-ideal body (experi-

mental condition) or images that are considered neutral (e.g.,

furniture; control condition). Following the experimental manipu-

lation, respondents are asked to complete assessments of body-

image-related constructs. Although experiment-based media expo-

sure cannot approximate the massive bombardment that occurs

naturally, a particular strength of this method is the potential for

causal inferences regarding the nature of the relation between the

media manipulation and women’s body image.

Using this paradigm, body-image researchers have repeatedly

shown that women who view thin-ideal images in the lab experi-

ence lower body satisfaction than do women who view neutral

images (e.g., Birkeland, Thompson, & Herbozo, 2005). For exam-

ple, findings among both adolescent and adult women indicate that

participants who viewed magazine ads featuring the thin-ideal

body type reported significantly greater body dissatisfaction than

did those who viewed neutral ads (e.g., Halliwell & Dittmar,

2004). Similar findings have been demonstrated with televised

media. For example, exposure to television commercials that fea-

ture the thin-ideal image (as opposed to average-weight women or

nonappearance-related content) increases women’s body dissatis-

faction (e.g., Hargreaves & Tiggemann, 2004) and eating disorder

symptomatology (e.g., Strahan, 2003). Similar results have been

obtained after the viewing of music videos (Tiggemann & Slater,

2003). Thus, a growing body of experimental research indicates

that exposure to thin-ideal models leads to increased body dissat-

isfaction and eating disorder symptomatology.

Other research, however, suggests that this is not invariably the

case and that experimental effects of exposure to the thin ideal are

not universal. First, certain factors make some women more vul-

nerable than others to the effects of media exposure (e.g., accep-

tance of societal attitudes toward female attractiveness; Heinberg

& Thompson, 1995). For example, it has been demonstrated that

prior levels of body dissatisfaction moderate women’s responses to

media images such that women who are initially dissatisfied with

their bodies are most sensitive to the adverse effects of media

exposure (Posavac, Posavac, & Posavac, 1998). Second, other

studies have found little to no immediate effect of thin-ideal media

portrayals on women’s body image or related concerns (e.g.,

Halliwell, Dittmar, & Howe, 2005). Similarly, null effects have

been reported for exposure to thin-ideal ads and adolescent girls’

self-reported physical attractiveness (Martin & Kennedy, 1993),

adult women’s body satisfaction (Irving, 1990), and endorsement

of dieting attitudes and behaviors (Thornton & Maurice, 1997).

Third, a few studies have reported that media exposure is nega-

tively related to dissatisfaction—in other words, after viewing

appearance-focused stimuli, women’s dissatisfaction decreased

(e.g., Coolican, 1999; Cusumano & Thompson, 1997). Overall,

however, many well-controlled, randomized experiments have

demonstrated an effect of the thin-ideal media on women’s body

image and related concerns in samples of varying ages with a

number of different outcome measures. Although some null or

conditional outcomes emerge, the majority of evidence from these

experiments indicates that brief exposure to media images depict-

ing the thin-ideal body often leads to short-term adverse outcomes

in women’s body image and related concerns.

Correlational Research

The second set of studies in this research area uses naturalistic,

correlational data to investigate the relationship between women’s

media consumption and their body dissatisfaction and related

issues (e.g., Bissell & Zhou, 2004; Jones, Vigfusdottir, & Lee,

2004). Here, findings indicate that more frequent exposure to

fashion magazines or to television programming featuring the

thin-ideal body type is associated with higher levels of body

dissatisfaction and eating disorder symptomatology among girls

and women (e.g., D. R. Anderson, Huston, Schmitt, Linebarger, &

Wright, 2001; Bissell & Zhou, 2004; Jones et al., 2004; Morry &

Staska, 2001; Sands & Wardle, 2003; Stice, Schupak-Neuberg,

Shaw, & Stein, 1994; Thomsen, 2002). Similar relations have been

demonstrated between generalized media use (Abramson &

Valene, 1991) or music television viewing (e.g., Hofschire &

Greenberg, 2001) and body image dissatisfaction.

With few exceptions, then, correlational research appears to

demonstrate a positive relation between media consumption and

body dissatisfaction among women (see Cusumano & Thompson,

461MEDIA AND BODY IMAGE

1997, for an exception). These correlational studies illustrate that

regular exposure to thin-ideal media is frequently associated with

comparatively higher levels of negative body image outcomes.

Although causal inferences cannot be drawn, these findings com-

plement the conclusions of the experimental studies and suggest

that the short-term effects found in controlled settings may be

generalizable outside of the laboratory.

Meta-Analysis

Although findings from experimental and correlational studies

suggest important connections between women’s media use and

their body image and related concerns, significant questions re-

main. How strong and consistent are these links, especially given

the presence of some null results? In what contexts are they most

relevant? Because a close inspection of individual articles reveals

use of varying stimuli, outcome measures, and methodology, a

firm understanding of the association between thin-ideal media

exposure and body image concerns among women is lacking.

Methodological differences in measurement and design type, the

presence of moderating factors, or simple random error that leads

to effect sizes of varying magnitude make it difficult to draw

generalizable conclusions. Meta-analytic work that allows for the

quantitative combination of all relevant data can estimate the

magnitude of the effects, analyze variations in study outcomes, and

investigate potential moderators of the relation between media

effects and body image.

Researchers have attempted to analyze this body of research

with just that aim, but the conclusions are somewhat inconsistent.

In one meta-analysis of 25 experimental studies investigating the

effects of media exposure on female body image (including only

generalized dissatisfaction measures), the authors reported an ef-

fect size of d � –.31 across all studies, indicating that women feel

worse after exposure to thin images versus neutral images (Groesz,

Levine, & Murnen, 2002). However, in a second meta-analysis

examining a similar question, Holmstrom (2004) analyzed findings

from 34 studies (mixed experimental and correlational) and re-

ported a notably smaller effect (r � –.08), suggesting that there is

little influence of media exposure on women’s body image. Be-

cause these reviews did not converge on similar findings, there

remains a need to examine the issue more closely. Furthermore,

neither meta-analysis reflects a comprehensive review of current

research. For example, Groesz et al. (2002) included only exper-

imental research, and of the 34 studies included in the Holmstrom

review, only 9 overlapped with those in the Groesz et al. review.

In addition, neither review included unpublished research, leading

to concerns about the file drawer problem (i.e., studies that were

conducted but never published; Rosenthal, 1979). Moreover, de-

spite the relative recency of these meta-analyses, an updated re-

view is warranted to reflect the rapidly growing number of articles

accumulating in this area of study. Finally, although the Holm-

strom review investigated four body image constructs (importance

of appearance, eating pathology and restrained eating, body dis-

satisfaction, and endorsement of the thin ideal), the author reported

an overall effect size collapsed across measures, thereby limiting

our understanding of how media use may contribute differently to

different outcomes.

Therefore, the current meta-analysis sought to improve upon the

two previous reviews in several important ways: (a) we included a

much larger sample of studies despite more stringent inclusion

criteria (N � 77); (b) we obtained and included unpublished

studies; (c) we reviewed both controlled experiments and correla-

tional studies; and (d) we viewed body image and related concerns

as multidimensional and therefore grouped our analyses on the

basis of four outcomes.

Measurement of Body Image and Eating Behaviors and

Beliefs

What is perhaps the greatest challenge to drawing sound con-

clusions from this large and growing literature is that results may

vary depending on the particular dimension of body image or

related eating behavior that is being measured. Researchers have

come to realize that body image concerns are multidimensional

and include thoughts, feelings, and behavioral responses related to

one’s body (Thompson & van den Berg, 2002). Thus, in the

burgeoning study of the media’s thin ideal, different components

of body image and related consequences such as disordered eating

behaviors have gained increasing attention since the 1990s. Given

this complexity, it is common for researchers to include in one

study several measures of body image or related constructs. For

example, researchers routinely use a body dissatisfaction measure,

a disordered eating measure, and a thin-ideal internalization mea-

sure in one study (e.g., Stice, Spangler, & Agras, 2001). Some

studies report consistent results across constructs (e.g., Bissell &

Zhou, 2004; Dunkley, Wertheim, & Paxton, 2001; Morry &

Staska, 2001), whereas others do not (e.g., Cusumano & Thomp-

son, 1997). For example, in some experimental studies researchers

report stronger media effects on internalization of the thin ideal

(Jones, Vigfusdottir, & Lee, 2004) and eating disorder symptom-

atology (e.g., Tiggemann, 2003) than on body dissatisfaction. To

complicate matters further, opposite results have been demon-

strated within the same study. Hawkins, Richards, Granley, and

Stein (2004) reported that exposure to thin-ideal magazine images

increased body dissatisfaction and negative mood among college

women but decreased internalization of the thin ideal. Thus, the

combination of null results and mixed results across constructs

makes it difficult to determine what construct related to body

image is most strongly linked to media exposure and points to the

importance of meta-analysis to sort out these findings.

In the current review we treated body image and related con-

cerns as multidimensional and examined the effects separately for

four outcomes related to body image. The first is body satisfaction/

dissatisfaction, which represents a global and subjective evaluation

of one’s body. Based on a review of published measures of body

image satisfaction and related constructs, Thompson and van den

Berg (2002) defined two additional dimensions of body image:

cognitive and behavioral. The authors argued that the cognitive

component of body image attempts to capture beliefs, thoughts,

and attributions of body image by measuring constructs such as

self-attentional focus, investment in one’s appearance, and inter-

nalization of social stereotypes regarding appearance. In our re-

view, we broke this category down further by distinguishing be-

tween (a) self-attentional focus or preoccupation with the body and

self-objectification (i.e., adopting a view of oneself as an object

whose value is based on appearance), which we believe to reflect

more clearly a degree of dysfunctional cognitive schema, and (b)

internalization of thin ideals, which we view as the adoption of

462 GRABE, WARD, AND HYDE

sociocultural appearance ideals as a personal goal and standard.

Finally, Thompson and van den Berg defined behavioral measures

as those that assess participants’ behaviors related to body image.

Given the large literature on eating disorders, we focus specifically

on behaviors related to eating but also broaden this category to

include beliefs related to eating because many measures assess

participants’ beliefs and attitudes as well as behaviors (e.g., “Feel

extremely guilty after eating”).

Method

Measures

We grouped our review of the relevant studies into the following

four categories of outcome variables: (a) body dissatisfaction, (b)

body self-consciousness/objectification, (c) internalization of the

thin ideal and drive for thinness, and (d) eating behaviors and

beliefs. When a study included more than one measure within a

category, effect sizes were calculated separately and then averaged

in order to produce one effect size per outcome variable of interest.

In the category of body dissatisfaction we focused on measures

that assess the evaluative component of body image, that is,

satisfaction/dissatisfaction with the body. The following scales

were classified as measures that assessed dissatisfaction with the

body and were included in the current review: (a) the Visual

Analogue Scales (Heinberg & Thompson, 1995), (b) the Body

Dissatisfaction Subscale from the Eating Disorders Inventory

(Garner, Olmsted, & Polivy, 1983); (c) the Body Satisfaction

Questionnaire (Berscheid, Walster, & Bohrnstedt, 1973), (d) the

Body Esteem subscale of the Body Image Scale (Conner, Martin,

Silverdale, & Grogan, 1996), (e) the Physical Appearance State

and Trait Anxiety Scale (Reed, Thompson, Brannick, & Sacco,

1991), (f) the Body Esteem Scale (Franzoi & Shields, 1984); (g)

the Appearance Self-Esteem subscale of the Current Thoughts

Scale (Heatherton & Polivy, 1991); (h) the Multidimensional

Body–Self Relations Questionnaire (T. A. Brown, Cash, &

Mikulka, 1990); (i) the Body Shape Questionnaire (Cooper, Tay-

lor, Cooper, & Fairburn, 1987); (j) the Figure Rating Scales

(Stunkard, Sorenson, & Schlusinger, 1983); (k) the Body Image

States Scale (Cash, Fleming, Alindogan, Steadman, & Whitehead,

2002); (l) the Body Satisfaction Scale (Slade, Dewey, Newton,

Brodie, & Kiemle, 1990); (m) the Body Attitudes Questionnaire

(Ben-Tovim & Walker, 1991); and (n) the Body Esteem Scale

(Mendelson & White, 1985). In addition to these scales, a variety

of scales that were not standardized but were specifically described

as measuring global body dissatisfaction were included. A total of

90 studies yielded effect sizes for body dissatisfaction.

The following scales assessed body self-consciousness or self-

objectification regarding the body and were included in the current

review: (a) the Body Self-Consciousness Questionnaire (Miller,

Murphy, & Buss, 1981); (b) the Self-Objectification Questionnaire

(Noll & Fredrickson, 1998); and (c) the Body Surveillance Scale

(McKinley & Hyde, 1996). Despite prominent theoretical analyses

of these constructs, only eight studies were available to compute

effect sizes for this outcome variable. Because eight studies is

typically too few to warrant meta-analyses, we did not retain this

category as a main outcome of interest in our final analyses.1

Measures that assess internalization of the thin ideal generally

measure how strongly individuals value thinness for themselves

and for others. The following scales assessed internalization of the

thin ideal and drive for thinness and were included in the current

review: (a) the Drive for Thinness subscale of the Eating Disorders

Inventory (Garner et al., 1983), (b) the Ideal-Body Stereotype

Internalization Scale (Stice et al., 1994), (c) the Internalization of

Thin Ideal subscale of the Sociocultural Attitudes Towards Ap-

pearance Scale (Heinberg, Thompson, & Stormer, 1995), (d) the

Internalization subscale of the Multidimensional Media Influence

Scale (Cusumano & Thompson, 2001), and (e) the Appearance

Schemas Inventory (Cash & Labarge, 1996). There were 23 stud-

ies that yielded effect sizes for this component of body image.

Finally, we also included measures that focused on girls’ and

women’s restrained eating, excessive exercise, or bingeing and

purging. The following scales assessed eating behaviors and be-

liefs: (a) the Bulimia subscale of the Eating Disorders Inventory,

(b) the Eating Disorder Diagnostic subscale (Stice, Telch, & Rizvi,

2000), (c) the Eating Disorder Examination Questionnaire (Fair-

burn & Belgin, 1994), (d) the Bulimia Test (Smith & Thelen,

1984), (e) the 26-item Eating Attitudes Test (Garner, Olmsted,

Bohr, & Garfinkel, 1982), (f) the Children’s Eating Attitudes Test

(Maloney, McGuire, & Daniels, 1988), (g) the Anorexia Bulimia

Inventory (Stein, 1991), (h) the Mizes Anorectic Cognitions Scale

(Mizes, 1990), and (i) the Dutch Eating Behavior Questionnaire

(Van Strien, Frijters, Bergers, & Defares, 1986). There were 20

datasets that yielded effect sizes for eating behaviors and beliefs.

Measurement of Media Use

Because our goal was to test directly the association between the

use of media and women’s body image and related concerns, we

included only those studies that investigated media use or media

exposure, as opposed to self-report of media influence (i.e., per-

ceived pressure from media to change exercise or eating patterns).

Experimental studies were included only if there were appearance-

focused and control media conditions. In other words, it was

required that both groups were exposed to some media. In most

cases the appearance-focused conditions manipulated exposure

through images taken from contemporary women’s fashion mag-

azines, television commercials, or television programming that

was appearance-focused. Control conditions most often used non-

appearance ads from the same magazines or network stations, but

in some cases they used average or overweight models as the

control condition. When a study included all three conditions (i.e.,

thin-ideal models, average or overweight models, and nonappear-

ance/object controls), the nonappearance or object condition was

chosen as the control because that was the comparison occurring

most regularly in the literature. Studies were not included if the

control group was not exposed to any media (e.g., Thornton &

Maurice, 1997), if specific instructions were given for participants

to compare themselves with the models (e.g., two subsamples in

Tiggemann & McGill, 2004), or if the media manipulation was an

1 Although the number of studies investigating the link between the

media and objectification is relatively low, in the interest of reporting a full

analysis of the current literature we offer a weighted mean effect size for

the effect of media exposure on women’s body self-consciousness or

self-objectification of – 0.30 (95% CI – 0.16 to – 0.44) that should be

interpreted with caution. We nevertheless include these preliminary find-

ings because they allow us to view the gaps in the literature.

463MEDIA AND BODY IMAGE

intervention aimed at reducing eating disorder symptomatology or

body dissatisfaction (e.g., Posavac, Posavac, & Weigel, 2001).

Correlational studies were included if participants’ media con-

sumption was directly assessed. The most commonly used method

was to assess frequency of fashion magazine reading and viewing

of television programming with a thin-ideal focus. It was also

common to assess media usage by measuring general media ex-

posure (i.e., the number of hours per week that participants read

newspapers or magazines, watched television or movies, or lis-

tened to the radio).

Sample of Studies

We used multiple methods to obtain relevant research. First, a

computerized database search of PsycINFO and the Web of Sci-

ence was conducted to generate a pool of potential articles. To

identify all articles that investigated the link between media use

and body image concerns, the words body image, media, televi-

sion, advertising, and magazines were used as key terms in the

literature search. These broad terms were selected to capture the

wide range of research that has been conducted. Search limits

restricted the results to articles published in English between 1975

and January 2007 and included studies conducted in English-

speaking countries (e.g., the United States, Canada, Great Britain,

and Australia). Appearance ideals can vary widely across cultures,

yet little research has been conducted in other cultures. We there-

fore restricted ourselves to these four closely related cultures in

which there is substantial research and often shared media. Sec-

ond, several reference lists were searched for relevant studies,

including prior reviews (e.g., Groesz, Levine, & Murnen, 2002;

Holmstrom, 2004; Ward & Harrison, 2005). Third, we conducted

a computerized search of PsycINFO for the years 1975 through

January 2007 to identify unpublished dissertations.

Abstracts were printed, examined, and excluded on the basis of

any of the following criteria: (a) the article did not describe an

empirical study; (b) the article did not present original data; (c) the

study was not conducted on an English-speaking sample; (d) the

article did not contain a relevant measure of body image; (e) the

article did not focus on TV, magazine, or movie content (whether

correlational or experimental); and (f) participants were prese-

lected on the basis of scores from a clinical assessment. In addi-

tion, because gender differences in body dissatisfaction have been

established in prior meta-analytic work (e.g., Feingold & Maz-

zella, 1998) and the bulk of research investigating the effects of the

thin ideal has been conducted on women (Dittmar, 2005), we

included studies of only female samples. We photocopied the

articles that met the criteria and examined them to determine

whether they presented sufficient statistics for an effect-size cal-

culation. Dissertations were ordered via interlibrary loan and re-

viewed at the receiving library.

The studies used in the two prior reviews were carefully coded,

and several were excluded from the current review to capture more

precisely the role of media in body image and related concerns.

Fifteen articles from the two prior reviews were not included in the

current study for the following reasons: (a) only beta weights from

multiple regressions had been used as opposed to correlations

representing the relation between media use and body image (e.g.,

Botta, 1999, 2000; Harrison, 1997; E. Henderson-King &

Henderson-King, 1997; Jane, Hunter, & Lozzi, 1999)2; (b) the

methodology was not appropriate, for example, when participants

were exposed to both the experimental and control conditions (e.g.,

Hamilton & Waller, 1993; Waller, Hamilton, & Shaw, 1992) or the

experimental manipulation included more than exposure to media

conditions (e.g., unique instructions; Martin & Gentry, 1997), (c)

the media measure did not meet our criteria (e.g., assessed per-

ceived influence of media as opposed to media consumption,

Vartanian, Giant, & Passino, 2001), (d) the outcome measure did

not fit into one of the four categories we delineated (e.g., Myers &

Biocca, 1992; Tan, 1979), or (e) the study was an unpublished

paper presented at a conference (more than 7 years ago) and was

therefore unavailable.

Efforts to obtain additional data. If articles were deemed

eligible but did not provide adequate information for coding (e.g.,

means and standard deviations for separate conditions were omit-

ted, precluding effect size computation) and were not more than 7

years old, we contacted the authors for the information via elec-

tronic mail. Electronic mail addresses were obtained from the

articles’ contact information, authors’ academic institution’s Web

directory, or from a Google search. We contacted the first authors

of 23 articles. Of those, 6 (30%) provided usable data and 6 could

not be reached.

Coding the studies. The following information was coded for

each study: (a) the type of media (magazine, television, or gener-

alized mass media); (b) the research design (experimental or

correlational); (c) the type of outcome measure used (body dissat-

isfaction, body self-consciousness/self-objectification, internaliza-

tion of thin ideal, or eating attitudes and behaviors); (d) whether

participants were recruited from eating disorder clinics or had a

history of body dissatisfaction; (e) all statistics on group differ-

ences or correlations, including means, standard deviations, t val-

ues, F values, and r values; (f) the mean age of the respondents (if

age was not reported, the following rules were used to generate an

estimate: if a range was given, the mean age was assumed to be the

median; if grade levels were given, 5 years was added to the grade

level; if the respondents were described as undergraduates, the

mean age was assumed to be 20); and (g) the date of publication.

Final sample of studies. The search and review procedures led

to a final sample of 77 articles from 32 different journals as well

as dissertations. These studies comprised 15,047 participants and

yielded 141 effect sizes. See Table 1 for studies included in the

meta-analysis and Table 2 for a summary of characteristics of the

studies. Shelly Grabe coded all articles, and Janet Shibley Hyde

double-coded 25% of them. We obtained 100% agreement on the

outcome measure used, the study design, and the type of media

measure used. Cohen’s kappa values for sample size and the

reported parameter values (i.e., correlation or means and standard

deviations) were .95 and .86, respectively. Discrepancies were

resolved by discussion after a review of the article.

2 We did not use � from hierarchical regressions because results from �

often included a number of covariates that would not allow us to compare

effect sizes. In other words, results from studies that include various other

factors in a regression render the final parameter values incomparable to

each other. Inclusion of these studies could potentially underestimate the

overall average effect size. Furthermore, when possible, the control vari-

ables that are partialed out in a regression analysis as “nuisance variables”

may prove to be interesting moderators (e.g., age). The authors of the cited

studies were e-mailed to request point biserial correlations.

464 GRABE, WARD, AND HYDE

Table 1

Effect Size Estimates and Moderator Variables

Study d

N

Mean age (yrs) Study design Media type Type of control MeasureE C S

Abramson & Valene (1991) �.45 101 21.8 Correlational Generalized media Bulimia Scale Anderson et al. (2001) �.61 283 17.4 Correlational Entertainment

television Weight

Dissatisfaction Aubrey (2006)

Time 1 �.17 149 19.6 Correlational Television Self-Objectification .01 149 19.6 Correlational Magazines Self-Objectification

Time 2 �.08 97 20.6 Correlational Television Self-Objectification �.12 97 20.6 Correlational Magazines Self-Objectification

Becker et al. (2002) 128 17 Experiment Television Duration Years of exposure Birkeland et al. (2005)

Appearance product conditions

�.59 35 34 21.8 Experiment Magazines VAS

Neutral product conditions

�.33 35 34 21.8 Experiment Magazines VAS

Bissell & Zhou (2004) �.47 218 19 Correlational Television EAT �.35 218 19 Correlational Television BDS-EDI �.43 218 19 Correlational Television DT- EDI

Borowiak (2003)a �.30 100 98 20 Experiment Television commercials Object BES Borzekowski et al. (2000) �.16 837 14.9 Correlational Music television Weight and Shape

Concerns A. Brown & Dittmar

(2005) �.43 25 27 52 21.23 Experiment Magazines Objects SATAQ

�.70 25 27 52 21.23 Experiment Magazines Objects PASTAS Cash et al. (1983) �.38 17 17 34 22.7 Experiment Magazines Average weight Body Satisfaction

Questionnaire Cattarin et al. (2000) �.56 90 90 22.97 Experiment Television commercials Average weight VAS Clay et al. (2005) �.56 68 68 136 13.5 Experiment Magazines Objects Body Dissatisfaction Coolican (1999)a .04 40 37 20 Experiment Baywatch News Body Dissatisfaction Crouch & Degelman (1998) �.68 20 20 15.4 Experiment Magazines Overweight Self-Attractiveness Cusumano & Thompson

(1997) .14 175 24 Correlational Magazines BDS-EDI .08 175 24 Correlational Magazines BUL-EDI

�.03 175 24 Correlational Magazines Internalization/Drive for Thinness

Dittmar & Howard (2004) �.36 50 50 32.7 Experiment Magazines Objects SATAQ �.48 50 50 32.7 Experiment Magazines Objects PASTAS

Dohnt & Tiggemann (2006a)

.03 128 7.5 Correlational Television Body Dissatisfaction

.22 128 7.5 Correlational Magazines Body Dissatisfaction Dunkley et al. (2001)

�.35 567 15.5 Correlational Magazines Body Attitudes Questionnaire

�.26 567 15.5 Correlational Magazines DEBQ Durkin & Paxton (2002)

Grade 7 �.22 74 42 12.9 Experiment Magazines Objects VAS Grade 10 �.33 67 58 15.5 Experiment Magazines Objects VAS

Esteban (2003)a �.46 112 112 20 Experiment Magazines BES Frisby (2004) �.08 48 48 19.9 Experiment Magazines No control BES Grogan et al. (1996) �.15 23 22 20 Experiment Magazines Objects BE-BIS Halliwell & Dittmar (2004) �.32 78 59 30.8 Experiment Magazines Objects PASTAS Halliwell et al. (2005) .06 24 25 32 Experiment Magazines Object PASTAS Hargreaves & Tiggemann

(2002) Normal viewing �.24 50 50 16 Experiment Television commercials Object VAS Distracted viewing �.15 50 50 16 Experiment Television commercials Object VAS

Hargreaves & Tiggemann (2003a)

�.39 23 19 15.5 Experiment Television commercials Object VAS

Hargreaves & Tiggemann (2003b)

�.71 80 80 14 Experiment Television commercials Object ASI

Hargreaves & Tiggemann (2004)

�.64 75 80 14.3 Experiment Television commercials Object VAS

Table continues

465MEDIA AND BODY IMAGE

Table 1 (continued)

Study d

N

Mean age (yrs) Study design Media type Type of control MeasureE C S

Harrison (2000) �.12 178 14.6 Correlational Magazines BDS-EDI �.35 178 14.6 Correlational Magazines DT-EDI �.37 178 14.6 Correlational Magazines chEAT

Harrison & Cantor (1997) �.63 232 20 Correlational Magazines EAT Hawkins et al. (2004) �1.01 74 71 20 Experiment Magazines Objects BDS-EDI

.29 74 71 20 Experiment Magazines Objects SATAQ �.50 74 71 20 Experiment Magazines Objects Anorexia Bulimia

Inventory Heinberg & Thompson

(1995) High body dissatisfaction �.71 31 29 20 Experiment Television commercials Objects VAS Low body dissatisfaction �.03 39 38 20 Experiment Television commercials Objects VAS

D. Henderson-King, Henderson-King, & Hoffmann (2001) Study 1 �.13 114 114 19 Experiment Magazines Objects BES Study 2

Importance of attractiveness—high

�.64 56 56 19 Experiment Magazines Objects BES

Importance of attractiveness—low

.26 56 56 19 Experiment Magazines Objects BES

Hofschire & Greenberg (2001)

�.32 71 15.5 Correlational Music video General Body Dissatisfaction

�.54 71 15.5 Correlational Magazines General Body Dissatisfaction

�.32 71 15.5 Correlational Thin-ideal TV programming

Endorsement of Thin Ideal

Irving (1990) .02 41 38 20 Experiment Magazines Objects BES Jones et al. (2004)

�.30 430 13.6 Correlational Magazines BDS-EDI �.61 430 13.6 Correlational Magazines SATAQ

Joshi et al. (2004) Restrained eaters .44 15 15 20.25 Experiment Magazines Objects Appearance Self-

Esteem Unrestrained eaters �1.0 16 15

Kalodner (1997) �.40 32 29 18.97 Experiment Magazines Average weight Body Self- Consciousness

Kozak (2001)a �.12 182 10.08 Correlational Thin-ideal TV programming

FRS

Lavin & Cash (2000) �.71 32 34 20 Experiment Generalized media Object VAS Lavine et al. (1999) �.45 29 28 19.31 Experiment Television commercials Object FRS Lin & Kulik (2002) �.65 22 23 20 Experiment Magazines Overweight BPSS Martin & Kennedy (1993) �.05 48 48 12 Experiment Magazines Object Physical

Attractiveness Mills et al. (2002)

Restrained eaters .97 13 19 19.73 Experiment Magazines Object Appearance Self- Esteem

Unrestrained eaters �.87 15 26 19.72 Experiment Magazines Object Appearance Self- Esteem

Monro & Huon (2005) High self-objectifiers �.27 18 18 20 Experiment Magazines Object VAS Low self-objectifiers �.61 18 18 20 Experiment Magazines Object VAS

Morry & Staska (2001) �.54 89 18.8 Correlational Magazines Self-Objectification �.49 89 18.8 Correlational Magazines EAT �.56 89 18.8 Correlational Magazines SATAQ

Ogden & Mundray (1996) �.86 10 10 20 Experiment Magazines Overweight Body Dissatisfaction Park (2005) �.56 432 20 Correlational Magazines Desire for Thinness Posavac et al. (1998)

Study 1 Dissatisfied �.53 41 41 20 Experiment Magazines Object BES Satisfied .23 30 24

Study 2 Experiment Magazines Object BES Dissatisfied �.52 43 42 20 Satisfied .51 15 19

466 GRABE, WARD, AND HYDE

Table 1 (continued)

Study d

N

Mean age (yrs) Study design Media type Type of control MeasureE C S

Study 3 20 Experiment Magazines Object BES Dissatisfied �.63 20 20 Satisfied 1.16 10 3

Richins (1991) Study 3 �.48 37 36 20 Experiment Magazines Object Satisfaction With

Attractiveness Study 4 �.52 42 45 20 Experiment Magazines Object Satisfaction With

Attractiveness Roberson (2001)a �.01 20 20 20.25 Experiment Magazines Object BES Rocchio (1996)a �.28 41 35 20 Experiment Magazines Object Body Dissatisfaction Sands & Wardle (2003) �.56 356 11 Correlational Magazines SATAQ

�.37 356 11 Correlational Magazines BES Schooler et al. (2004)

�.21 635 18.8 Correlational Television BES �.31 635 18.8 Correlational Television DT-EDI �.15 635 18.8 Correlational Television BUL-EDI

Shaw (1995) �.26 24 24 14.5 Experiment Magazines Object Body Satisfaction

Scale �.04 24 24 27.3 Experiment Magazines Object Body Satisfaction

Scale Stice et al. (1994) �.00 238 20 Correlational Media exposure SATAQ

�.20 238 20 Correlational Media exposure BDS-EDI �.52 238 20 Correlational Media exposure EAT

Stice & Shaw (1994) �.13 50 52 19 Experiment Magazines Object BDS-EDI �.24 50 52 19 Experiment Magazines Object SATAQ

Stice et al. (2001) �.25 96 126 15 Experiment Magazines Object Body Dissatisfaction .03 96 126 15 Experiment Magazines Object Thin-Ideal

Internalization �.06 96 126 15 Experiment Magazines Object Bulimic

Symptomatology Strahan (2003)a

Study 1 �.91 13 13 20 Experiment Television commercials Object Restrained Eating Study 2 �.61 34 34 20 Experiment Television commercials Object Appearance Self-

Esteem Study 3 �.66 17 18 20 Experiment Television commercials Object Restrained Eating Study 4 �1.36 21 21 20 Experiment Television commercials Object Restrained Eating

Strauss et al. (1994) High restraint .58 13 11 20 Experiment Television commercials Object Food Restraint Low restraint �.48 13 16

Thomsen (2002) �.45 340 21.3 Correlational Magazines Body Shape Questionnaire

Thomsen, McCoy, et al. (2002)

�.37 536 20 Correlational Magazines Anorectic Cognitions Scale

Thomsen, Weber, & Brown (2002)

�.25 504 15 Correlational Magazines Pathogenic Dieting Behaviors

Thornton & Maurice (1997) Adherence to attractive ideal:

High �.23 25 33 20.8 Experiment Magazines Object BDS-EDI Medium �.17 25 33 20.8 Experiment Magazines Object BDS-EDI Low �.47 26 34 20.8 Experiment Magazines Object BDS-EDI

Tiggemann (2003) �.39 104 20.7 Correlational Magazines FRS �.65 104 20.7 Correlational Magazines SATAQ �.12 104 20.7 Correlational Magazines EDI �.45 104 20.7 Correlational Television FRS

.08 104 20.7 Correlational Television SATAQ �.12 104 20.7 Correlational Television EDI

Tiggemann (2005) �.41 799 14.37 Correlational Magazines Internalization �.24 799 14.37 Correlational Magazines BUL-EDI

Tiggemann (2006) Time 1 �.59 214 13.98 Correlational Magazines Internalization

�.00 214 Correlational Magazines Body Dissatisfaction �.29 214 Correlational Television Internalization

.20 214 Correlational Television Body Dissatisfaction

Table continues

467MEDIA AND BODY IMAGE

Calculation of Effect Sizes

Formulas for the effect size d were taken from Hedges and

Becker (1986). When means and standard deviations were avail-

able, the effect size was computed as the mean body image score

for the control condition minus the mean body image score for the

experimental condition, divided by the pooled within-groups stan-

dard deviation. Therefore, negative effect sizes represent a more

negative outcome (e.g., more body dissatisfaction) for women

exposed to thin-ideal media than for women in the control condi-

tion. Means and standard deviations were available for 74 (93%) of

the experimental studies. When means and standard deviations for

experimental studies were not available, the effect size was calcu-

lated from reported t or F tests. When t or F was reported, d was

calculated using the formula provided by Hedges and Becker

(1986). Among the correlational studies (43% of total sample; see

Table 2), d was calculated from r on the basis of formulas provided

by Hedges and Becker (1986).

Because effect sizes tend to be upwardly biased when based on

small sample sizes, effect sizes were corrected for bias in the

estimation of population effect sizes using the formula provided by

Hedges (1981). All effect size analyses were weighted analyses

(i.e., each effect size was weighted by an inverted variance; Lipsey

& Wilson, 2001).

To conduct the meta-analyses, we used mixed-effects models,

which assume that effect size variance can be explained by both

systematic and random components (Lipsey & Wilson, 2001). In

mixed-effects models, certain identifiable study characteristics

may act as moderator variables that are associated with systematic

differences among effect sizes at the same time that a random

component of residual variance remains after the systematic por-

tion is accounted for. The mixed-effects model is preferable in this

case because a fixed-effects model assumes that the only source of

variation is from systematic factors and the random-effects model

assumes none of the variation is from systematic sources. Mixed-

effects models assume that the effects of between-study variables

are systematic but that there is a remaining unmeasured random

effect in the effect size distribution in addition to sampling error.

As is done in random-effects models, a random-effects variance

component (derived from the residual homogeneity value after the

Table 1 (continued)

Study d

N

Mean age (yrs) Study design Media type Type of control MeasureE C S

Time 2 �.57 214 14.92 Correlational Magazines Internalization �.26 214 Correlational Magazines Body Dissatisfaction �.37 214 Correlational Television Internalization

.08 214 Correlational Television Body Dissatisfaction Tiggemann & McGill

(2004) �1.63 14 14 20.6 Experiment Magazines Object VAS

Tiggemann & Pickering (1996)

�.63 94 15.5 Correlational Thin-ideal TV programming

Body Dissatisfaction

�.52 94 15.5 Correlational Music television DT-EDI Tiggemann & Slater (2003) �.42 42 41 20.23 Experiment Music television Object VAS Turner et al. (1997)

�.63 24 25 18.63 Correlational Magazines Object Body Dissatisfaction �.49 24 25 18.63 Correlational Magazines Object Dieting �.81 24 25 18.63 Correlational Magazines Object Preoccupation With

Thinness Van den Bulck (2000) �.24 534 17 Correlational Thin-ideal TV

programming Wegner et al. (2000) �1.27 34 33 20 Experiment Magazines Average weight Body Self-

Consciousness Wilcox & Laird (2000) �.67 21 20 20 Experiment Magazines Average weight BES Yamamiya et al. (2005)

High internalizers �1.47 17 15 32 Experiment Magazines Object BISS Low internalizers �.71 16 15 31 Experiment Magazines Object BISS

Note. A positive d indicates a positive relationship between media use and women’s body image attitudes. E � experimental condition; C � control condition; S � survey study; VAS � Visual Analogue Scale; EAT � Eating Attitudes Test; BDS-EDI � Body Dissatisfaction Subscale of the Eating Disorders Inventory; DT-EDI � Drive for Thinness subscale of the Eating Disorders Inventory; BES � Body Esteem Scale; SATAQ � Sociocultural Attitudes Towards Appearance Scale; PASTAS � Physical Appearance State and Trait Anxiety Scale; BUL-EDI � Bulimia Scale of the Eating Disorders Inventory; DEBQ � Dutch Eating Behavior Questionnaire; BE-BIS � Body Esteem subscale of the Body Image Scale; ASI � Appearance Schemas Inventory; chEAT � Children’s Eating Attitudes Test; FRS � Figure Rating Scale; BPSS � Body Parts Satisfaction Scale; BISS � Body Image States Scale. a Dissertation.

Table 2

Summary of Experimental and Correlational Studies

Measure type No. studies Experimental Correlational

Body image dissatisfaction 90 62 28 Body self-consciousness 8 3 5 Internalization 23 7 16 Eating behaviors 20 8 12 Total 141 80 61

468 GRABE, WARD, AND HYDE

moderators are taken into account) is estimated and added to the

standard error associated with each effect size, and inverted vari-

ance weights are calculated.

Moderator Analyses

Because a meta-analysis provides the opportunity to determine

whether specific study or sample characteristics influence research

findings, we conducted analyses to partition the variance among

the effect sizes when homogeneity analyses indicated that total

heterogeneity was significant. We considered six potential mod-

erators. In one set of analyses, we examined whether study design

(i.e., experimental or correlational) moderated the magnitude of

the association between media use and women’s body-image-

related concerns. Investigating age as a second potential modera-

tor, we divided effect sizes into two groups on the basis of the

average age of the participants: (a) 10- to 18-year-olds and (b)

those over 19 years old. Type of media was the third potential

moderator. Media were grouped in three main categories: (a)

magazines, (b) television, or (c) generalized media (e.g., amount of

newspaper, magazines, television, movies, and radio consumed by

respondent). History of body dissatisfaction (yes/no) was exam-

ined as a fourth potential moderator. Because publication bias is a

concern in any meta-analysis, we examined publication status as a

fifth moderator. To investigate publication year, we divided effect

sizes into two groups: studies published between 1990 and 2000

and those published between 2001 and 2007. One study published

outside these categories (i.e., 1983) was excluded from the mod-

erator analyses. Finally, although we conceptualize ethnic back-

ground as an important variable that may influence the effects of

media on body image, only two studies in this review examined the

hypothesized relations among subgroups of women (see Bor-

zekowksi, Robinson, & Killen, 2000, for separate effects among

Asian, Black, Latina, and White girls; see Schooler, Ward, Mer-

riwether, & Caruthers, 2004, for an African American and White

comparison). Two additional studies examined the hypothesized

relations among only groups of ethnic minority women (see

Becker, Burwell, Gilman, Herzog, & Hamburg, 2002, for a Fijian

sample; Frisby, 2004, for an African American sample). Thus,

there was not a sufficient number of studies that included ethnic

minority women to examine differences among subgroups of

women.

Results

Mean Effect Sizes

Mean effect sizes were calculated for each category of out-

comes. The results are reported in Table 3 and are discussed

below. The number of samples (k), the weighted d (weighted by w:

Hedges & Vevea, 1998; Lipsey & Wilson, 2001), the 95% confi-

dence interval (CI) for d, and the total homogeneity statistic (QT)

for each comparison are reported. The majority of effect sizes were

negative (85%).

Body Dissatisfaction

Mean effect size. As can be seen in Table 3, the weighted

mean effect size, averaged over 90 independent effect sizes, for the

relation between media exposure and body dissatisfaction was

– 0.28, representing a small to moderate effect by Cohen’s (1988)

criteria. The negative value indicates that, overall, media exposure

is associated with decreased levels of body satisfaction for women.

Homogeneity analyses using procedures specified by Hedges and

Becker (1986) and Lipsey and Wilson (2001) indicated that the set

of 90 effect sizes was homogenous, QT � 100.34, compared with

a critical value of �2(89, N � 90) � 112.02, p � .05. Because

significant heterogeneity was not present, moderator analyses were

not warranted.

Internalization

Mean effect size. As can be seen in Table 3, the weighted

mean effect size for the relation between media exposure and

women’s internalization of the thin ideal, averaged over 23 inde-

pendent effect sizes, was – 0.39 (95% CI was – 0.33 to – 0.44),

representing a small to moderate effect by Cohen’s (1988) criteria.

Homogeneity analyses indicated that the set of 23 effect sizes was

significantly heterogeneous: QT � 66.15, the critical value of

� 2(22, N � 23) � 48.27, p � .001.

Moderator analyses. Because the set of effect sizes was het-

erogeneous, moderator analyses were warranted. Results of mod-

erator analyses are shown in Table 4. Because no studies included

participants with a prior history of body dissatisfaction and no

dissertations assessed internalization as an outcome, moderator

analyses were not run for these variables. Significant between-

groups heterogeneity appeared for study design and publication

year such that larger effects were found in the correlational liter-

ature than in the experimental literature �2(1, N � 2) � 6.64, p �

.01, and for studies published in the 2000s compared with those in

the 1990s, �2(1, N � 2) � 10.83, p � .001. This finding suggests

that either the effects of media exposure on women’s internaliza-

tion of the thin ideal have grown stronger in the 2000s relative to

the 1990s or that study designs have become more sensitive to

assessing potential associations. However, because the number of

studies in these comparisons is few, interpretations of these mod-

erated relations should be made with caution. Furthermore, al-

though the presence of multiple moderators often warrants multi-

ple regression analyses to determine the relative influence of

moderator variables on effect size magnitudes (Hedges & Becker,

1986), in our judgment there were too few studies in each group to

justify multiple regression analyses in this case.

Eating Behaviors and Beliefs

Mean effect size. As reported in Table 3, averaged over 20

independent effect sizes, the weighted mean effect size for the

Table 3

Summary of Mean Effect Sizes for Mixed-Effects Analyses

Measure type No.

studies d 95% CI QT

Body image dissatisfaction 90 �.28 �.21 to �.35 100.34 Internalization 23 �.39 �.33 to �.44 66.15*

Eating behaviors and beliefs 20 �.30 �.24 to �.36 46.30***

Note. A negative d indicates that the control group scored higher than the experimental group on negative body image. CI � confidence intervals; QT � Total heterogeneity. *

p � .05. *** p � .001.

469MEDIA AND BODY IMAGE

relation between media exposure and women’s eating behaviors

and beliefs was – 0.30 (95% CI was – 0.24 to – 0.36), representing

a small to moderate effect by Cohen’s (1988) criteria. The negative

value indicates that, overall, media use is related to higher eating

disorder symptomatology. Homogeneity analyses indicated that

the set of 20 effect sizes was heterogeneous (QT � 46.30) com-

pared with a critical value of �2(19, N � 20) � 43.82, p � .001.

Moderator analyses. The results of the moderator analyses for

eating behaviors and beliefs are shown in Table 5. Because only

one study included participants without a prior history of body

dissatisfaction, moderator analyses were not run for prior history.

The significant between-groups homogeneity statistics for age,

� 2(1, N � 2) � 3.84, p � .05; media type, �2(1, N � 2) � 3.84,

p � .05; and publication status, �2(1, N � 2) � 10.83, p � .001,

suggest that there is a significant difference in the magnitude of

effect sizes as a function of these moderator variables. These

findings suggest that the relation between media exposure and

eating behaviors and beliefs is slightly stronger for adults than for

adolescents, for generalized media use as opposed to television or

magazine use, and much stronger for published versus unpublished

manuscripts. Again, however, in each comparison the number of

studies was few, precluding the use of multiple regression analyses

and lending caution to interpretation of these findings.

Discussion

This meta-analysis represents a systematic inquiry into the over-

all associations of thin-ideal media exposure and three main areas

of women’s body image and related concerns. The results show

consistent associations across both experimental and correlational

designs and across multiple measures of women’s body image and

eating behaviors and beliefs. Thus, these findings provide strong

support for the notion that exposure to mass media depicting the

thin-ideal body is related to women’s vulnerability to disturbances

related to body image.

Body Dissatisfaction

Consistent with the findings of Groesz et al. (2002), which were

based on experimental studies, we found a small to moderate effect

size suggesting that exposure to media images that depict the

thin-ideal body is indeed linked to women’s dissatisfaction with

their own bodies. We replicated this finding with double the

number of effect sizes, providing even greater support for the small

to moderate negative relation between media exposure and wom-

en’s body satisfaction. The finding from the experimental literature

in the current review (57% of studies) provides evidence of a link

between exposure to thin-ideal media images and body dissatis-

faction in women. The similar outcome found in the correlational

literature supports this finding and suggests that this phenomenon

also operates outside a laboratory context. Prospective studies will

be important in fully assessing the role of the media in women’s

vulnerability to disturbances related to body image.

Internalization and Eating Behaviors and Beliefs

In addition to clarifying the inconsistent findings demonstrated

in the prior two meta-analytic reviews that focused on women’s

body dissatisfaction, the current review provides new information

regarding the link between media and additional dimensions con-

cerning women’s experience of their bodies. Importantly, we

found that media exposure was related to multiple outcome mea-

sures. Specifically, and consistent with our expectations, we found

relationships between media and internalization of the thin ideal as

well as between media and women’s eating behaviors and beliefs.

The small to moderate effect sizes found for these outcomes were

comparable to the effect sizes for media exposure on body dissat-

isfaction. These findings suggest that, overall, thin-ideal media

exposure is related to higher levels of body dissatisfaction, stron-

ger internalization of the thin ideal, and more frequent bulimic and

anorexic attitudes and behaviors. Interestingly, for the internaliza-

tion outcome variable, we found that effects were stronger in the

2000s compared with in the 1990s. This finding should be inter-

preted cautiously because publication year may not accurately

reflect the year that data were collected. However, this finding

Table 4

Variables Potentially Moderating the Link Between Media

Exposure and Internalization

Variable Between- groups Q

No. studies d

Within-group Q

Study design 7.10**

Experimental 7 �.21 25.83***

Correlational 16 �.42 33.22***

Age group in years 3.78 Adolescent (10–18) 13 �.42 26.18*

Young adult/adult (19–32) 10 �.31 36.19 Media type 5.10

Television 7 �.39 5.09 Magazines 14 �.37 45.07 Generalized media 2 �.33 10.89***

Publication year 12.85***

1990–1999 4 �.13 3.75 2000–2005 19 �.42 45.55***

Note. Q � heterogeneity. *

p � .05. ** p � .01. *** p � .001.

Table 5

Variables Potentially Moderating the Link Between Media

Exposure and Eating Behaviors and Beliefs

Variable Between- groups Q

No. studies d

Within-group Q

Study design 0.84 Experimental 8 �.36 21.91**

Correlational 12 �.28 28.46**

Age group in years 6.43*

Adolescent (ages 10–18) 4 �.20 4.38 Young adult/Adult (ages

19–32) 16 �.35 40.40***

Media type 4.0*

Television 7 �.29 22.42**

Magazines 11 �.26 24.70**

Generalized media 2 �.50 .09 Publication status 11.42***

Published 17 �.27 37.72**

Not published 3 �.99 2.07 Publication year 0.09

1990–1999 8 �.30 25.81***

2000–2005 12 �.28 25.31**

Note. Q � heterogeneity. *

p � .05. ** p � .01. *** p � .001.

470 GRABE, WARD, AND HYDE

allows us to speculate that the increasingly more prevalent objec-

tifying images of women in the media may lead to increased

internalization of the publicized ideal (see American Psychological

Association, 2007, for a review). Furthermore, there was evidence

that the magnitude of the effect size between media exposure and

internalization was larger in the correlational literature, perhaps

reflecting the fact that internalization of the thin ideal develops

over time and with massive exposure, making it difficult to capture

in a one-time laboratory setting. In sum, there does appear to be

evidence that media exposure and women’s internalization of the

thin ideal are linked.

The effect sizes for the relation between media exposure and

eating behaviors and beliefs were also consistent with the hypoth-

esis that women exposed to thin-ideal media would score higher on

measures that assess bulimia, purging, and anorexic attitudes and

behaviors. Obviously, during a brief experiment we would not

expect changes in behavior; however, many items on these mea-

sures concern beliefs about eating, purging, and dieting. In the

context of an experiment, these direct effects are of particular

concern because they suggest that even a brief manipulation can

directly affect women’s beliefs about dieting and eating and can

encourage acceptance of behaviors that are potentially harmful to

women’s health, including purging and severe caloric restriction

(Hawkins, Richards, Granley, & Stein, 2004). Furthermore, al-

though there was statistical evidence that the effect sizes for eating

behaviors were moderated, all of the effect sizes were in the same

direction and in the small to moderate range. A finding linking

media exposure to disordered eating behaviors and beliefs should

warrant public attention. Eating disorders are among the 10 leading

sources of disability among young women, and anorexia nervosa

has the highest mortality rate of all mental disorders (Striegel-

Moore & Bulik, 2007).

Concerns about eating disorders—specifically, anorexia and

bulimia—must be balanced against concerns about the epidemic of

obesity in the American population, including the population of

American women. Obesity, of course, carries its own set of health

risks as well.

Finally, the findings related to women’s self-consciousness sur-

rounding their bodies were too preliminary to be conclusive. The

few studies eligible for this review highlight that much more

research is warranted to understand the media’s role in the devel-

opment of body self-consciousness.

Conclusion

Taken together, the findings from these analyses suggest that

media exposure is linked to women’s generalized dissatisfaction

with their bodies, increased investment in appearance, and in-

creased endorsement of disordered eating behaviors. These effects

appear robust: They are present across multiple outcomes and are

demonstrated in both the experimental and correlational literatures.

Thus we can see that media exposure appears to be related to

women’s body image negatively regardless of assessment tech-

nique, individual difference variables, media type, age, or other

idiosyncratic study characteristics. Moreover, although 43% of the

effect sizes in our analyses were from correlational studies, thereby

precluding causal inferences, 57% were from experimental de-

signs. Indeed, because no single methodological approach can

stand alone in answering these key questions, we believe that

converging results from studies using multiple methodologies en-

hance confidence in the validity of the conclusions drawn. How-

ever, what remains necessary is the use of longitudinal, prospec-

tive designs; longitudinal studies are positioned to provide

additional evidence regarding the role of media in disturbances

related to body image.

Other Research on Media Effects

The current findings can be interpreted in the context of other,

more well established areas of media research. For example,

researchers have focused extensively on the influence of violent

media on the aggressive behavior of youth. Findings from a

meta-analysis summarizing the most up-to-date literature demon-

strated that both experimental and correlational studies, on aver-

age, yielded an effect of violent video games on aggressive be-

havior that was comparable to the effects reported in the current

study (average effect size r � .28; C. A. Anderson et al., 2004).

The authors reported that the experimental studies demonstrated

that brief exposure to violent video games led to an immediate

increase in aggressive behavior, whereas the correlational studies

linked repeated exposure to violent video games to a variety of

types of real-world aggressive behavior, including violent criminal

behavior. Of course, media violence research is a much more

mature area of scholarship with a longer history of research and

increasingly sophisticated designs that make these inferences war-

ranted. Thin-ideal media research is much newer and inferences

must therefore be more modest, but the media violence research

provides a roadmap for ways in which research can proceed.

Implications

The findings from this study can inform prevention and inter-

vention efforts particularly in the areas of education and advertis-

ing. With respect to education, media literacy can be used to teach

girls and women to become more active, critical consumers of

appearance-related media to prevent the development of body

dissatisfaction and disturbed eating behaviors. For example, Posa-

vac et al. (1998) found that female college students with negative

body image who were given a 7-min psychoeducational presenta-

tion involving media analysis were less likely to engage in social

comparison and less likely to be negatively affected by images of

slender beauty than were students who had seen the same images

without prior education. In another study, Irving, Dupen, and Berel

(1998) found that female high school students who participated in

a media literacy discussion reported lower perceived realism of

media images and less internalization of the popular standard of

beauty. However, Irving et al. also reported that the groups did not

differ on levels of body dissatisfaction. In fact, despite the critical

awareness that media literacy training stands to offer, several

studies have found limited evidence of the effectiveness of media

literacy, suggesting that the pervasiveness of the media’s promo-

tion of the thin ideal is far greater than the proactive messages

offered in one-time interventions (e.g., Irving & Berel, 2001;

McVey & Davis, 2002). Thus, short-term media literacy interven-

tions alone may not suffice to counteract massive media exposure

to the thin ideal.

Perhaps of greater benefit would be to reduce the emphasis on

an unrealistically thin ideal that is perpetuated through the objec-

471MEDIA AND BODY IMAGE

tification of women’s bodies in the media. Interestingly, Dittmar

and Howard (2004) found that women reported less body-focused

anxiety after exposure to attractive, average-size models than after

exposure to no models; the lowered anxiety, in a sense, demon-

strates a relief effect due to exposure to “average” models. Impor-

tantly for the advertising industry, research in this area has also

demonstrated that when average-size models and ultra-thin models

are equally attractive, they are also perceived to be equally effec-

tive in advertising a product (Dittmar & Howard, 2004; Halliwell

& Dittmar, 2004; Halliwell, Dittmar, & Howe, 2005). These find-

ings suggest that use of average-size models in advertising could

help protect some women from developing body dissatisfaction or

at least avoid exacerbating existing body image concerns.

Limitations and Future Directions

Despite the contributions of the present study, there are limita-

tions that future research may want to address. First, much of what

is known about women’s body dissatisfaction is based largely on

White samples (Grabe & Hyde, 2006), with a significant omission

of women of color from this research area. It is therefore unclear

from our results whether media exposure would operate similarly

across other ethnic groups. The limited number of studies in this

review that did examine the role of ethnicity suggested that it does

affect women’s level of body dissatisfaction in the face of main-

stream media (e.g., Schooler et al., 2004). Therefore, this review

highlights the extreme neglect of women of color in this research

area. Further study of media exposure among girls and women

from diverse ethnic groups, and with ethnic-focused media, is

needed to increase our knowledge of the role that the media play

in body image disturbance in girls and women of color. Further-

more, the findings of this review are not generalizable beyond

English-speaking countries.

Second, although we believe that the correlational data en-

hanced the validity of the experimental findings by providing data

on actual media diets, the nature of correlational data do not permit

identification of the prospective contributions of media to the

development of negative body image. Although there were not

enough prospective studies to include in the meta-analytic para-

digm, recent longitudinal investigation has begun to demonstrate

that exposure to appearance-focused media prospectively contrib-

utes to the development of body image issues among girls and

women. Specifically, it has been found that viewing sexually

objectifying television predicts subsequent self-objectification one

year later among college women (Aubrey, 2006). Other findings

indicate that increased television viewing among grade school girls

is associated with higher disordered eating one year later (Harrison

& Hefner, 2006); that frequent viewing of appearance-focused

television among girls predicts lower levels of appearance satis-

faction one year later (Dohnt & Tiggemann, 2006b); and that

frequent magazine and television exposure among teenage girls

each predict higher levels of internalization, core beliefs about

appearance value, and drive for thinness one year later (Tigge-

mann, 2006). Although more longitudinal research designs are

ultimately needed to test the long-term effects of media exposure,

the initial findings, coupled with the meta-analytic results, strongly

suggest that the media are influential in the development of body

image issues among women.

Third, research on the potential consequences of thin-ideal media

need to be extended to include other outcomes, such as obesity and

body self-consciousness. The findings we analyzed related to wom-

en’s self-consciousness surrounding their bodies were too preliminary

to be conclusive. However, the few studies eligible for this review

highlight that much more research is warranted to understand the

media’s role in the development of body self-consciousness. In addi-

tion, given the roles of body dissatisfaction and dieting behavior in the

onset of obesity (e.g., Field & Colditz, 2001; Haines & Neumark-

Sztianer, 2006), research in this area should also begin to include

obesity and other weight-related behaviors as outcomes, both directly

and indirectly. At the moment, media use is assumed to connect to

obesity via exposure to repeated advertisements of unhealthy foods

and via the inactivity that comes with viewing (e.g., Haines &

Neumark-Sztianer, 2006). But it is also likely that media exposure,

which means exposure to the thin ideal, contributes to obesity through

its promotion of body dissatisfaction, bingeing behaviors, and un-

healthy attitudes and practices, such as meal skipping. Evidence that

dieting is a significant predictor of obesity, which characterizes 30%

of American women (Centers for Disease Control, 2006), continues to

build. For example, data from the prospective longitudinal sample of

Neumark-Sztianer and colleagues (Neumark-Sztianer et al., 2006;

Neumark-Sztianer, Wall, Haines, Story, & Eisenberg, 2007) indicate

that adolescents who reported dieting were at nearly twice the risk for

being overweight 5 years later and that those who used unhealthful

weight control behaviors, such as meal skipping and diet pills, were at

3 times the risk. More extensive study of the role of thin-ideal media

exposure in these important health behaviors is needed.

Finally, it is interesting to note that in a small percentage of

studies there was a positive effect of media on women’s body

image concerns, suggesting that some women actually feel better

about themselves after viewing media images. However, this effect

was found in only 8 of 141 samples. Interestingly, in half of those,

the positive effect was demonstrated among either restrained eaters

or body-satisfied women (e.g., Joshi, Herman, & Polivy, 2004;

Mills, Polivy, Herman, & Tiggemann, 2002). Thus, it is possible

that women who are consciously addressing their body image (e.g.,

restricting calories) or are already satisfied with their bodies feel

elevated satisfaction in the presence of the appearance-related cues

provided by the media. However, given that the number of studies

in this area were few, interpretations of this finding are tentative.

It would also be important to examine potential defenses against

the negative correlates of media use. Several studies have demon-

strated that the extent to which women internalize cultural ideals of

thinness and appearance as a personal standard operates as a

moderator of their vulnerability to the negative impact of thin-ideal

media images on their own body image (Dittmar & Howard,

2004). Thus, minimizing the importance of attractiveness seems to

be an important avenue for inoculating women against thin-ideal

media images. However, given the prevalence of the mass media

it seems unrealistic to expect that the majority of girls and women

can be sufficiently defended against a vast array of messages that

reinforce the notion that attractiveness should be of primary im-

portance to women. New policies adopted in Spain and Italy, and

more tentatively by the Council of Fashion Designers of America,

that exclude hyperthin women from modeling may be helpful not

only to the models themselves but also to millions of girls and

women who view these images.

472 GRABE, WARD, AND HYDE

References

References marked with an asterisk indicate studies included in the

meta-analysis.

*Abramson, E., & Valene, P. (1991). Media use, dietary restraint, bulimia,

and attitudes toward obesity: A preliminary study. British Review of

Bulimia and Anorexia Nervosa, 5, 73–76.

American Psychological Association Task Force on the Sexualization of

Girls. (2007). Report of the Task Force on the Sexualization of Girls.

Washington, DC: Author. Retrieved January 10, 2007, from http://

www.apa.org/pi/wpo/sexualizationrep.pdf

Anderson, C. A., Berkowitz, L., Donnerstein, E., Huesmann, L. R., John-

son, J. D., Linz, D., et al. (2003). The influence of media violence on

youth. Psychological Science in the Public Interest, 4, 81–110.

Anderson, C. A., Carnagey, N. L., Flanagan, M., Benjamin, A. J., Eubanks,

J., & Valentine, J. (2004). Violent video games: Specific effects of

violent content on aggressive thoughts and behavior. Advances in Ex-

perimental Social Psychology, 36, 199 –249.

*Anderson, D. R., Huston, A. C., Schmitt, K. L., Linebarger, D. L., &

Wright, J. C. (2001). Early childhood television viewing and adolescent

behavior. Monographs of the Society for Research in Child Develop-

ment, 66, 108 –118.

*Aubrey, J. S. (2006). Effects of sexually objectifying media on self-

objectification and body surveillance in undergraduates: Results of a

2-year panel study. Journal of Communication, 56, 366 –386.

Bearman, S. K., Presnell, K., & Martinez, E. (2006). The skinny on body

dissatisfaction: A longitudinal study of adolescent girls and boys. Jour-

nal of Adolescence, 35, 217–229.

Bearman, S. K., Stice, E., & Chase, A. (2003). Evaluation of an interven-

tion targeting both depressive symptoms and bulimic pathology: A

randomized prevention trial. Behavior Therapy, 34, 277–293.

*Becker, A., Burwell, R. A., Gilman, S., Herzog, D., & Hamburg, P.

(2002). Eating behaviors and attitudes following prolonged exposure to

television among ethnic Fijian adolescent girls. British Journal of Psy-

chiatry, 180, 509 –514.

Ben-Tovim, D. I., & Walker, M. K. (1991). The development of the

Ben-Tovim Walker Body Attitudes Questionnaire (BAQ), a new mea-

sure of women’s attitudes towards their own bodies. Psychological

Medicine, 21, 775–784.

Berscheid, E., Walster, E., & Bohrnstedt, G. (1973). The happy American

body: A survey report. Psychology Today, 21, 119 –131.

*Birkeland, R., Thompson, J., & Herbozo, S. (2005). Media exposure,

mood, and body image dissatisfaction: An experimental test of person

versus product priming. Body Image, 2, 53– 61.

*Bissell, K. L., & Zhou, P. (2004). Must-see TV or ESPN: Entertainment

and sports media exposure and body-image distortion in college women.

Journal of Communication, 54, 5–21.

*Borowiak, D. M. (2003). The antecedents and consequences of body

image dissatisfaction: A structural modeling analysis and a controlled

laboratory task. Unpublished doctoral dissertation, University of North

Dakota.

*Borzekowski, D. L. G., Robinson, T. N., & Killen, J. D. (2000). Does the

camera add 10 pounds? Media use, perceived importance of appearance,

and weight concerns among teenage girls. Journal of Adolescent Health,

26, 36 – 41.

Botta, R. A. (1999). Television images and adolescent girls’ body image

disturbance. Journal of Communication, 49, 22– 41.

Botta, R. A. (2000). The mirror of television: A comparison of Black and

White adolescents’ body image. Journal of Communication, 50, 144 –159.

*Brown, A., & Dittmar, H. (2005). Think ‘thin’ and feel bad: The role of

appearance schema activation, attention level, and thin-ideal internaliza-

tion for young women’s responses to ultra-thin media ideals. Journal of

Social and Clinical Psychology, 24, 1088 –1113.

Brown, J. D. (2002). Mass media influences on sexuality. Journal of Sex

Research, 39, 42– 45.

Brown, T. A., Cash, T. F., & Mikulka, P. J. (1990). Attitudinal body image

assessment: Factor analysis of the Body-Self Relations Questionnaire.

Unpublished manuscript.

*Cash, T. F., Cash, D. W., & Butters, J. W. (1983). “Mirror, mirror on the

wall . . . ?”: Contrast effects and self-evaluations of physical attractive-

ness. Personality and Social Psychology Bulletin, 9, 351–358.

Cash, T. F., Fleming, E. C., Alindogan, J., Steadman, L., & Whitehead, A.

(2002). Beyond body image as a trait: The development and validation

of the Body Image States Scale. Eating Disorders: The Journal of

Treatment & Prevention, 10, 103–113.

Cash, T. F., & Labarge, A. S. (1996). Development of the appearance

schemas inventory: A new cognitive body image assessment. Cognitive

Therapy Research, 20, 37–50.

*Cattarin, J., Williams, R., Thomas, C. M., & Thompson, J. K. (2000).

Body image, mood, and televised images of attractiveness: The role of

social comparison. Journal of Social and Clinical Psychology, 19, 220 –

239.

Centers for Disease Control. (2006). Chartbook on trends in the health of

Americans. Hyattsville, MD: National Center for Health Statistics, U.S.

Department of Health and Human Services.

*Clay, D., Vignoles, V. L., & Dittmar, H. (2005). Body image and

self-esteem among adolescents girls: Testing the influence of sociocul-

tural factors. Journal of Research on Adolescence, 15, 451– 477.

Cohen, J. (1988). Statistical power analysis for the behavioral sciences

(2nd ed.). Hillsdale, NJ: Erlbaum.

Conner, M., Martin, E., Silverdale, N., & Grogan, S. (1996). Dieting in

adolescence: Underlying beliefs and attitudes. British Journal of Health

Psychology, 1, 315–325.

*Coolican, C. R. (1999). The effect of television programming that em-

phasizes beauty/thinness on women’s body image and self-esteem. Un-

published doctoral dissertation, University of Alberta, Edmonton, Al-

berta, Canada.

Cooper, P. J., Taylor, M. J., Cooper, Z., & Fairburn, C. G. (1987). The

development and validation of the Body Shape Questionnaire. Interna-

tional Journal of Eating Disorders, 6, 485– 494.

*Crouch, A., & Degelman, D. (1998). Influence of female body images in

printed advertising on self-ratings of physical attractiveness by adoles-

cent girls. Perceptual & Motor Skills, 87, 585–586.

*Cusumano, D., & Thompson, J. (1997). Body image and body shape

ideals in magazines: Exposure, awareness, and internalization. Sex

Roles, 37, 701–721.

Cusumano, D. L., & Thompson, J. K. (2001). Media influence and body

image in 8 –11 year old boys and girls: A preliminary report on the

Multidimensional Media Influence Scale. International Journal of Eat-

ing Disorders, 29, 37– 44.

Dittmar, H. (2005). Vulnerability factors and processes linking sociocul-

tural pressures and body dissatisfaction. Journal of Social and Clinical

Psychology, 24, 1081–1087.

*Dittmar, H., & Howard, S. (2004). Thin-ideal internalization and social

comparison tendency as moderators of media models’ impact on wom-

en’s body-focused anxiety. Journal of Social and Clinical Psychology,

23, 768 –791.

*Dohnt, H. K., & Tiggemann, M. (2006a). Body image concerns in young

girls: The role of peers and media prior to adolescence. Journal of Youth

and Adolescence, 35, 135–145.

Dohnt, H., & Tiggemann, M. (2006b). The contribution of peer and media

influences to the development of body satisfaction and self-esteem in young

girls: A prospective study. Developmental Psychology, 42, 929 –936.

*Dunkley, T. L., Wertheim, E. H., & Paxton, S. J. (2001). Examination of

a model of multiple sociocultural influences on adolescent girls’ body

dissatisfaction and dietary restraint. Adolescence, 36, 265–279.

*Durkin, S. J., & Paxton, S. J. (2002). Predictors of vulnerability to

473MEDIA AND BODY IMAGE

reduced body image satisfaction and psychological well-being in re-

sponse to exposure to idealized female media images in adolescent girls.

Journal of Psychosomatic Research, 53, 995–1005.

*Esteban, C. M. (2003). The effects of media images on women’s body

esteem across ethnicity. Unpublished doctoral dissertation, Alliant In-

ternational University, Fresno, California.

Fairburn, C. G., & Belgin, S. J. (1994). Assessment of eating disorders:

Interview or self-report questionnaire? International Journal of Eating

Disorders, 16, 363–370.

Feingold, A., & Mazzella, R. (1998). Gender differences in body image are

increasing. Psychological Science, 9, 190 –195.

Field, A., & Colditz, G. (2001). Frequent dieting and the development of

obesity among children and adolescents. Nutrition, 17, 355–356.

Fouts, G., & Burggraf, K. (1999). Television situation comedies: Female

body images and verbal reinforcement. Sex Roles, 40, 473– 481.

Fouts, G., & Burggraf, K. (2000). Television situation comedies: Female

weight, male negative comments, and audience reactions. Sex Roles, 42,

925–932.

Franzoi, S. L., & Shields, S. A. (1984). The Body Esteem Scale: Multidi-

mensional structure and sex differences in a college population. Journal

of Personality Assessment, 48, 173–178.

*Frisby, C. M. (2004). Does race matter? Effects of idealized images on

African American women’s perceptions of body esteem. Journal of

Black Studies, 34, 323–347.

Garner, D. M., Garfinkel, P. E., Schwartz, D., & Thompson, M. (1980).

Cultural expectations of thinness in women. Psychological Reports, 47,

483– 491.

Garner, D. M., Olmsted, M. P., Bohr, Y., & Garfinkel, P. E. (1982). The

eating attitudes test: Psychometric features and clinical correlates. Psy-

chological Medicine, 12, 871– 878.

Garner, D. M., Olmsted, M. P., & Polivy, J. (1983). Development and

validation of a multidimensional eating disorder inventory for anorexia

nervosa and bulimia. International Journal of Eating Disorders, 2,

15–34.

Gerbner, G., Gross, L., & Morgan, M. (2002). Growing up with television:

Cultivation processes. In J. Bryant & D. Zillman (Eds.), Media effects:

Advances in theory and research (2nd ed., pp. 43– 67). Mahwah, NJ:

Erlbaum.

Grabe, S., & Hyde, J. S. (2006). Ethnicity and body dissatisfaction among

women in the United States: A meta-analysis. Psychological Bulletin,

132, 622– 640.

Grabe, S., Hyde, J., & Lindberg, S. (2007). Body objectification and

depression in adolescents: The role of gender, shame, and rumination.

Psychology of Women Quarterly, 31, 164 –175.

Greenberg, B. S., Eastin, M., Hofschire, L., Lachlan, K., & Brownell, K.

(2003). Portrayals of overweight and obese individuals on commercial

television. American Journal of Public Health, 93, 1342–1348.

Groesz, L. M., Levine, M. P., & Murnen, S. K. (2002). The effect of

experimental presentation of thin media images on body satisfaction: A

meta-analytic review. International Journal of Eating Disorders, 31,

1–16.

*Grogan, S., Williams, Z., & Conner, M. (1996). The effects of viewing

same gender photographic models on body-esteem. Psychology of

Women Quarterly, 20, 569 –575.

Haines, J., & Neumark-Sztianer, D. (2006). Prevention of obesity and

eating disorders: A consideration of shared risk factors. Health Educa-

tion Research, 21, 770 –782.

*Halliwell, E., & Dittmar, H. (2004). Does size matter? The impact of

models’ body size on women’s body-focused anxiety and advertising

effectiveness. Journal of Social and Clinical Psychology, 23, 104 –122.

*Halliwell, E., Dittmar, H., & Howe, J. (2005). The impact of advertise-

ments featuring ultra-thin or average-size models on women with a

history of eating disorders. Journal of Community & Applied Social

Psychology, 15, 406 – 413.

Hamilton, K., & Waller, G. (1993). Media influences on body size esti-

mation in anorexia and bulimia. British Journal of Psychiatry, 162,

837– 840.

*Hargreaves, D. A., & Tiggemann, M. (2002). The effect of television

commercials on mood and body dissatisfaction: The role of appearance-

schema activation. Journal of Social and Clinical Psychology, 21, 287–

308.

*Hargreaves, D. A., & Tiggemann, M. (2003a). Longer-term implications

of responsiveness to ‘thin-ideal’ television: Support for a cumulative

hypothesis of body image disturbance? European Eating Disorders

Review, 11, 465– 477.

*Hargreaves, D. A., & Tiggemann, M. (2003b). The effect of “thin ideal”

television commercials on body dissatisfaction and schema activation

during early adolescence. Journal of Youth and Adolescence, 32, 367–

373.

*Hargreaves, D. A., & Tiggemann, M. (2004). Idealized media images and

adolescent body image: ‘Comparing’ boys and girls. Body Image, 1,

351–361.

Harrison, K. (1997). Does interpersonal attraction to thin media personal-

ities promote eating disorders? Journal of Broadcasting and Electronic

Media, 41, 478 –500.

*Harrison, K. (2000). The body electric: Thin-ideal media and eating

disorders in adolescents. Journal of Communication, 50, 119 –143.

*Harrison, K., & Cantor, J. (1997). The relationship between media con-

sumption and eating disorders. Journal of Communication, 47, 40 – 67.

Harrison, K., & Hefner, V. (2006). Media exposure, current and future

body ideals, and disordered eating among preadolescent girls: A longi-

tudinal panel study. Journal of Youth & Adolescence, 35, 146 –156.

*Hawkins, N., Richards, P. S., Granley, H., & Stein, D. M. (2004). The

impact of exposure to the thin-ideal media images on women. Eating

Disorders: The Journal of Treatment & Prevention, 12, 35–50.

Heatherton, T. F., & Polivy, J. (1991). Chronic dieting and eating disor-

ders: A spiral model. In J. H. Crowther, S. E. Hobfall, M. A. P. Stephens,

& D. L. Tennebaum (Eds.), The etiology of bulimia: The individual and

family context (pp. 133–155). Washington, DC: Hemisphere.

Hedges, L. V. (1981). Distribution theory for Glass’s estimator of effect

size and related estimators. Journal of Educational Statistics, 6, 107–

128.

Hedges, L. V., & Becker, B. J. (1986). Statistical methods in the meta-

analysis of research on gender differences. In J. S. Hyde & M. C. Linn

(Eds.), The psychology of gender (pp. 14 –50). Baltimore: Johns Hopkins

University Press.

Hedges, L. V., & Vevea, J. L. (1998). Fixed- and random-effects models in

meta-analysis. Psychological Methods, 3, 486 –504.

*Heinberg, L. J., & Thompson, J. K. (1995). Body image and televised

images of thinness and attractiveness: A controlled laboratory investi-

gation. Journal of Social and Clinical Psychology, 14, 325–328.

Heinberg, L. J., Thompson, J. K., & Stormer, S. (1995). Development and

validation of the Sociocultural Attitudes Towards Appearance Question-

naire. International Journal of Eating Disorders, 17, 81– 89.

*Henderson-King, D., Henderson-King, E., & Hoffman, L. (2001). Media

images and women’s self-evaluations: Social context and importance of

attractiveness as moderators. Personality & Social Psychology Bulletin,

27, 1407–1416.

Henderson-King, E., & Henderson-King, D. (1997). Media effects on

women’s body esteem: Social and individual difference factors. Journal

of Applied Social Psychology, 27, 399 – 417.

*Hofschire, L. J., & Greenberg, B. S. (2001). Media’s impact on adoles-

cents’ body dissatisfaction. In J. D. Brown & J. R. Steele (Eds.), Sexual

teens, sexual media (pp. 125–149). Mahwah, NJ: Erlbaum.

Holmstrom, A. J. (2004). The effects of the media on body image: A meta-

analysis. Journal of Broadcasting & Electronic Media, 48, 196 –217.

*Irving, L. M. (1990). Mirror image: Effects of the standard of beauty on

474 GRABE, WARD, AND HYDE

the self- and body-esteem of women exhibiting varying levels of bulimic

symptoms. Journal of Social and Clinical Psychology, 9, 230 –242.

Irving, L. M., & Berel, S. (2001). Comparison of media literacy programs

to strengthen college women’s resistance to media images. Psychology

of Women Quarterly, 6, 119 –131.

Irving, L. M., Dupen, J., & Berel, S. (1998). A media literacy program for

high school females. Eating Disorders: The Journal of Treatment and

Prevention, 25, 103–111.

Jane, D. M., Hunter, G., & Lozzi, B. M. (1999). Do Cuban American

women suffer from eating disorders? Effects of media exposure and

acculturation. Hispanic Journal of Behavioral Science, 21, 212–218.

Johnson, F., & Wardle, J. (2005). Dietary restraint, body dissatisfaction,

and psychological distress: A prospective analysis. Journal of Abnormal

Psychology, 114, 119 –125.

*Jones, D. C., Vigfusdottir, T. H., & Lee, Y. (2004). Body image and the

appearance culture among adolescent girls and boys: An examination of

friend conversations, peer criticism, appearance magazines, and the

internalization of appearance ideals. Journal of Adolescent Research, 19,

323–339.

*Joshi, R., Herman, C. P., & Polivy, J. (2004). Self-enhancing effects of

exposure to thin-body images. International Journal of Eating Disor-

ders, 35, 333–341.

*Kalodner, C. R. (1997). Media influences on male and female non-eating-

disordered college students: A significant issue. Eating Disorders: The

Journal of Treatment & Prevention, 5, 47–57.

Klein, H., & Shiffman, K. S. (2005). Thin is ‘in’ and stout is ‘out’: What

animated cartoons tell viewers about body weight. Eating and Weight

Disorders, 10, 107–116.

*Kozak, A. (2001). Media consumption and body image disturbance in late

elementary school-age children. Unpublished doctoral dissertation,

Texas Woman’s University.

*Lavin, M. A., & Cash, T. F. (2000). Effects of exposure to information

about appearance stereotyping and discrimination on women’s body

images. International Journal of Eating Disorders, 29, 51–58.

*Lavine, H., Sweeney, D., & Wagner, S. (1999). Depicting women as sex

objects in television advertising: Effects on body dissatisfaction. Per-

sonality and Social Psychology Bulletin, 25, 1049 –1058.

Levine, M. P., & Harrison, K. (2004). Media’s role in the perpetuation and

prevention of negative body image and disordered eating. In J. K.

Thompson (Ed.), Handbook of eating disorders and obesity (pp. 695–

717). Hoboken, NJ: Wiley.

*Lin, L. F., & Kulik, J. A. (2002). Social comparison and women’s body

satisfaction. Basic and Applied Social Psychology, 24, 115–123.

Lipsey, M. W., & Wilson, D. B. (2001). Practical Meta-Analysis. Applied

Social Research Methods Series (Vol. 49). Thousand Oaks, CA: Sage

Publications.

Maloney, M. J., McGuire, J. B., & Daniels, S. R. (1988). Reliability testing

of a children’s version of the Eating Attitudes Test. Journal of the

American Academy of Child and Adolescent Psychiatry, 27, 541–543.

Martin, M. C., & Gentry, J. W. (1997). Stuck in the model trap: The effects

of beautiful models in ads on female pre-adolescents and adolescents.

Journal of Advertising, 26, 19 –33.

*Martin, M. C., & Kennedy, P. F. (1993). Advertising and social compar-

ison: Consequences for female preadolescents and adolescents. Psychol-

ogy and Marketing, 10, 513–530.

McKinley, N. M., & Hyde, J. S. (1996). The Objectified Body Conscious-

ness Scale: Development and validation. Psychology of Women Quar-

terly, 20, 181–215.

McVey, G. L., & Davis, R. (2002). A program to promote positive body

image: A 1-year follow-up evaluation. Journal of Early Adolescence, 22,

97–109.

Mendelson, B. K., & White, D. R. (1985). Development of self-body-esteem

in overweight youngsters. Developmental Psychology, 21, 90 –96.

Miller, L. C., Murphy, R., & Buss, A. H. (1981). Consciousness of body:

Private and public. Journal of Personality and Social Psychology, 41,

397– 406.

*Mills, J., Polivy, J., Herman, C. P., & Tiggemann, M. (2002). Effects of

exposure to thin media images: Evidence of self-enhancement among re-

strained eaters. Personality and Social Psychology Bulletin, 28, 1687–1699.

Mizes, J. S. (1990). Criterion-related validity of the Anorectic Cognitions

Questionnaire. Addictive Behaviors, 15, 153–163.

*Monro, F., & Huon, G. (2005). Media-portrayed idealized images, body

shame, and appearance anxiety. International Journal of Eating Disor-

ders, 38, 85–90.

Monteath, S. A., & McCabe, M. P. (1997). The influence of societal

factors on the female body image. Journal of Social Psychology, 137,

708 –727.

Morris, A., Cooper, T., & Cooper, P. J. (1989). The changing shape of

female fashion models. International Journal of Eating Disorders, 8,

593–596.

*Morry, M. M., & Staska, S. L. (2001). Magazine exposure: Internaliza-

tion, self-objectification, eating attitudes, and body satisfaction in male

and female university students. Canadian Journal of Behavioural Sci-

ence, 33, 269 –279.

Myers, P. N., & Biocca, F. A. (1992). The elastic body image: The effect

of television advertising and programming on body image distortions in

young women. Journal of Communication, 42, 108 –133.

Neumark-Sztianer, D., Paxton, S., Hannan, P., Haines, J., & Story, M.

(2006). Does body satisfaction matter? Five-year longitudinal asso-

ciations between body satisfaction and health behaviors in adolescent

females and males. Journal of Adolescent Health, 39, 244 –251.

Neumark-Sztianer, D., Wall, M., Haines, J., Story, M., & Eisenberg, M.

(2007). Why does dieting predict weight gain in adolescents? Findings

from Project EAT-II: A 5-year longitudinal study. Journal of the Amer-

ican Dietetic Association, 107, 448 – 455.

Noll, S. M., & Fredrickson, B. L. (1998). A mediational model linking

self-objectification, body shame, and disordered eating. Psychology of

Women Quarterly, 22, 623– 636.

*Ogden, J., & Mundray, K. (1996). The effect of the media on body

satisfaction: The role of gender and size. European Eating Disorders

Review, 4, 171–182.

*Park, S.-Y. (2005). The influence of presumed media influence on wom-

en’s desire to be thin. Communication Research, 32, 594 – 614.

Paxton, S., Neumark-Sztianer, D., & Hannan, P. (2006). Body dissatisfac-

tion prospectively predicts depressive mood and low self-esteem in

adolescent girls and boys. Journal of Clinical Child and Adolescent

Psychology, 35, 539 –549.

*Posavac, H., Posavac, S., & Posavac, E. (1998). Exposure to media

images of female attractiveness and concern with body weight among

young women. Sex Roles, 38, 187–201.

Posavac, H. D., Posavac, S. S., & Weigel, R. G. (2001). Reducing the

impact of media images on women at risk for body image disturbance:

Three targeted interventions. Journal of Social and Clinical Psychology,

20, 324 –340.

Reed, D. L., Thompson, J. K., Brannick, M. T., & Sacco, W. P. (1991).

Development and validation of the Physical Appearance State and

Trait Anxiety Scale (PASTAS). Journal of Anxiety Disorders, 5,

323–332.

*Richins, M. L. (1991). Social comparison and the idealized images of

advertising. Journal of Consumer Research, 18, 71– 83.

*Roberson, S. C. (2001). The effects of media on body esteem of female and

male viewers. Unpublished doctoral dissertation, University of

Missouri–Columbia.

*Rocchio, L. M. (1996). The pursuit of beauty through thinness and the

impact of advertising on college women’s attitudes. Unpublished doc-

toral dissertation, University of Rhode Island.

Rosenthal, R. (1979). The “file drawer problem” and tolerance for null

results. Psychological Bulletin, 86, 638 – 641.

475MEDIA AND BODY IMAGE

*Sands, E. R., & Wardle, J. (2003). Internalization of ideal body shapes in

9 –12-year-old girls. International Journal of Eating Disorders, 33,

193–204.

*Schooler, D., Ward, L. M., Merriwether, A., & Caruthers, A. (2004). Who’s

that girl?: Television’s role in the body image development of young White

and Black women. Psychology of Women Quarterly, 28, 38 – 47.

*Shaw, J. (1995). Effects of fashion magazines on body disorders and

eating psychopathology in adolescent and adult females. European Eat-

ing Disorders Review, 3, 15–23.

Silverstein, B., Perdue, L., Peterson, B., & Kelly, E. (1986). The role of the

mass media in promoting a thin standard of bodily attractiveness for

women. Sex Roles, 14, 519 –532.

Slade, P. D., Dewey, M. E., Newton, T., Brodie, D., & Kiemle, G. (1990).

Development and preliminary validation of the Body Satisfaction Scale

(BSS). Psychology and Health, 4, 213–220.

Smith, M. C., & Thelen, M. H. (1984). Development and validation of a

test for bulimia. Journal of Consulting and Clinical Psychology, 52,

862– 872.

Spitzer, B., Henderson, K. A., & Zivian, M. T. (1999). Gender differences

in population versus media body sizes: A comparison over four decades.

Sex Roles, 40, 545–565.

Stein, D. M. (1991). The Anorexia Bulimia Inventory: Assessing primary

and comorbid problems in eating disorders. Unpublished manuscript.

*Stice, E., Schupak-Neuberg, E., Shaw, H., & Stein, R. (1994). Relation of

media exposure to eating disorder symptomatology: An examination of

mediating mechanisms. Journal of Abnormal Psychology, 103, 836 – 840.

*Stice, E., & Shaw, H. E. (1994). Adverse effects of the media portrayed

thin-ideal on women and linkages to bulimic symptomatology. Journal

of Social and Clinical Psychology, 13, 288 –308.

Stice, E., & Shaw, H. E. (2002). Role of body dissatisfaction in the onset

and maintenance of eating pathology: A synthesis of research findings.

Journal of Psychosomatic Research, 53, 961–962.

*Stice, E., Spangler, D., & Agras, W. S. (2001). Exposure to media

portrayed thin-ideal images adversely affects vulnerable girls: A longi-

tudinal experiment. Journal of Social and Clinical Psychology, 20,

270 –288.

Stice, E., Telch, C. F., & Rizvi, S. L. (2000). Development and validation

of the Eating Disorder Diagnostic Scale: A brief self-report measure for

anorexia, bulimia, and binge eating disorder. Psychological Assessment,

12, 123–131.

*Strahan, E. J. (2003). Selling thinness: How media images increase

importance of weight and beauty as a basis of women’s self-esteem and

decrease their body satisfaction and eating. Unpublished doctoral dis-

sertation, University of Waterloo, Waterloo, Ontario, Canada.

*Strauss, J., Doyle, A. E., & Kreipe, R. E. (1994). The paradoxical effect

of diet commercials on reinhibition of dietary restraint. Journal of

Abnormal Psychology, 103, 441– 444.

Striegel-Moore, R., & Bulik, C. (2007). Risk factors for eating disorders.

American Psychologist, 62, 181–198.

Stunkard, A. J., Sorenson, T., & Schlusinger, F. (1983). Use of the Danish

adoption register for the study of obesity and thinness. In S. Kety, L. P.

Rowland, R. L. Sidman, & S. W. Matthaysse (Eds.), The genetics of

neurological and psychiatric disorders (pp. 115–120). New York:

Raven Press.

Tan, A. S. (1979). TV beauty ads and role expectations of adolescent

female viewers. Journalism Quarterly, 56, 283–288.

Thompson, J. K., & van den Berg, P. (2002). Measuring body image

attitudes among adolescents and adults. In T. F. Cash & T. Pruzinsky

(Eds.), Body image: A handbook of theory, research, and clinical prac-

tice (pp. 142–154). New York: Guilford Press.

*Thomsen, S. R. (2002). Health and beauty magazine reading and body

shape concerns among a group of college women. Journalism and Mass

Communication Quarterly, 79, 988 –1007.

*Thomsen, S. R., McCoy, J. K., Gustafson, R. L., & Williams, M. (2002).

Motivations for reading beauty and fashion magazines and anorexic risk

in college-age women. Media Psychology, 4, 113–135.

*Thomsen, S. R., Weber, M. M., & Brown, L. B. (2002). The relationship

between reading beauty and fashion magazines and the use of pathogenic

dieting methods among adolescent females. Adolescence, 37, 1–18.

*Thornton, B., & Maurice, J. (1997). Physique contrast effect: Adverse

impact of idealized body images for women. Sex Roles, 37, 433– 439.

*Tiggemann, M. (2003). Media exposure, body dissatisfaction and disor-

dered eating: Television and magazines are not the same! European

Eating Disorders Review, 11, 418 – 430.

*Tiggemann, M. (2005). Television and adolescent body image: The role

of program content and viewing motivation. Journal of Social and

Clinical Psychology, 24, 361–381.

*Tiggemann, M. (2006). The role of media exposure in adolescent girls’

body dissatisfaction and drive for thinness: Prospective results. Journal

of Social and Clinical Psychology, 25, 523–541.

*Tiggemann, M., & McGill, B. (2004). The role of social comparison in

the effect of magazine advertisements on women’s mood and body

dissatisfaction. Journal of Social and Clinical Psychology, 23, 23– 44.

*Tiggemann, M., & Pickering, A. S. (1996). Role of television in adoles-

cent women’s body dissatisfaction and drive for thinness. International

Journal of Eating Disorders, 20, 199 –203.

*Tiggemann, M., & Slater, A. (2003). Thin ideals in music television: A

source of social comparison and body dissatisfaction. International

Journal of Eating Disorders, 35, 48 –58.

*Turner, S., Hamilton, H., Jacobs, M., Angood, L. M., & Dwyer, D. H. (1997).

The influence of fashion magazines on the body image satisfaction of

college women: An exploratory analysis. Adolescence, 32, 603– 614.

*Van den Bulck, J. (2000). Is television bad for your health? Behavior and

body image of the adolescent “couch potato.” Journal of Youth and

Adolescence, 29, 273–288.

Van Strien, T., Frijters, J. E. R., Bergers, G. P. A., & Defares, P. B. (1986).

The Dutch Eating Behavior Questionnaire (DEBQ) for assessment of

restrained, emotional, and external eating behavior. International Jour-

nal of Eating Disorders, 5, 295–315.

Vartanian, L. R., Giant, C. L., & Passino, R. M. (2001). “Ally McBeal vs.

Arnold Schwarzenegger”: Comparing mass media, interpersonal feed-

back, and gender as predictors of satisfaction with body thinness and

muscularity. Social Behavior and Personality, 29, 711–723.

Waller, G., Hamilton, K., & Shaw, J. (1992). Media influences on body

size estimation in eating disordered and comparison subjects. British

Review of Bulimia & Anorexia Nervosa, 6, 81– 87.

Ward, L. M., & Harrison, K. (2005). The impact of media use on girls’

beliefs about gender roles, their bodies, and sexual relationships: A

research synthesis. In E. Cole & J. H. Daniels (Eds.), Featuring females:

Feminist analyses of media (pp. 3–23). Washington, DC: American

Psychological Association.

*Wegner, B. S., Hartmann, A. M., & Geist, C. R. (2000). Effect of

exposure to photographs of thin models on self-consciousness in female

college students. Psychological Reports, 86, 1149 –1154.

*Wilcox, K., & Laird, J. D. (2000). The impact of media images of

super-slender women on women’s self-esteem: Identification, social

comparison, and self-perception. Journal of Research in Personality, 34,

278 –286.

Wiseman, C., Gray, J., Moismann, J., & Ahrens, A. (1992). Cultural

expectations of thinness in women: An update. International Journal of

Eating Disorders, 11, 85– 89.

*Yamamiya, Y., Cash, T. F., & Melnyk, S. E. (2005). Women’s exposure to

thin-and-beautiful media images: Body image effects of media-ideal inter-

nalization and impact-reduction interventions. Body Image, 2, 74 – 80.

Received July 13, 2006

Revision received December 13, 2007

Accepted January 15, 2008 �

476 GRABE, WARD, AND HYDE