Meta-Analytic Examination of Studies of the Correlation Between Negative Body Image, Disordered Eating, and Extent of Exposure to Mass Media Michael P. Levine and Sarah K. Murnen (Kenyon College) Jennifer Smith (Klein Associates) Lisa M. Groesz (University of Texas) Paper presented at the International Conference on Eating Disorders, Barcelona, Spain, June 9, 2006

Fundamental Question: Does more extensive use of – and thus exposure to – media, such as fashion magazines and television, cultivate and reinforce internalization of cultural beauty ideals body image dissatisfaction weight control behaviors, and disordered eating?

Does more extensive use of – and thus exposure to – media, such as fashion magazines and television, cultivate and reinforce

internalization of cultural beauty

ideals

body image dissatisfaction

weight control behaviors, and

disordered eating?

Secondary Questions: Do different types of media (e.g., magazines vs. television) yield different effects? Do media affect various outcomes differently? Is there a gender difference in effect sizes?

Do different types of media (e.g., magazines vs. television) yield different effects?

Do media affect various outcomes differently?

Is there a gender difference in effect sizes?

Method Published and unpublished studies that related media exposure in a naturalistic setting to scores on measures related to body dissatisfaction and eating problems Effect size = Fisher r ( z test for statistical significance) 23 ([3 X 4 X 2] - 1) different data sets were compiled: Three Categories of Media = 1. Combined media 2. Television exposure 3. Magazine exposure Four Categories of Dependent Measures = 1. Internalization 2. Body Image 3. Weight Control 4. Eating Disorder Symptoms Females vs. Males ( note there were insufficient data for TV exposure and internalization among males )

Published and unpublished studies that related media exposure in a naturalistic setting to scores on measures related to body dissatisfaction and eating problems

Effect size = Fisher r ( z test for statistical significance)

23 ([3 X 4 X 2] - 1) different data sets were compiled:

Three Categories of Media = 1. Combined media 2. Television exposure 3. Magazine exposure

Four Categories of Dependent Measures = 1. Internalization

2. Body Image 3. Weight Control 4. Eating Disorder Symptoms

Females vs. Males ( note there were insufficient data for TV exposure

and internalization among males )

Method (continued) 47 studies were used in the analyses, which yielded 298 effect sizes with data from 20,550 individuals (14,956 females, and 5,594 males) Many samples contributed data for more than one effect size, so the total number of data points across the samples was 104,482 (80,482 from females, 24,000 from males) The smallest data set, correlating TV exposure and internalization, contained three effect sizes ( k = 3) from 1,093 males. One of the larger data sets, examining the association between combined media exposure and body image dissatisfaction, contained 33 effect sizes ( k = 33) from 9,227 females.

47 studies were used in the analyses, which yielded 298 effect sizes with data from 20,550 individuals (14,956 females, and 5,594 males)

Many samples contributed data for more than one effect size, so the total number of data points across the samples was 104,482 (80,482 from females, 24,000 from males)

The smallest data set, correlating TV exposure and internalization, contained three effect sizes ( k = 3) from 1,093 males.

One of the larger data sets, examining the association between combined media exposure and body image dissatisfaction, contained 33 effect sizes ( k = 33) from 9,227 females.

Method (continued) Homogeneity in r values across studies was examined Within many of the data sets it was possible to examine the extent to which certain study characteristics affected variation in the size of r . The study characteristics examined : Age of the participants: samples younger than 18 compared to samples older than 18 Type of dependent measure (e.g., for internalization of cultural ideal many studies used the SATAQ – those studies were grouped together and compared to studies using other measures to see if there was variation associated with the measure) Whether the sample was from the United States or not The ethnicity of the sample: samples with >80% Caucasian compared to samples that were <80% Caucasian

Homogeneity in r values across studies was examined

Within many of the data sets it was possible to examine the extent to which certain study characteristics affected variation in the size of r . The study characteristics examined :

Age of the participants: samples younger than 18 compared to samples older than 18

Type of dependent measure (e.g., for internalization of cultural ideal many studies used the SATAQ – those studies were grouped together and compared to studies using other measures to see if there was variation associated with the measure)

Whether the sample was from the United States or not

The ethnicity of the sample: samples with >80% Caucasian compared to samples that were <80% Caucasian

Results In the data sets for females ( n = 12), all effect sizes were statistically significant; in most data sets the effects were heterogeneous In the data sets for males ( n = 11), 7 ( ~ ¾) of the effect sizes were significant, and in four data sets they were heterogeneous Generally, effects were stronger for females (range of r = = .07 to .21) than males (range of r = .03 to .13) For females, effects were strongest for fashion magazines, and the largest effect is fashion magazines and internalization of the slender beauty ideal

In the data sets for females ( n = 12), all effect sizes were statistically significant; in most data sets the effects were heterogeneous

In the data sets for males ( n = 11), 7 ( ~ ¾) of the effect sizes were significant, and in four data sets they were heterogeneous

Generally, effects were stronger for females (range of r =

= .07 to .21) than males (range of r = .03 to .13)

For females, effects were strongest for fashion magazines, and the largest effect is fashion magazines and internalization of the slender beauty ideal

Data for Females INTERN = internalization slender ideal BODIMG = body image WTCON = weight control DISEAT = disordered eating

Data for Males INTERN = internalization slender ideal BODIMG = body image WTCON = weight control DISEAT = disordered eating

Combined Media: Females vs. Males INTERN = internalization slender ideal BODIMG = body image WTCON = weight control DISEAT = disordered eating Significant gender differences, two-tailed *p<.05 **p<.01 ***p<.001

TV Exposure: Females vs. Males INTERN = internalization slender ideal BODIMG = body image WTCON = weight control DISEAT = disordered eating

Magazine Exposure: Females vs. Males INTERN = internalization slender ideal BODIMG = body image WTCON = weight control DISEAT = disordered eating Significant gender differences, two-tailed *p<.05 **p<.01 ***p<.001

Highlights of Heterogeneity Analyses Females : Age affected variation in r in 5 data sets but not in a consistent direction (media seemed to lead to greater r’ s for internalization among younger girls; greater associations with weight control among older girls) Measure used significantly affected variation in r in 7 of the 12 data sets In 4 of the 12 data sets the r values from the U.S. samples were significantly higher than those from non-U.S. samples In 6 of the 12 data sets the r values for the predominantly Caucasian group were the highest Males: Data sets were not sufficiently large to reach any generalizations about patterns of variation related to these variables

Females :

Age affected variation in r in 5 data sets but not in a consistent direction (media seemed to lead to greater r’ s for internalization among younger girls; greater associations with weight control among older girls)

Measure used significantly affected variation in r in 7 of the 12 data sets

In 4 of the 12 data sets the r values from the U.S. samples were significantly higher than those from non-U.S. samples

In 6 of the 12 data sets the r values for the predominantly Caucasian group were the highest

Males: Data sets were not sufficiently large to reach any generalizations about patterns of variation related to these variables

Conclusions & Discussion In general, the data are consistent with sociocultural models that point to the media as a source of information and reinforcement for the components of negative body image and disordered eating. theories suggesting that greater use of and involvement with fashion and style magazines and with TV is associated with greater levels of the components of disordered eating Effect sizes (small to moderate) are comparable with those in cross-sectional and longitudinal studies of sociocultural factors as predictors (see Cafri et al., 2005; Stice, 2002). Converting data for females the concerning magazine exposure and “trait” body image in this study, r = .13, d = .26 compared to the effect size from a meta-analysis of experimental research relating exposure to slender media and “state” body image, r = .15, d = .31

In general, the data are consistent with

sociocultural models that point to the media as a source of information and reinforcement for the components of negative body image and disordered eating.

theories suggesting that greater use of and involvement with fashion and style magazines and with TV is associated with greater levels of the components of disordered eating

Effect sizes (small to moderate) are comparable with those in cross-sectional and longitudinal studies of sociocultural factors as predictors (see Cafri et al., 2005; Stice, 2002).

Converting data for females the concerning magazine exposure and “trait” body image in this study, r = .13, d = .26

compared to the effect size from a meta-analysis of experimental research relating exposure to slender media and “state” body image, r = .15, d = .31

Conclusions & Discussion With respect to gender Females may be more influenced by (and involved with) fashion magazines Males may be more influenced by TV than magazines (although) Females and males at high risk for eating disorders may both be particularly susceptible to media messages Much remains to be known and done in terms of research Data are all correlational, so we can’t determine causation; not enough longitudinal data Types of media Can’t distinguish well between effects of particular types of media (e.g., magazines that emphasize a slender ideal vs. those that emphasize fitness) Relatively unstudied types (e.g., video games, the internet, pornography) Other important variables Mediators (e.g., social comparison; appearance schema) Moderators, especially age, ethnicity, culture/ethnicity

With respect to gender

Females may be more influenced by (and involved with) fashion magazines

Males may be more influenced by TV than magazines (although)

Females and males at high risk for eating disorders may both be particularly susceptible to media messages

Much remains to be known and done in terms of research

Data are all correlational, so we can’t determine causation; not enough longitudinal data

Types of media

Can’t distinguish well between effects of particular types of media (e.g., magazines that emphasize a slender ideal vs. those that emphasize fitness)

Relatively unstudied types (e.g., video games, the internet, pornography)

Other important variables

Mediators (e.g., social comparison; appearance schema)

Moderators, especially age, ethnicity, culture/ethnicity