This document discusses two hypotheses regarding factors that influence students' satisfaction with their appearance. The first hypothesis is that students who feel low are more likely to feel dissatisfied with their body appearance due to media influences. The second hypothesis is that the higher a student's BMI, the less likely they are to be satisfied with their appearance due to dissatisfaction with weight. Previous literature is reviewed that supports these hypotheses, showing links between feeling low and lower body satisfaction, and between higher BMI and lower body satisfaction. The document then outlines the plan to test these hypotheses using data from the Health Behavior in School-Aged Children study.

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Research Methods Final Paper
Manjyot Kaur, Nicholas Addo, Millie Savaille
775:395:03

2. 2
INTRODUCTION
As their bodies change during puberty, adolescent boys and girls tend to have a difficult
time transitioning. They may feel discomfort and uncertainty with the changes their bodies are
undergoing, and often feel dissatisfied with their appearance as a result. This sense of
dissatisfaction may be attributed to an individual’s body mass index (BMI) classification as well
as their exposure to idealized media images. Not only can an individual's body mass index reflect
and affect their physical health, but their exposure to idealized media images can also impact
their mental health since "the mass media, which include magazines and television, are often
regarded as the single strongest influencing factor on adolescent body image" (Hargreaves &
Tiggemann, 2004).
When adolescents are exposed to unrealistic appearance ideals, they tend to express
higher levels of body dissatisfaction because they are unable to match these beauty standards. In
a study conducted by Hargeaves and Tiggemann to better understand the relationship between
body dissatisfaction, appearance comparison, and idealized media images, it was discovered that
those who were exposed to thin-ideal/muscular-ideal commercials "produced more body
dissatisfaction" than those who viewed non-appearance commercials and "girls viewing thin-
ideal commercials had significantly greater body dissatisfaction than those viewing the non-
appearance commercials" and displayed a greater tendency to compare their appearance to others
(Hargeaves & Tiggemann, 2004). Not only did they have greater body dissatisfaction, but both
girls and boys in the experimental condition also "reported significantly greater negative mood"
(Hargeaves & Tiggemann, 2004). These negative effects may lead to hazardous behaviors such
as eating disorders or unhealthy weight-control behaviors such as excessive exercise, which is
why this is an important issue to understand and address, especially since these negative effects
are stronger in studies where the participants are less than 19 years old. In the case of this
particular study being conducted, girls in 10th grade were more likely to exhibit negative effects
such as anxiety than those in 7th grade (Durkin & Paxton, 2002). According to McCabe and
Ricciardelli’s study (2001), those in higher grades (8, 9, 10) display lower levels of body
satisfaction.
To further illustrate, Durkin and Paxton discuss how "initially poor body image may
predispose a woman to decreased body satisfaction following exposure to idealized female
images" (Durkin & Paxton, 2002). This serves to support our hypothesis that those who feel low
are more likely to feel dissatisfied with their body appearance when exposed to media influences,
since they are more vulnerable to make appearance comparisons and be negatively impacted by
these idealized media images. It should be noted that while feelings of depression and
vulnerability lead to low body satisfaction, low body satisfaction can also contribute to feelings
of depression amongst other changes in mood and psychological well-being. “Depressed girls of
this age may feel threatened by images of any kind which confront them with challenges of a
glamorous world they may not feel they can be part of” (Durkin & Paxton, 2002). In other
words, for those who already have a negative body image and feel low about their body,
idealized media images can only heighten one’s realization that they’ve failed to meet ideal
beauty standards. “Depression may [also] increase the risk of weight gain and obesity in youth,
making depression a potential risk factor for obesity,” which would consequently contribute to
body dissatisfaction (Goldfield et al, 2010). On the other hand, those who feel insecure and “lack
a sense of self” may rely on these culturally defined ideals as well.

3. 3
Although media influences may impact one’s satisfaction with their appearance, their
body mass index classification also plays a role. In a study conducted to understand the link
between body dissatisfaction, dietary restraint, depression, and weight status in adolescents, a
link between higher levels of BMI and higher levels of body dissatisfaction was found. “Obese
youth reported higher body dissatisfaction than overweight youth, who reported more body
dissatisfaction than normal weight youth” (Goldfield et al., 2010). Not only were levels of body
dissatisfaction higher among those who were obese but so were scores of depression.
In another study examining the association between body mass index, body
dissatisfaction, and weight and shape concern in adolescent boys and girls, a similar association
was found between BMI and body dissatisfaction. In this particular study, it was displayed that
“each unit increase in BMI percentile was associated with greater likelihood of reporting body
dissatisfaction and greater levels of weight and shape concern” (Calzo et al., 2010). “Girls above
the 50th BMI percentile reported greater body dissatisfaction than girls below the 50th
percentile; by contrast, boys who reported the most body dissatisfaction were either above the
75th BMI percentile (approaching overweight) or below the 10th percentile (approaching
underweight)” (Calzo et al., 2012). Since girls generally aim for the thin-ideal and boys aim for
the muscular-ideal, this makes sense as girls are more interested in looking thin and weighing
less whereas boys are interested in looking muscular and being lean. The association between
BMI and body dissatisfaction was also supported by a study conducted by McCabe and
Ricciardelli (2001) where “respondents from the highest BMI group show[ed] less satisfaction
than those in the normal group, who, in turn, show[ed] less satisfaction than those in the
underweight group.”
Through this paper, we aim to analyze the relationship between feeling low and body
dissatisfaction as well as BMI and body dissatisfaction, since low body satisfaction can
negatively impact one’s physical and mental well-being. While literature supports our
hypotheses and displays an obvious link, we will determine whether those findings can be
generalized to the population being studied in the Health Behavior in School-Aged Children
(HBSC) data set and if our findings match theory. This paper is designed to provide an
understanding of the factors that impact a student’s feelings about their body, particularly their
satisfaction with their appearance.
HYPOTHESES
Our research question seeks to examine the factors that influence one’s feelings about
their body, specifically their satisfaction with their appearance. Listed below are the hypotheses
and null hypotheses used to do so.
Hypothesis 1: Students who feel low are more likely to feel dissatisfied with their body
appearance due to media influences.
Null 1: Feeling low and dissatisfaction with body appearance are independent of each
other.
Hypothesis 2: The higher a student’s BMI, the less likely they are to be satisfied with
their appearance due to dissatisfaction with weight.
Null 2: BMI and satisfaction with appearance are independent of each other.

4. 4
This paper seeks to examine the relationship between BMI and feeling low in terms of
their effect on one’s feelings about their body, specifically their satisfaction with their
appearance. In this paper, satisfaction with appearance is defined as how positively individuals
view their bodies or how content they are with their appearance. Our research hypothesis states
that students who feel low are more likely to feel dissatisfied with their body appearance due to
media influence. We defined feeling low as being vulnerable, having low self-esteem, or being
depressed. Those who are feeling low are more likely to make appearance comparisons and face
the negative impacts of idealized media images, and are likely to be dissatisfied with their bodies
as a result. We also proposed that the higher a student’s BMI, the less likely they are to be
satisfied with their appearance due to dissatisfaction with weight.
METHODOLOGY
Methods
The Health Behavior in School-Aged Children (HBSC) research collects data on students
nationwide (Health Behavior In School-Aged Children, 2016). The survey data of this study was
conducted by the CDM Group, Inc., Bethesda, MD and funded by the United States Department
of Health and Human Services (Iannotti, 2013). The HBSC gathers data on adolescents between
the ages of eleven and fifteen on their well-being, social environments and health behaviors
every four years (Health Behavior In School-Aged Children, 2016). An increase of independence
during this age period has an effect on the health as well as the health behaviors of the students
(Health Behavior In School-Aged Children 2016). The primary objectives of the HBSC study are
to monitor health-risk behaviors in youth and develop a health promotion initiative. Secondly, it
aims to help researchers get a better understanding of health attitudes and behaviors and explain
the development of individuals through early adolescence. Thus, the HBSC studies often
encompass areas such as body image, eating behaviors, obesity, and life satisfaction among
others (Health Behavior In School-Aged Children, 2016). These areas help researchers explore
how individuals’ health develops as they transition from adolescence into adulthood.
The study was conducted in the school year of 2009-2010 on individual students in
public, Catholic, and other private schools in the tenth grade (Iannotti, 2013). Subjects of the
study were sampled through three stages: districts, schools, and classes (Iannotti, 2013). About
314 of 475 eligible schools and 90% of 98% of students who had consent participated in the
study (Iannotti, 2013). In order to obtain better representation of the African American and
Hispanic students, the study oversampled these groups (Iannotti, 2013). Data was collected
through administered surveys in a classroom setting. Surveys usually took approximately 45
minutes to complete. Overall, there were 1,898 tenth grade students interviewed for this study
with the objective of monitoring health risk behaviors in students for data and identifying at risk
individuals for health promotion initiatives (Iannotti, 2013). In terms of privacy, the variables
that may identify individuals were recoded or distorted (Iannotti, 2013). The margin of error
(MOE) at a 95 percent confidence level was +/- 2.2 (Iannotti, 2013). Additionally, the threats to
validity in this study were question wording and question order, sampling error, and nonresponse
error. The subsequent tables indicate the weighted and unweighted data. The former is in
percentage and N indicates unweighted data.

5. 5
Data
The following analysis from the HBSC dataset focuses on the relationship between the
variables of feeling low and body mass index (BMI) on body image. The first independent
variable, past 6 months how often had: feeling low (Q42D), is defined in this analysis as feeling
vulnerable, having low self-esteem, or being depressed. The response categories for this variable
include: 1 = About every day, 2 = More than once a week, 3 = About every week, 4 = About
every month, and 5 = Rarely or never. Furthermore, the second independent variable was
recoded from body mass index (BMI) to weight status using BMI and is label as WGHT_STAT.
The values of the original variable were too much to interpret therefore the data was reduced into
four categories. The response categories are 1 = Underweight, 2 = Normal or Healthy Weight, 3
= Overweight, and 4 = Obese. Finally, the dependent variable is feelings about body: satisfied w/
appearance (Q38B), which measures body image in this analysis. The response categories for
this variable consist of: 1 = Strongly disagree, 2 = Disagree, 3 = Neither agree or disagree, 4 =
Agree, and 5 = Strongly agree.
TABLE 1: PAST 6 MONTHS HOW OFTEN HAD: FEELING LOW
Percent N
About every day 8% 135
More than once a week 9% 154
About every week 13% 224
About every month 23% 381
Rarely or never 47% 790
Total 100% 1684
When the students were asked how often had they felt low in the past three months, eight percent
responded about every day as compared to 9% who responded more than once a week, 13%
reported about every week, approximately one quarter (23%) reported about every month, and
almost half (47%) of the students reported they rarely or never feel low (Table 1).
Table 2: WEIGHT STATUS USING BMI
Percent N
Underweight 12% 211
Normal or Healthy Weight 62% 1068
Overweight 18% 305
Obese 8% 135

6. 6
Total 100% 1719
Among the students who reported their weight status using BMI, 12% reported they were
underweight, 62% reported their weight as being normal or healthy, 18% responded they were
overweight, and only 8% reported that they were obese (Table 2).
Table 3: FEELINGS ABOUT BODY: SATISFIED WITH APPEARANCE
Percent N
Strongly disagree 4% 73
Disagree 14% 237
Neither agree or disagree 23% 387
Agree 38% 641
Strongly agree 21% 351
Total 100% 1689
Of the students surveyed about feelings on their body, 4% reported they strongly disagree on
being satisfied with appearance, 14% reported that they disagreed, about a quarter (23%)
reported neither agree or disagree, the majority (38%) agree on being satisfied with their
appearance, and 21% reported they strongly agree with being satisfied with their
appearance (Table 3).
FINDINGS: BIVARIATE INTERPRETATION
Table 1A shows a crosstab analysis on our first hypothesis. We hypothesized that
students who feel low are more likely to feel dissatisfied with their body appearance due to
media influence. Of the students who reported they disagreed with being satisfied with their
appearance, 33% reported feeling low about every day in comparison to 7% who responded they
rarely or never feel low. On the other side of the spectrum, of the students that agreed with being
satisfied with their appearance, 18% reported feeling low about every day compared to 41% who
reported that they rarely or never feel low. We observed a weak positive relationship between
how often an individual feels low and satisfaction with their appearance (Cramer’s V = 0.188, n
= 1,663). There are also enough observations in each column (n>100) to draw reliable
generalizations to the population. Although we observed a weak relationship between the two
variables, we rejected the null hypothesis that feeling low and satisfaction with body appearance
are independent of each other, chi square (p < 0.001). In addition, we observed a monotonic
relationship across all dependent values of those who disagreed and a curvilinear relationship
with those who agreed. The observed differences across the rows are not larger than the MOE
(+/- 2.4). In sum, our hypothesis does not hold because of the observed weak relationship.

7. 7
Table 1A: Feelings about body by feeling low
FEELINGS ABOUT
BODY: PAST 6 MONTHS HOW OFTEN HAD: FEELING LOW
SATISFIED W/
APPEARANCE
About
every day
More than once
a week
About every
week
About every
month
Rarely or
never
Strongly disagree 12% 8% 3% 3% 3%
Disagree 33% 29% 16% 14% 7%
Neither agree or disagree 23% 29% 32% 25% 18%
Agree 18% 28% 40% 42% 41%
Strongly agree 14% 5% 9% 16% 31%
Total
N
100%
132
100%
153
100%
221
100%
375
100%
782
Cramer’s value = 0.188; p-value <0.001
Table 2A displays the crosstab analysis of our second hypothesis. We hypothesized that
the higher a student’s BMI, the less likely they are to be satisfied with their appearance due to
dissatisfaction with weight. Of the respondents who agreed to being satisfied with their
appearance, a quarter of the students reported they were obese, one-third were overweight, 40%
reported they were normal or healthy weight, and 43% were underweight. In contrast, among the
students who disagreed with being satisfied with their appearance, about a quarter of them were
obese compared to 17% who were overweight, 13% reported they were normal or healthy
weight, and 5% who were underweight. We observed a weak positive relationship between
weight status (using BMI) and satisfaction with appearance (Cramer’s V = 0.145, n = 1,689).
There are enough observations in each column to draw reliable generations to the population. We
rejected the null hypothesis that the variable are independent of each other because of the chi
square (p < 0.001) indicating statistical significance. In the dependent values analyzed, we
observed a monotonic relationship. The observed differences across the rows are not larger than
the MOE (+/- 2.4). In closing, our second hypothesis also does not hold because of the observed
weak relationship.
Table 2A: Feelings about body by weight status using BMI

8. 8
FEELINGS ABOUT BODY: SATISFIED
W/ APPEARANCE
WEIGHT STATUS USING BMI
Underweight
Normal or
Healthy Weight Overweight Obese
Strongly disagree 2% 4% 4% 15%
Disagree 5% 13% 17% 26%
Neither agree or disagree 22% 21% 31% 24%
Agree 43% 40% 33% 25%
Strongly agree 28% 22% 16% 10%
Total
N
100%
209
100%
1047
100%
303
100%‘
130
Cramer’s V value = 0.145; p-value < 0.001
DISCUSSION/CONCLUSION
There are a myriad of factors that influence individuals’ perceptions of themselves.
Satisfaction with body appearance manifests differently across age, gender, weight, and
socioeconomic status. Nonetheless, adolescents share the common struggle of facing some
difficulties with their changing appearance as they transition into adulthood. Therefore, we
thought it was important to explore the relationship between variables that shape feelings about
one’s body. We predicted that individuals with a higher weight status, using the variable BMI,
would be more likely to be dissatisfied with their appearance because they are dissatisfied with
their weight. We also predicted that students who feel low are more likely to feel dissatisfied
with their body appearance due to media influences. Both hypotheses turned out to be
statistically significant (p < 0.001); thus we rejected the nulls. However, we observed a weak
relationship between the variables that manifested in both monotonic and curvilinear patterns.
Our findings held true in the literature but not our analysis and results. Therefore we may not
have chosen the right variables to measure one’s feelings about body/body image.
For some individuals, feeling low has nothing to do with how they satisfied they are with
their appearance. While feeling low and depressed may put you in a vulnerable state and make
you more susceptible to media influence and feelings of body dissatisfaction, it should be noted
that depression is not just a cause for body dissatisfaction but also an effect of body
dissatisfaction; therefore, it may be difficult to accurately measure. Similarly, BMI, which is
calculated using weight and height, may not be the most effective variable to measure body
dissatisfaction either. The reason behind this is because it disregards gender, but also because
there is a possibility of some BMI misclassification occurring, since those with high muscle mass
would be ranked into high BMI percentiles but that does not mean that they are
overweight/unhealthy or experiencing body dissatisfaction. Our research question aimed to
analyze the factors that impact one’s feelings about their body, specifically their satisfaction with

9. 9
their appearance. Our hypothesis proposed that the higher a student’s BMI, the less likely they
are to be satisfied with their appearance due to dissatisfaction with weight. However, this is not
always true and may even be a slightly gender-biased hypothesis. While this hypothesis appears
to hold true for girls, it fails to hold true for boys overall because boys underweight also feel
body dissatisfaction and may have a desire to be muscular and bulky. On the other hand, our
other hypothesis stated that students who feel low are more likely to feel dissatisfied with their
body appearance due to media influences. This, again, does not necessarily hold true for boys.
While exposure to idealized images leads to appearance comparison and negative mood for both
boys and girls, it only leads to body dissatisfaction for girls. This may be due to the fact that
there are more sources of idealized media images pertaining girls than boys, and as a result, girls
are more vulnerable to them. Another possibility is that the measurement of boys’ body image is
difficult to acquire. While some boys may feel comfortable sharing body image issues, others
may not feel comfortable sharing feelings of body/appearance dissatisfaction due to the stigma
surrounding boys and their masculinity.
While theory provides support for our hypotheses, the variables used to measure the
concept are not necessarily the most reliable and valid. Measurement error is definitely present in
this study since the variables feeling low and BMI do not take into account all factors that may
contribute to feelings of body dissatisfaction. For instance, instead of using weight alone, for
BMI, to measure one’s satisfaction with their appearance, it may be more effective to include
shape as it would account for boys and their muscular idealized images as well. There are
definitely limitations to the study that can be addressed by rethinking the variables being used to
ensure that all possible gaps are bridged.

10. 10
REFERENCES
Calzo, J. P., Sonneville, K. R., Haines, J., Blood, E. A., Field, A. E., & Austin, S. B. (2012). The
development of associations among body mass index, body dissatisfaction, and weight
and shape concern in adolescent boys and girls. Journal of Adolescent Health, 51(5), 517-
523.
Durkin, S. J., & Paxton, S. J. (2002). Predictors of vulnerability to reduced body image
satisfaction and psychological wellbeing in response to exposure to idealized female
media images in adolescent girls. Journal of psychosomatic research, 53(5), 995-1005.
Goldfield, G. S., Moore, C., Henderson, K., Buchholz, A., Obeid, N., & Flament, M. F. (2010).
Body dissatisfaction, dietary restraint, depression, and weight status in adolescents.
Journal of School Health, 80(4), 186-192.
Hargreaves, D. A., & Tiggemann, M. (2004). Idealized media images and adolescent body
image:“Comparing” boys and girls. Body image, 1(4), 351-361.
Health Behavior in School-Aged Children. (2016). Retrieved May 02, 2016, from
http://www.hbsc.org/about/index.html
Iannotti, Ronald J. Health Behavior in School-Aged Children (HBSC), 2009-2010. ICPSR34792-
v1. Ann Arbor, MI: Inter-university Consortium for Political and Social Research
[distributor], 2013-11-20.
McCabe, M. P., & Ricciardelli, L. A. (2001). Parent, peer, and media influences on body image
and strategies to both increase and decrease body size among adolescent boys and girls.
Adolescence, 36(142), 225.
AUTHOR CONTRIBUTIONS
All team members contributed to the analysis of data. Manjyot Kaur contributed to the
Introduction and Hypothesis Section. Nicholas Addo and Millie Savaille contributed to the
Methods and Data. Nicholas Addo prepared tables and figures. Manjyot Kaur, Millie Savaille,
and Nicholas Addo contributed to the discussion as well as findings.