Body Appreciation in Light of Psychological, Health- and Weight-Related Variables Among Female Adolescents

In the context of the prevalence of overweight and obesity among children and adolescents having increased over recent decades (NCD Risk Factor Collaboration, 2017), Whitehead et al. (2018) have reported that the fear of weight gain is most prevalent among women aged between 16 and 25. Such weight concerns are associated within a complex web of factors such as body mass index (BMI), negative body image, body dissatisfaction, negative self-concept, and potentially, the development of eating disorders (O’Dea & Dibley, 2014; Whitehead et al., 2018). Therefore, it is important for researchers to focus on developing an understanding of factors relevant to these constructs, particularly among adolescent girls and emerging adult females.

To do this, many studies have focused on the risk factors, correlates and possible consequences of body dissatisfaction and negative body image. For example, body weight perception and lower body satisfaction have been found to predict dieting, unhealthy weight control behaviors and binge eating, and lower levels of physical activity among girls (Kennedy, Schneiderman, & Ramseyer Winter, 2019; Neumark-Sztainer et al., 2006). Negative body image and body dissatisfaction may also play a role in binge drinking and smoking among adolescent girls (Jones, Ramseyer Winter, Pekarek, & Walters, 2018). Further, body image may also contribute to adolescents’ own health, with body dissatisfaction being associated with a higher risk of developing undesirable health-related outcomes (Meland, Haugland, & Breidablik, 2006), including poorer physical competence and increased anxiety level (Dolenc, 2019).

While numerous studies have investigated body dissatisfaction and negative body image, recently, researchers have begun to focus on positive body image. An important element of positive body image is body appreciation, that is, favorable opinions of the body regardless of its actual weight or size, or real or perceived imperfections. Positive body image is more than simply the absence of the elements of negative body image (Dignard & Jarry, 2019) in that it also encompasses a willingness to actively take care of the body’s needs (Tylka & Wood-Barcalow, 2015). Consistent with the proposition that it is not enough to simply remove negative attitudes toward the body, there is also a need to replace them with positive attitudes that may lead to healthy body image (Smolak & Cash, 2011). Thus, some current studies have focused on protective or resilience factors that might assist individuals to resist the strong sociocultural pressures that negatively influence body image and instead, help develop positive body identity (Snapp, Hensley-Choate, & Ryu, 2012). Therefore, in health promotion strategies to facilitate this process we need to strengthen certain skills and attitudes, such as self-esteem, optimism and a positive approach to life (Choate, 2007).

In qualitative studies, body appreciation has been found to be closely related to self-esteem, optimism and life satisfaction (Frisén & Holmqvist, 2010; Wood-Barcalow, Tylka, & Augustus-Horvath, 2010). In quantitative studies with adults, body appreciation has also been found to be positively correlated with self-esteem and positive affect and negatively correlated with negative psychological indicators, such as guilt or shame (Razmus & Razmus, 2017). Several quantitative studies have also found body appreciation to be positively associated with satisfaction with life among youth (Alcaraz-Ibáñez, Cren Chiminazzo, Sicilia, & Teixeira Fernandez, 2017).

Not surprisingly, many of these studies have focused on female populations. In a study of female university students, body appreciation was positively associated with appearance satisfaction, self-esteem and optimism, and negatively associated with BMI (Alleva, Martijn, Veldhuis, & Tylka, 2016). Among college women, it was positively correlated with enjoyment-based physical activity (Homan & Tylka, 2014), health consciousness and health behavior, such as not smoking in a sample of medical students (Dumitrescu, Zetu, Teslaru, Dogaru, & Dogaru, 2008). In a longitudinal study, body appreciation predicted a decrease in dieting, alcohol, and cigarette use, and an increase in physical activity 1 year later (Andrew, Tiggemann, & Clark, 2016).

In addition to psychological and behavioral correlates of youth’s body appreciation and body image, Webb, Rogers, Etzel, and Padro (2018) have found family eating habits and attitudes towards overweight to be important correlates for females. In their study with undergraduate females, family fat talk (e.g., a self-critical talk about being fat) predicted mindful eating via body appreciation. Indeed, disordered eating is often based on intergeneration transmission of attitudes and habits, for example, through learning about appearance standards. In reporting their study of 242 daughter–mother–grandmother triads, Arroyo, Segrin, and Anderson (2017) suggested that direct and indirect maternal communication might facilitate disordered eating, such as dieting or bulimia. Another study found that overweight mothers’ daughters are also more likely to be overweight (Sonneville et al., 2012). However, we know little about how obesity or eating disorders may be associated with adolescents’ body appreciation.

Method

Results

Discussion

Although body image receives considerable attention in literature, to date more studies have focused on negative body image than on positive aspects, such as body appreciation (Voelker et al., 2015). This is particularly critical in female adolescents for whom developing positive attitudes towards their body can prevent eating disorders and distorted body image later. In health promotion programs, developing and supporting a positive body image can be a key focus. Therefore, in this paper we concentrated on psychological, weight- and health-related contributors to body appreciation in a sample of Hungarian female adolescents. Some of these variables may serve as protective factors, while others may elevate the risk of lower levels of body appreciation.

Our findings support previous suggestions that body appreciation is closely connected to self-esteem: having a higher level of self-esteem may contribute to a positive approach to our body and vice versa (Alleva et al., 2016; Frisén & Holmqvist, 2010; Wood-Barcalow, Tylka, & Augustus-Horvath, 2010). Previous studies also reported a close association between these two variables (Alleva et al., 2016; Razmus & Razmus, 2017). The other two psychological variables played lesser roles in body appreciation than we had expected: satisfaction with life was positively but relatively weakly related, and optimism even less so. Previous studies reported stronger connections with these variables (Alcaraz-Ibáñez et al., 2017; Frisén & Holmqvist, 2010; Wood-Barcalow et al., 2010). While bidirectional associations between body appreciation and these two variables were relatively stronger, in multiple regression analyses their role became weaker. This is likely because self-esteem, as the dominant variable supressed their role in body appreciation. Future research is needed to further clarify these associations and to identify other psychological variables that may contribute to body appreciation among adolescent girls.

Our results also confirmed that body appreciation is closely related to subjective evaluations of health (Meland, Haugland, & Breidablik, 2006). Those participants who perceived their own health to be good or excellent also displayed higher level of body appreciation. Health behavior also played a role, particularly sporting engagement: those who were engaged in sports reported better body appreciation. This is in concordance with previous research findings (e.g., Homan & Tylka, 2014). However, while previous studies also found a relationship between smoking, drinking and body appreciation (Dumitrescu et al., 2008; Jones et al., 2018; Kennedy et al., 2019; Neumark-Sztainer et al., 2006), we found only a slight negative association with binge drinking, with those who engaged in binge drinking tending to be less appreciative of their own body. Although cause-and-effect relationships cannot be identified here, we may hypothesize that those who do not appreciate their own body do not take care of it in an appropriate way. The difference between smoking and binge drinking may be both practical and cultural: While negative impacts of binge drinking can be directly experienced by adolescents, smoking can contribute to longer term health consequences. In addition, female smoking is much more accepted in Hungary than female binge drinking. Another finding also supports interpretation of self care in relation to body image: those who reported higher levels of body appreciation also tended to take care of their diet. This is consonant with other findings (Neumark-Sztainer et al., 2006).

Finally, the role of family has also been implicated in the development of either positive or negative attitudes towards our body (Arroyo et al., 2017; Sonneville et al., 2012; Webb et al., 2018). Our results emphasized the role of eating disorders in the family; the presence of such problems may lead to lower body appreciation among female adolescents. The bivariate relationships suggest that those who reported eating disorders in the family also scored lower on the life satisfaction, self-esteem and optimism scales, and also tended to slim themselves. More research is necessary to gain deeper insight into these associations. In addition, there was a slight but negative correlation between body appreciation and overweight in the family; however, in multivariate analyses it became nonsignificant.

As mentioned above, due to the cross-sectional nature of our research, cause-and-effect relationships cannot be determined from our data. A second limitation is that we relied on self-report for our data. While this is not necessarily a significant issue for the psychological variables, it may have impacted on the reliabilty of our measurement of variables such as BMI, family history of eating problems and engagement in health behaviors. Further, some of the values of correlation and regression coefficients are rather weak. Finally, due to specific cultural context, generalizability of our study may be limited.

There are several contributions of our study to the current literature. Most importantly, confirming the strong association between self-esteem and female adolescents’ body appreciation, our study indicates a need for future research to explore other psychological variables that might also be related to positive body image. In addition, our results also draw the attention to the potential role of family factors (e.g., overweight and eating disorder in the family) in the development of adolescents’ body image. Although qualitative studies can more deeply explore the mechanisms underpinning these associations, our data provide evidence of them. Third, our results also emphasize that sporting and binge drinking may play opposite roles in forming body appreciation among girls.

Furthermore, an important strength of our paper is that our findings highlight the difference in associations of various types of substance use with body image, in that while binge drinking is associated, smoking is not, perhaps due to its social acceptance and its delayed health consequences. Finally, we believe that using a sample of Hungarian adolescents is also a strength since to our best knowledge, body appreciation has not yet been explored in this culture.