Prevalence of body dissatisfaction among a United States adult sample

Highlights

• Prevalence of body dissatisfaction among United States women ranges between 13.4% and 31.8%.

• Prevalence of body dissatisfaction among United States men ranges between 9.0% and 28.4%.

• Overweight and obese adults are at greater risk of body dissatisfaction.

• The prevalence of body dissatisfaction has plateaued or declined over time.

Abstract

Body dissatisfaction (BD) is a primary determinant of eating disorders and has been linked to chronic disease via decreased likelihood of cancer screening self-exams and smoking cessation. Yet, there are few recent estimates of the prevalence of BD among United States adults. Using an internet-based, opt-in, cross-sectional survey, United States adults (N = 1893) completed assessments of demographic variables, body areas satisfaction, appearance evaluation, fitness evaluation, health evaluation, and overweight preoccupation. Results revealed that the range of BD is 13.4%–31.8% among women and 9.0%–28.4% among men. Compared to previous assessments of prevalence (1973, 1986, 1995, 1997), the prevalence of BD among United States adults may have plateaued or declined over time.

Introduction

Body image is defined as a persons body-related self-perceptions and self-attitudes, including thoughts, feelings, and behaviors (Cash, 2003). In some cases, extreme levels of body dissatisfaction (BD) can result in eating disorders (e.g., anorexia nervosa, bulimia nervosa), which have a lifetime prevalence of 2.5% and 0.8% for United States women and men, respectively (Hudson, Hiripi, Pope, & Kessler, 2007). For those who seek treatment, annual treatment costs range from $US 1288 to $US 8042 per person, per year (Stuhldreher et al., 2012). BD is also known to negatively influence behavioral risk factors for chronic disease, which affect an even greater proportion of the US population. For example, breast cancer is the most common cancer among women, with a lifetime prevalence of 12.3% (Howlader et al., 2013). A recent literature review demonstrates that BD is associated with lower likelihood of engaging in breast cancer self-exams (Ridolfi & Crowther, 2013), which could provide early detection of the disease. BD is also associated with lower likelihood of smoking cessation (King et al., 2005), where smoking costs $US 96.8 billion annually in lost productivity and is responsible for almost 30% of cancer deaths (Centers for Disease Control, Prevention, 2008).

With such robust potential to influence health care costs as well as an individual's health and quality of life across the lifespan, it is imperative for behavioral scientists, clinicians, and public health professionals to be informed of the current overall prevalence of BD among the United States population, changes in BD prevalence over time, as well as understand which sub-populations are at risk. Salient to this study are four preceding national surveys assessing body image/BD among United States adults (Berscheid et al., 1973, Cash and Henry, 1995, Cash et al., 1986, Garner, 1997). Since 1972, a series of surveys have documented an increase in dissatisfaction in overall appearance among both men (15% to 43%) and women (23% to 56%). This often-cited research has led many to conclude that there is a ‘normative discontent’ or an ‘epidemic’ of BD in the United States, especially among women (Frederick et al., 2012, Rodin et al., 1984, Tantleff-Dunn et al., 2011). Since Garner (1997), however, very few studies have used national surveys of United States adults, and the few containing national samples, have either not used psychometrically valid measurement tools (Frederick, Peplau, & Lever, 2006), have used single-item measures of body satisfaction (Kruger, Lee, Ainsworth, & Macera, 2008), or have focused on specific United States subgroups (Peplau et al., 2009). Thus, a more recent assessment of overall prevalence of BD among United States adults is timely and the purpose of this study is threefold:

• To provide an overall estimate of the national prevalence of BD among United States men and women,

• To examine differences in BD across population subgroups (e.g., sex, race/ethnicity, age, body mass index category),

• To compare the rates of BD of the present sample to previously published national samples.