“We should educate the public that cosmetic procedures are as safe as normal medicine”: Understanding corporate social responsibility from the perspective of the cosmetic procedures industry

The cosmetic procedures industry is profitable and expanding. Through its premise and promotion, the industry contributes to unrealistic societal appearance pressures considered harmful to body image. In the context of limited regulation, there is an uneasy reliance on businesses in the sector to act in a socially responsible way. Corporate social responsibility (CSR) refers to voluntary business practices designed to benefit society, and engagement in CSR is shaped by extrinsic and intrinsic drivers. This study aimed to explore how senior UK industry professionals view CSR as it applies to their sector and to body image. Findings from 14 semi-structured interviews show that participants’ understanding of CSR was limited to a myopic focus on patients. Little reflexivity was demonstrated in relation to the industry’s responsibilities concerning negative body image in society. More broadly, the drivers of socially responsible practice were overwhelmingly extrinsic – oftentimes explicitly linked to bolstering or protecting company and/ or industry reputation. Participants, acknowledging a lack of intrinsic motivation for CSR across the sector, were largely in support of greater regulation. This research contributes to understandings of how the adoption of a CSR agenda might combine with regulatory efforts to curb the industry’s impact on negative body image

A novel, scalable social media-based intervention Warna-Warni Waktu to reduce body dissatisfaction among young Indonesian women: Protocol for a parallel randomized controlled trial

Background: Despite the prevalence of body dissatisfaction among young Indonesian women and its consequential negative impacts, there are currently no evidence-based, culturally appropriate interventions to tackle this issue. Therefore, there is a need to develop scalable, cost-effective, and accessible interventions to improve body image among this population. Objective: This paper describes the study protocol of a parallel randomized controlled trial to evaluate the effectiveness of Warna-Warni Waktu, a social media–based intervention that aims to reduce state and trait body dissatisfaction and improve mood among young Indonesian women aged 15-19 years. Methods: The trial will take place online. Approximately 1800 young women from 10 cities in Indonesia, evenly split across the ages of 15-19 years, will be recruited via a local research agency’s established research panel. Participants will be randomly allocated to the intervention condition or a waitlist control condition. The intervention consists of six 5-minute videos, with each video supplemented with up to five brief interactive activities. The videos (and associated activities) will be delivered at a rate of one per day across 6 days. All participants will complete three self-report assessments: at baseline (Day 1), 1 day following the intervention (Day 9), and 1 month following the intervention (Day 36). The primary outcome will be change in trait body dissatisfaction. Secondary outcomes include change in internalization of appearance ideals, trait mood, and skin shade satisfaction. Intervention effectiveness on these outcomes will be analyzed using linear mixed models by a statistician blinded to the randomized condition. Intervention participants will also complete state measures of body satisfaction and mood before and after watching each video to assess the immediate impact of each video. This secondary analysis of state measures will be conducted at the within-group level. Results: Recruitment began in October 2021, with baseline assessments underway shortly thereafter. The results of the study will be submitted for publication in 2022. Conclusions: This is the first study to evaluate an eHealth intervention aimed at reducing body dissatisfaction among young Indonesian women. If effective, the intervention will be disseminated to over half a million young women in Indonesia via Facebook, Instagram, and YouTube. Trial Registration: ClinicalTrials.gov NCT05023213; https://clinicaltrials.gov/ct2/show/NCT05023213 International Registered Report Identifier (IRRID): PRR1-10.2196/33596

Promoting positive body image: Body size diversity in media imagery

Negative body image is a significant public health concern, due to its high prevalence among women and men across the lifespan, and its detrimental effect on psychological and physical health. Exposure to mass media images depicting idealised, thin and muscular models is a risk factor for the development of negative body image. In recognition of this, governments, politicians and researchers worldwide have called for increased body size diversity in media imagery, in order to promote positive body image. Until recently, however, there has been little methodologically and ecologically sound research to inform these recommendations. Most negative body image and eating disorder prevention research has instead focused on training individual consumers to deconstruct and resist unhealthy media imagery, rather than on the process and impact of changing the images directly. Furthermore, despite no empirical evidence to support their assertions, some industry stakeholders have expressed concerns about the marketability, and health implications, of using more average-sized models in media imagery. The primary aim of this thesis, therefore, was to contribute to an evidence base that has the capacity to inform policy and advocacy in relation to increasing body size diversity in media imagery, as a public health strategy to promote positive body image. To fulfil this aim, this thesis explored the potential for using models with body sizes and shapes that are more representative of the general population – defined here as ‘average-size models’ – to provide a healthy and marketable alternative to current thin and muscular media imagery. The thesis adopted a mixed methodology to provide a comprehensive and contextualised investigation of the use of average-size models in the media. Chapter One provides a general introduction to previous research which demonstrates that the mass media have increasingly promoted narrowly defined cultural ideals of beauty that emphasise thinness and muscularity. It also describes previous research which shows that exposure to thin and muscular media imagery negatively impacts upon body image, and it reviews past research that has examined the use of average-size models in media imagery. Chapters Two and Three address the absence of research investigating the use of average-size models in an Australian context, and the lack of research focused on average-size male models; they describe two experimental studies that examined the impact of female and male average-size models on young Australians’ body image and perceptions of advertisement effectiveness. Then, to provide an often neglected qualitative consumer perspective, Chapter Four describes a series of focus group discussions that explored young Australians’ opinions on body image, the media, and the use of average-size models in media imagery. Chapters Five and Six attempt to address a potential barrier to consumer and industry acceptance of average-size models, that was identified in Chapter Four, by describing the development and evaluation of a brief educational intervention that aimed to reduce the stigmatisation of overweight and obesity. The results of this research suggest that increasing body size diversity in media imagery has the capacity to provide an effective public health intervention to promote positive body image. The studies presented in Chapters Two and Three found that viewing average-size female and male models in print advertisements was associated with more positive body image among some young Australian men and women, than viewing thin female models or no models. They also found that advertisements featuring average-size models were perceived by both women and men to be as effective as advertisements featuring thin and muscular models. The findings from the focus groups study presented in Chapter Four also suggest that there is consumer demand for the media to show models that are more diverse and representative of the general population. However, they also highlighted the need for further research and advocacy to reduce the stigmatisation of overweight and obesity if body size diversity is to be accepted by consumers. In response to this, the findings from the study presented in Chapter Six suggest that learning about weight stigma and challenging beliefs about the capacity for individuals to control their body weight may provide an effective strategy to reduce the stigmatisation of overweight and obesity. Chapter Seven presents a general discussion of these findings, including their implications for future research, policy and advocacy, and their strengths and limitations. In summary, this thesis contributes to an emerging evidence base for the health and marketing benefits associated with the use of average-size models in media imagery. The findings support previous research and suggest that increasing body size diversity in media imagery has the capacity to provide an effective public health intervention to promote positive body image. This research has the potential to inform and support policy and government recommendations regarding increasing body size diversity in the mass media

Psychological and sociocultural influences on body image among midlife women with and without a history of breast cancer: Testing the Tripartite Influence Model of Body Image

Body image concerns are common among breast cancer survivors and women in midlife. However, effective interventions are lacking for breast cancer survivors. This may be related to prior research having examined non-modifiable and medicalised influences on body image, instead of modifiable sociocultural and psychological influences. An adaptation of the ‘Tripartite Influence Model of Body Image’ was tested among women with (n = 169; mean age = 49.9) and without (n = 323; mean age = 47.6) a history of breast cancer, to investigate whether psychological and sociocultural influences on body image were similar between groups. Structural equation modelling revealed the model fit was satisfactory. Media pressure had an indirect effect on body image among both groups, and a direct effect among women treated for breast cancer. An additional influence of relevance only to women without breast cancer was pressure from friends. Overall, findings indicate common influences of media pressure and appearance comparisons on body image among both groups of women. This suggests that with some tailoring, existing evidence-based body image interventions designed for midlife women targeting these factors may also be relevant and beneficial for breast cancer survivors

A pilot study of a body image intervention for breast cancer survivors

© 2018 Elsevier Ltd Body image interventions for breast cancer survivors are lacking in empirical support. Examining existing research on effective body image interventions for women in midlife more broadly may provide useful insights. This pilot study assessed the acceptability, feasibility, and preliminary effects of a Cognitive Behavioural Therapy-based intervention adapted from women in midlife to promote positive body image among breast cancer survivors. Twenty-two breast cancer survivors received the 7-week group intervention, co-facilitated by a clinical psychologist and peer. Participant evaluations suggested the intervention was both acceptable (e.g., 94% would recommend it) and feasible (e.g., 91% completed the intervention). Improvements were identified at either post-test or 1-month follow-up in nearly all body image measures. Maintained improvements were found in body appreciation, weight and shape concern, acceptance of aging-related appearance changes, and self-esteem. This study suggests that the adapted intervention is acceptable, feasible, and demonstrates preliminary efficacy in improving body image and secondary outcomes among breast cancer survivors