Abstract Body dissatisfaction can be significantly detrimental to wellbeing. Little is known about older adults' body image, despite that ageing causes unique bodily changes and that sociocultural pressures to resist these changes abound. We conducted six focus groups with a UK community sample of White British and South Asian older adults aged 65-92 years. Thematic analysis highlighted four themes: appearance indicates capability and identity; physical ability trumps appearance, felt pressures to age 'gracefully' while resisting appearance changes, and gender and cultural differences. These findings suggest that older adults' body image can have important implications for their wellbeing and merits researchers' attention. Keywords: Ageing, Appearance, Health, Body Image Running Head: AGEING AND BODY IMAGE AMONG OLDER ADULTS 3 Looking age-appropriate while growing old gracefully: A qualitative study of ageing and body image among older adults Ageing is accompanied by significant changes to physical appearance and functionality. These may include hair loss and change of colour, weight changes, the use of dentures, hearing and mobility aids, and changes in body shape and skin elasticity. Despite these changes reflecting normal ageing processes, individuals experience them within a culture that highly values and emphasises the importance of a youthful appearance (Becker et al., 2013). Older adults often experience sociocultural pressures to conform to youthful appearance ideals. 1 These pressures can impact their body image, which is an individual's thoughts, feelings and behaviours associated with their appearance and physical ability Despite the rapid increase in ageing populations in developed and less developed countries, whereby the number of people aged 65 and above has tripled in the last 50 years (United Nations, 2013), most appearance and body image research has focused on childhood, adolescence and early adulthood. Only limited research has examined the presence and nature of body image and related sociocultural pressures during mid to older adulthood. Furthermore, such research has tended to produce inconsistent findings and has overly focused on White older adult women Qualitative research with White women aged between 50-70 years suggests that 1 There is no definitive rule for what age constitutes the start of older adulthood. In ageing research, however, the convention is for older adulthood to be defined as 65 years and older (Erber, 2013). Running Head: AGEING AND BODY IMAGE AMONG OLDER ADULTS 4 concerns regarding the effect of ageing on body image are prevalent among this sample and that felt sociocultural appearance pressures are salient (e.g., Research is similarly equivocal about the effect of ageing on men's and women's general this area has been "deficient in fully uncovering the nuances of diversity and the ways that intersectionality informs older adults' embodied experience". They add "there is a strong need to capture both the perceptions and the experiences of the aging body from the perspective of older men and women". In summary, while the existing research suggests that age-related appearance changes may be salient and give rise to appearance concerns, little is known about how older adults actually experience body image in the context of an appearance orientated society and an ageing body. The aim of this study therefore was to use a focus group methodology to explore indepth how ageing, appearance, and sociocultural appearance pressures may influence older adults' body image (defined here as those aged 65 years and older). An additional aim was to recruit a more diverse population of older adults than has been traditionally sampled in previous research (i.e., a sample that included men and ethnic minority groups). Because there has been limited research with older adults, and the research to date has produced mixed Running Head: AGEING AND BODY IMAGE AMONG OLDER ADULTS 6 findings, we selected a qualitative design so that the results would largely be driven by participants' accounts, rather than researchers' assumptions about the nature and scope of body image concerns and sociocultural appearance pressures for older adults Method Procedure Nine community support organisations for older adults, based in the south west of England, were approached to request permission to invite their members to take part in a focus group on body image, ageing and society. Three organisations (Age UK Bristol, LinkAge and Dhek Bhal 2 ) granted permission for the first author to attend their local meetings to recruit older adults for this study. Subsequently, six focus groups were conducted between March and June 2012. Each focus group consisted of 4-6 participants, with four single-sex groups (two groups of males, two groups of females) and two mixed-sex groups. Ethics approval from the University of the West of England was granted for this study. Focus groups were conducted until saturation was reached, a point at which no new themes or information were apparent. Participants A total of 28 women and men (16 women, 12 men) aged 66-92 years (M =79.38, SD 2 Dhek Bhal is an organization that aims to support South Asian adults living in Bristol, UK, and the surrounding area Running Head: AGEING AND BODY IMAGE AMONG OLDER ADULTS 7 = 7.26) took part in the focus group discussions 3 . Participants identified as White British (n = 20; 71%) or South Asian (n = 8; 29%). Of the participants who reported their marital status, most identified as 'married' (n = 13, 61%), with fewer as 'widowed' (n = 4, 19%), 'single' (n = 2, 10%), or 'divorced' (n = 2, 10%). Of the participants who reported their height and weight, the average BMI was 21.06 (SD = 11.13) which is within the 'normal' range for adults of this age group Data collection and analysis Four focus groups were led by the first author (a White British male in his twenties) with the remaining two were led by the third author (a White British female in her forties). Two female White British research assistants in their twenties observed the focus groups to record notes on speaker order. Each focus group discussion lasted between 50 and 63 minutes. Within each focus group, the discussions were interactive and all participants contributed freely to the discussion (i.e., responding to the moderator, as well as other participants). After participants provided written consent and demographic information, each moderator led the focus group using a semi-structured discussion schedule, derived from
