THINNESS = BEAUTY: FACTORS THAT INFLUENCE WOMEN'S COGNITIVE BIAS TOWARD WEIGHT LOSS.
Han (2003) suggested that when women are exposed to images of thin models, they compare themselves to the models and become dissatisfied with their own body shape. Hence, in pursuit of model status, these women begin to exhibit negative phenomena, including eating disorders, increased proneness to anxiety, feeling that they are too fat and need to lose weight, and dieting behaviors. Pritchard and Cramblitt (2014) proposed that the internalization of general/nonathletic body ideals promoted in the media may have an impact on the drive for thinness in both men and women. Kao (1997) suggested that women's body autonomy and management are strongly impacted by experts and important others in their lives, through increasing self-discipline to achieve a thin body shape. Bias toward slimness is a significant issue for women in Taiwan; however, there are few studies on the prioritization of the various factors that influence WCBS. Therefore, I developed a framework to discuss and analyze the relative weighting of these factors. My research objectives were as follows: (a) to discuss the effect of Taiwanese society on women's slimness perceptions, (b) to explore the factors influencing WCBS, (c) to construct a framework for prioritizing the factors influencing WCBS, and (d) to draw conclusions and make suggestions for educational institutions, mass media, and future researchers to guide WCBS and promote good health.
Literature Review and Hypotheses
Perceptions of Female Body Shape in Taiwanese Society
According to international standards, medical standard weight is used to assess whether a person's weight is excessive. Another measure of weight is the body mass index, which is calculated as weight (kg)/height [(m).sup.2]. In Taiwan, a person with a body mass index under 18.5 is considered underweight, 18.5-24.0 is normal, 24.1-26.9 is overweight, and 27.0 or above is obese (Ministry of Health and Welfare, 2016).
Du (2004) observed that the ideal body image for women presented in advertising in Taiwan is usually slim, which communicates and creates a social stereotype, and defines the criteria of female beauty, attractiveness, and success. Cultural preferences and beauty standards for the female body have changed over time in traditional Chinese society: Slimness has become a symbol of beauty, not only for men judging women but also for women judging themselves (Du, 2004). Ko et al. (2013) suggested that women should develop appropriate diet plans, undertake regular exercise activities, and aim for body weight control, in consultation with professional fitness advisors. In addition, Ko et al. recommended that women should fortify their relevant fitness knowledge to control their body shape and achieve an ideal figure.
Mass Media Influences on Young Women's Slimness Cognition
Stice, Schupak-Neuberg, Shaw, and Stein (1994) proposed that the media transmit a thin ideal body size that people internalize in regard to their body image through the identification of gender roles. In line with this, Grabe, Ward, and Hyde (2008) found that exposure to mass media depicting the thin body ideal is linked to body image disturbance in women. Scholars have reported finding significant correlations between fashion magazine consumption and women's body dissatisfaction and drive for thinness (L. Lin & Reid, 2009; Tiggemann, Polivy, & Hargreaves, 2009). Kim and Aubrey (2015) suggested that most researchers agree that the thin body image ideal promoted by media is one of the primary sociocultural factors that directly affects the development of a negative body image and leads to negative behavioral outcomes, such as disordered eating. Many slimness advertisements display a contempt for obesity, extolling a slimming consciousness, so that the wider society believes the myth that thin = beautiful and good. In summary; the exaggeration in mass media of the slimness issue has become the focus of attention for women.
Important Others Influence Young Women's Slimness Cognition
Huang and Hung (2003) proposed that parents, peers, siblings, and other important people affect young women's self-evaluation of their body. Steep increases in height and weight, and sexuality development during adolescence cause young women to be particularly sensitive to their body image and highly aware of attention from their friends and family (Jones, Vigfusdottir, & Lee, 2004; Keery, Boutelle, van den Berg, & Thompson, 2005; H. Kim, 2017). Researchers have further indicated that parental messages and feedback about body size and shape are significant predictors of adolescents' body satisfaction (Helfert & Warschburger, 2011; Holsen, Carlson Jones, & Skogbrott Birkeland, 2012).
Social Influence on Young Women's Slimness Cognition
Zhang (2002) stated that obesity is stigmatized in Taiwan, and that the social stereotype of thin = beautiful has been applied to women's bodies for a long time. Pinkasavage, Arigo, and Schumacher (2015) reported that comparing one's body to those of others who are perceived as more attractive is common among college-aged women, and has been associated with increases in body dissatisfaction and disordered eating. Previous researchers have also explored the impact of sociocultural changes in East Asia, such as the shift from Confucianism to feminism, on WCBS (H. Kim, 2017).
In summary, slimness cognition is different at each stage during social change; however, the public is continuously concerned with the issue of slimness. When an individual is making a self-conscious self-judgment, social ideals regarding the desirability of a slim body type create more extreme illusions of women's appropriate body weight, and increase the emphasis placed on weight loss. Thus, the development of individuals' body image is influenced by the sociocultural ideal of body size standards.
Influence of Individual Factors on Young Women's Slimness Cognition
Body image may be conceptualized as a multidimensional construct that represents how individuals think, feel, and behave with regard to their own physical attributes (Muth & Cash, 1997). Body image is formed by cognitive evaluation of, and comparison to others, often done unconsciously, and involves neurological, emotional, and social elements (Cash & Smolak, 2011; Thompson & Stice, 2001). Brener, Eaton, Lowry, and McManus (2004) suggested that dietary habits and weight-control behaviors are greatly influenced by adolescents' perception of their body shape or body weight. In summary, young women are generally influenced by the social ideal of the female body shape, and wish to be as thin as possible to meet this ideal.
Constructing the Framework for Prioritizing the Factors Influencing WCBS
I developed a research framework to prioritize the factors influencing WCBS. The framework consists of four stages, as shown in Figure 1.
I used an integrated, modified Delphi task-analytical hierarchy process (AHP) approach to identify the factors that influence WCBS in Taiwan. The modified Delphi method has been used in surveys to examine a variety of factors in the cognitive bias and weight loss fields, and the AHP has been used to define their priority in terms of strength of influence on the focal variable. The modified Delphi-AHP approach can be applied to a wide range of complex multicriteria decisions that require a group of experts to make judgments on qualitative features.
The Modified Delphi Method
Linstone and Turoff (1975) developed the Delphi technique as a method for structuring a group communication process so that it is effective in allowing a group of individuals, as a whole, to deal with a complex problem. A Delphi method study is an interactive and iterative process that can include as many rounds as necessary to yield a consensus. After two or three rounds of obtaining the opinions of the expert panelists, a pattern of consensus typically begins to emerge (Di Zio & Maretti, 2014; Isaac & Michael, 1995; Park & Yoon, 2011; Ziglio, 1996).
The difference between the Delphi method and the modified Delphi method is that, in the first stage, the latter requires the development of a structural questionnaire through conducting a literature review, instead of the original practice of using open-ended questionnaires. The modified Delphi method enables scale construction and development and the validation of scale items representing particular constructs.
The optimal number of experts in a group using the Delphi method is between 10 and 30 (Murry & Hammons, 1995). The participation of experts in the group means that the screening and confirmation of group members should be meticulous. Generally, two indicators are used to judge whether or not the experts have professional ability on a specific topic: (a) whether they possess more knowledge on such topics than others do, and (b) whether they possess significant work experience or are members of a specialized organization. My sample comprised 16 experts from an educational group and a medical group, and I selected this sample size on the basis of the availability of research funds and group size feasibility. Educational group participants included 10 educational experts and medical group participants included six medical experts.
The first stage of questionnaire development involves screening the factors influencing WCBS; hence, I conducted an importance analysis using the threshold values setting. Because the methods for threshold value setting involve mostly subjective judgments, a high threshold value is set by the decision maker before screening the factors. My research instrument was a questionnaire for studying the factors influencing WCBS, which was developed in three stages:
Round 1 modified Delphi survey. In round 1 of the modified Delphi method, I used a series of statements for which responses were made on a 5-point Likert scale ranging from 1 (very unimportant) to 5 (very important). I also provided an open column for supplementary comments from experts. I analyzed and synthesized replies and comments from the experts and conducted importance and consistency tests. For consistency, standard deviation is generally used as the criterion; that is, a smaller SD indicates higher consistency, and SD < 1 is the judgment standard. I also calculated the expert's comment distribution of quartile deviation (QD) for each item; a QD of [less than or equal to] .60 indicates that the experts had reached a consensus (Faherty, 1979). A mean of [greater than or equal to] 3.75 indicates that the item is important. The questionnaire was then revised according to expert comments to form the round 2 version.
Round 2 modified Delphi survey. To present the responses and comments from experts in the round 1 survey, the M, SD, and QD are used as a reference point. In the data analysis, M [greater than or equal to] 3.75 indicates an item is important, and SD < 1 and QD [less than or equal to] 0.6 indicate that the experts have reached a consensus. The results were used to form the relative weight questionnaire.
Relative weight survey using the analytical hierarchy process. I further analyzed the results obtained from the modified Delphi method by using AHP. Saaty (1980) developed the AHP, which has been identified as an important method for prioritizing preferences or importance in multicriteria decision-making problems. The AHP is currently used as a tool for decision makers and researchers to make judgments or decisions via numerical ratings from pairwise comparison, based on nine fundamental scales to obtain a priority or importance weighting for each criterion (Kuo & Chen, 2006). The reciprocal matrix built from pairwise comparison is used in the decision-making process because this allows qualitative data to be transformed into ratios that are used for determining criteria importance or priority (Deng, 1999).
Stage 1: Conducting a Literature Review to Explore the Factors Influencing WCBS
I reviewed the literature to explore and analyze the factors influencing WCBS, and constructed four dimensions: (a) a mass media aspect regarding the strength of the influence of television advertising and entertainment artists (I. I. Chen, 2007; Han, 2003; Honeycutt, 1996; Keeton, Cash, & Brown, 1990; L. Lin & Reid, 2009; Webber, 1994; Zhang, 2000); (b) an important others aspect exploring caring others' perspectives and associated desire to lose weight (Aliyev & Turkmen, 2014; Han, 2003; Jacobi & Cash, 1994; Mintz & Betz, 1986; Pai, 2004; Stice, Maxfield, & Wells, 2003; Yu, 2002; Zhang, 2002); (c) a social influence aspect caused by societally established impressions that thinness is beautiful (I. I. Chen, 2007; Chia, 2001; Crook, 1994; I. C. Lin, 1999; S.-Y. Lin, 2008; Y. Y. Lin, Chiang, & Tsai, 2005; Smith, Handley, & Eldredge, 1998; Stice, 2002; Zhang, 2002); and (d) an individual factors aspect that includes being concerned with others talking about one (Y. X. Chang, 2005; Chuang, 1998; S.-Y. Lin, 2008; Robinson et al., 1996; Slade, 1994).
These four dimensions can be divided into the following 12 subdimensions: television advertisements, fashion magazines, and film and television entertainers (mass media); family, peers, and important other people (important others); fashionable attire, social pressure, and social distance (social influence); and body image, psychological feeling, and body feeling (individual factors). These subdimensions can then be further divided into 42 indicators (see Table 2).
Stage 2: Refining and Identifying the Factors Influencing WCBS by Using the Modified Delphi Method
Round 1: Modified Delphi survey analysis. I sent a survey form to the Delphi panel members in the first round. Respondents rated their opinions of the statements included in the four major dimensions, 12 subdimensions, and 42 indicators. Each indicator had a result of M [greater than or equal to] 3.75, indicating that they are all important; however, some indicators' SD and QD values did not meet the standard for consensus, and the experts also suggested the addition of some further indicators. These dimensions, as well as the number of indicators for each dimension, are listed in Table 1. The results obtained in the first round were sorted and synthesized for use in the second round.
Round 2: Modified Delphi survey analysis. In round 2, respondents received additional information on the M, SD, and QD of each indicator to assist with reconsideration of their opinion. The results of the round 2 Delphi survey showed that the SD and QD for each indicator met the standard for consensus, and that the M (importance) for each indicator was higher than that in the first round. Thus, I identified 44 indicators for four major dimensions and 12 subdimensions.
The summary of results of the round 2 modified Delphi survey is shown in Table 2, along with M, SD, and QD values. The indicators that the panel members provided are categorized into four dimensions: mass media, important others, social influence, and individual factors. The three factors rated highest by the panel members were, in descending order, fashion magazines, important other people, and television advertisements.
Stage 3: Prioritizing the Factors Influencing WCBS by Using the AHP Method
The AHP's evaluation system is divided into three levels. The first level is the objective layer (i.e., factors influencing WCBS). The second level is the criterion layer, containing four major dimensions: mass media, important others, social influence, and individual factors. The third level is the subdimension classification, which contains 12 specific factors: television advertisements, fashion magazines, film and television entertainers, family, peers, other important people, fashionable attire, social pressure, social distance, body image, psychological feeling, and body feeling.
The AHP questionnaire was sent to panel members, and the respondents rated the statements using Expert Choice 2000 software to determine which one among each pair of factors was more important to the objective, rated on a 9-point Likert scale ranging from 1 = equally important to 9 = much more important (Vaidya & Kumar, 2006).
The description development follows a three-step process: (1) compose a pairwise comparison matrix, (2) calculate the maximal eigenvalue, and (3) complete a consistency analysis. Generally, the consistency ratio (CR) can be used as a guideline to check for consistency. If the CR value is less than .10, the judgments are consistent; thus, the derived weights can be adopted (Chen et al., 2006; Saaty, 1994).
Regarding the four-dimension priority analysis result, the construct's CR values met the standard of [less than or equal to] .10 (see Figure 2). The priorities assigned to the factors influencing WCBS were as follows: (1) mass media, (2) important others, (3) social factors, and (4) individual factors. This implies that the power of the mass media is sufficient to affect WCBS.
The results of the integrated AHP are shown in Table 3. The five most important key factors, in descending order, were as follows: television advertisements, family, fashion magazines, fashionable attire, and film and television entertainers. However, three of these factors (television advertisements, fashion magazines, and film and television entertainers) fell in the mass media dimension. These results show that exposure to mass media describing the thin body ideal has the strongest effect on the development of body image disturbance in women in Taiwan.
I developed a framework for prioritizing the factors influencing WCBS in a Taiwanese context. This framework has two significant features: First, to avoid possible errors, I used multiple analysis processes involving two rounds of the modified Delphi method, followed by one round of AHP. Second, the framework provides a visualization model to understand the problem of WCBS and identify which factors influencing WCBS need attention and should be addressed.
Theoretical and Practical Implications
After two rounds of modified Delphi surveys and one round of AHP completed by a panel of 16 experts, the model I constructed of the factors influencing WCBS showed that, listed in order of the degree of influence, the priority of the four main dimensions was as follows: (A) mass media (three factors), (B) important others (three factors), (C) social factors (three factors), and (D) individual factors (three factors). This model is depicted in Figure 2.
If these factors are rearranged in an integrated manner to compare relative weightings in AHP, then television advertisements have the strongest influence on WCBS, followed by family and then fashion magazines. This finding extends those in previous studies, in which researchers have focused on one or two factors that influence women's body image (Byely, Bastiani Archibald, Graber, & Brooks-Gunn, 2000; Holsen, et al., 2012; Pritchard & Cramblitt, 2014) but did not consider and discuss the priority of factors that influence WCBS from an integrated perspective. Although more people in Taiwan are beginning to focus on WCBS, the corresponding systems and support measures remain immature (Du, 2004; Ko et al., 2013). In the case of the family factor, parental criticisms about their own children's weight and physical limitations are a crucial factor in adolescents developing body image dissatisfaction. According to the findings of previous researchers (Aliyev & Turkmen, 2014; Byely et al., 2000), it is important for parents to set a positive example and avoid making negative comments about their children's body shape.
The study results show that the four dimensions of mass media, important others, social factors, and individual factors have different degrees of influence on WCBS, with mass media having the most significant impact. In practical terms, this issue should raise awareness that the mass media should be careful to transmit appropriate cognitive images of slimness and avoid spreading exaggerated messages about thin being the ideal body shape in the future. Using resources from the government, social groups, and networks, researchers should publish information on issues related to bias in body image, thereby enhancing public awareness of the hazards related to unrealistic expectations regarding body image, as well as how to maintain vigilance to avoid slimness bias.
I also found that negative feedback from family affects the development of body image issues in overweight women, and that parental attention to comparison of body image between siblings affects women's feelings about their own bodies. I recommend that women's family members avoid engaging in these actions. Instead, family members should show empathy, give support, and discuss the women's strengths to help them establish a positive body image. Teachers at educational institutions should foster in their students the concept of distinguishing and reading appropriate media reports from childhood, so that the students can verify how these impact on their own physical aesthetics and health.
Limitations and Future Research Directions
There are some limitations in this research. First, I used the modified Delphi method to obtain data; however, the expert panel members were scholars and medical representatives, and their comments were written down rather than provided in face-to-face interviews. Use of this method of data collection may have produced insufficient communication of ideas and more generalized conclusions. Second, I focused on women in the northern area of Taiwan; therefore, my results may not be generalizable to Taiwan's other regions or to other countries, and additional research is required. Future researchers may also explore in more depth the four dimensions and 12 factors used in this study. Further, future researchers could consider using the modified Delphi-fuzzy AHP approach to study the topic, to construct a more complete structural appraisal.
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Hsing Wu University of Science and Technology
Chia-Chan Chou, Department of Business Administration, Hsing Wu University of Science and Technology.
Supplementary materials and data can be obtained by contacting the author.
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Table 1. Number of Indicators Developed from Round 1 of the Delphi Survey Dimension Factors Number of indicators developed Mass media Television advertisements 4 Fashion magazines 4 Film and television 4 entertainers Important others Family 4 Peers 4 Important other people 4 Social influence Fashionable attire 3 Social pressure 4 Social distance 4 Individual factors Body image 3 Psychological feeling 3 Body feeling 3 Table 2. Indicators for Evaluating Women's Cognitive Bias Toward Slimness Dimension Factors Indicators Mass media Television advertisements Strength of advertising messages promoting slimness can affect women's intention to lose weight. Numerous slimness advertisements appear on television, continually preaching contempt for obesity and extolling slimness consciousness, which promotes the myth that thin = beautiful and good. There are frequent encouragements for women to assess and change their appearance to fit the slim ideal. Impressions generated by advertisements that one should use weight loss products significantly increase women's cognitive bias toward slimness. Fashion magazines Fashion magazines influence the perceived ideal for female body appearance. As fashion magazines exaggerate the ideal of a slim female body shape, women who do not meet this ideal experience dissatisfaction and anxiety with their appearance. The biased body shape shown in fashion magazines makes women believe that diet and exercise should be a priority in their daily life. Women often read fashion magazines that strengthen their desire to be slim. Film and television entertainers Comparing their body with that of a supermodel causes women to feel dissatisfied with their own shape. Mass media exaggeration of incorrect information, such as exaggeration of incorrect information regarding the slimness issue spurs women to experience dissatisfaction with their body shape. Women seeking a slim shape will be affected by film and television entertainers. The preferred image of female film and television entertainers has long been a slim shape, such that women viewing these entertainers try weight reduction activities to achieve a similar look. Important Family others Having a mother who cares excessively about weight reduction, sets her own stringent aesthetic standards, and comments on her children's failure to meet these standards, often has a negative impact on the children. Women feel pressured by their family to reduce their weight. When parents mock each other's weight this affects their children's views of their own appearance. Parents' excessive focus on, and interference with, their children's diet may give rise to children's disordered eating. Peers Having their shape or weight made fun of by others causes girls distress. There is a tendency for girls to believe that most classmates and friends pay attention to their appearance. One is negatively affected by classmates' and friends' criticisms of one's shape. Female peers may exchange information about weight loss, imitate each other's dietary and exercise behaviors, and put pressure on, or mock, those who fail to conform to these behaviors. Important other people Women tend to think that men like women who have a thin shape. Important others promote the slender standards molded by the media, strengthening woman's desire to attain such a body shape. The perception of the opposite sex of the ideal shape for women affects women's body satisfaction. Receiving negative comments from important others will cause women to attempt to change themselves to achieve the ideal body shape. Social Fashionable attire influence Young women's clothes tend to be quite good-fitting, but good-fitting clothes pick people to wear. Popular culture emphasizes thinness, giving a conditionality connection to goods (e.g., one size clothing is easier to buy). Thin women are encouraged to wear revealing clothes whereas fat women are encouraged to cover themselves up. Social pressure Peer evaluations of women's body shape creates social pressure to conform to the ideal shape. Social criticism influences women's body dissatisfaction. Social comparison can increase women's motivation to become thin. Strong mainstream social views increase the pressure for women to achieve a thin body shape, which has the effect of normative control. Social distance The pursuit of thinness is not aimed at maintaining health but at meeting societal standards of female beauty. Historical social trends regarding the relationship between women's body size and body weight have been reversed, with affluent society members now pursuing a slim shape. Evaluation of the female body is based on external social standards. Others' negative opinions, feedback, and comments negatively affect women's development of their body image. Individual Body image Having thin female factors friends causes women to want to be thin too. Women compare their shape with that of others; however, they also variously appreciate, praise, and criticize other women's body shape and clothing. Caring about others' praise or appreciation can cause women to overlook their own judgments about their body shape. Psychological feeling Women equate thinness with beauty and confidence. The gap between the real self and the ideal self influences the importance women place on having a thin body shape. Being called negative weight-related nicknames (e.g., fatty) as a child, and being made fun of for being fat leads to the belief that thin = beautiful. Body feeling Finding that their trousers and clothes are very tight causes women to undertake weight loss measures. When being measured for clothes by a tailor, women want to show they have lost weight since they were last measured. Women's current weight concerns influence their weight loss behavior. Dimension M SD QD Mass media 4.61 0.73 .44 4.67 0.89 .50 4.75 0.62 .38 4.75 0.45 .38 4.25 0.96 .50 4.69 0.69 .40 4.58 0.90 .38 4.75 0.62 .50 4.75 0.62 .37 4.67 0.65 .38 3.46 0.64 .30 4.75 0.62 .38 4.33 0.67 .38 4.57 0.64 .25 4.75 0.62 .21 Important 4.37 0.79 .57 others 4.58 0.90 .38 4.25 0.67 .50 4.08 0.90 .88 4.58 0.67 .50 4.46 0.87 .41 4.50 0.90 .50 4.58 0.90 .38 4.50 0.80 .38 4.25 0.90 .38 4.62 0.80 .39 4.33 0.78 .17 4.83 0.88 .50 4.75 0.62 .50 4.58 0.90 .38 Social 4.17 0.81 .42 influence 4.08 0.79 .38 4.42 0.79 .50 4.00 0.85 .38 3.90 0.78 .47 4.42 0.9 .50 3.58 0.79 .50 3.75 0.62 .50 3.83 0.83 .38 4.41 0.83 .56 4.25 0.75 .50 4.58 0.90 .38 4.58 0.90 .38 4.25 0.75 .50 Individual 4.58 0.79 .50 factors 3.92 0.51 .50 3.92 0.62 .38 3.97 0.80 .38 3.92 0.67 .25 4.00 0.95 .38 4.00 0.79 .50 4.32 0.76 .46 4.17 0.83 .38 4.50 0.72 .50 4.30 0.72 .50 Note. QD = quartile deviation. Table 3. The Weight and Priority of Factors for Women's Cognitive Bias Toward Slimness Dimension CR Factors Weight Overall Overall weight rank Mass media .0789 Television .6080 .3155 1 advertisements Fashion magazines .2721 .1412 3 Film and television .1199 .0623 5 entertainers Important .0824 Family .6944 .1877 2 others Peers .2269 .0613 6 Important other .0787 .0213 9 people Social .0886 Fashionable attire .6619 .0926 4 influence Social pressure .2538 .0355 8 Social distance .0843 .0118 11 Individual .0856 Body image .6584 .0466 7 factors Psychological feeling .2528 .0179 10 Body feeling .0888 .0063 12 Note. CR = consistency ratio.
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|Publication:||Social Behavior and Personality: An International Journal|
|Date:||Jun 1, 2018|
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