Internalization of body shape ideals and body dissatisfaction: A systematic review and meta-analysis

Objective: The present meta-analysis summarizes existing evidence on the relationship between the internalization of body shape ideals (IBSI) and body dissatisfaction. Method: Pooled effect sizes (r) were computed using a random-effects model. The robustness of the results was examined using influence analyses. Potential predictors of effect heterogeneity were examined using subgroup analysis and univariable/multivariable meta-regressions. Publication bias was examined using the three-parameter selection model (3PSM). Results: A total of 141 effect-sizes from 78 studies (N = 39,491) were retrieved. Results revealed medium (r =.25; muscular/athletic-ideal internalization) to very large (r =.43, general attractiveness-ideal internalization; and r =.45, thin-ideal internalization) relationships, all these being largely similar in male and female individuals. Discussion: IBSI and body dissatisfaction were strongly linked: (a) in younger individuals (general attractiveness-ideal internalization); (b) when IBSI was operationalized in terms of endorsement rather than mere awareness of appearance ideals; (c) in studies of lower methodological quality (muscular/athletic-ideal internalization); and (d) when IBSI was assessed using instruments involving social comparisons. Given the largely cross-sectional nature of data included in this meta-analysis, further testing in prospective and experimental studies is needed to confirm hypotheses about causality of observed associations. Such findings would have impact for prevention and intervention studies.