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The prevalence of breast augmentation and breast lift surgery suggests that many women are dissatisfied with their breasts. This study analyzed women's and men's views about breast size and shape among 52,227 heterosexual adults, ages 18–65, who responded to an online survey. Although most women (70%) were dissatisfied with the size or shape of their breasts, most men (56%) were satisfied with their partner's breasts. Younger and thinner women worried that their breasts were too small; older and heavier women were more concerned with breast droopiness. Women who were dissatisfied with their breasts were more likely to report lower body satisfaction and to express concern about wearing a bathing suit in public. Further, dissatisfied women were also less willing to undress in front of their partner and were more likely to conceal their breasts from their partner during sex. These findings suggest that dissatisfaction with breasts is widespread among adult women.
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The Barbie Mystique: Satisfaction with Breast Size
and Shape across the Lifespan
David A. Frederick
Anne Peplau
Janet Lever
ABSTRACT. The prevalence of breast augmentation and breast lift surgery suggests that many women
are dissatisfied with their breasts. This study analyzed women’s and men’s views about breast size and
shape among 52,227 heterosexual adults, ages 18–65, who responded to an online survey. Although
most women (70%) were dissatisfied with the size or shape of their breasts, most men (56%) were
satisfied with their partner’s breasts. Younger and thinner women worried that their breasts were too
small; older and heavier women were more concerned with breast droopiness. Women who were
dissatisfied with their breasts were more likely to report lower body satisfaction and to express concern
about wearing a bathing suit in public. Further, dissatisfied women were also less willing to undress in
front of their partner and were more likely to conceal their breasts from their partner during sex. These
findings suggest that dissatisfaction with breasts is widespread among adult women.
KEYWORDS. Body image, breasts, men, women, physical attractiveness
Tremendous pressure is placed on women to
attain the ideal body. The popular Barbie doll,
with her slender body, narrow hips, and large
breasts, epitomizes this ideal. The proportions
represented by Barbie are, however, so extreme
that only one of every 100,000 women pos-
sesses Barbie’s body type (Norton, Olds, Olive,
& Dank, 1996). The pervasiveness of the busty
ideal has led some researchers to posit that
women’s concerns about their breast size and
shape can affect their self-esteem, feelings of
attractiveness, and sense of femininity. For ex-
ample, Millsted and Frith (2003, p. 455) claimed
that “Women’s breasts are invested with social,
cultural, and political meanings. ...Breasts are
seen simultaneously as a marker of woman-
hood, as a visual signifier of female sexualisa-
David A. Frederick Department of Psychology, University of California, Los Angeles, UCLA Center for
Culture, Brain, and Development and UCLA Center for Behavior, Evolution, and Culture
Anne Peplau Department of Psychology, University of California, Los Angeles and UCLA Interdisciplinary
Relationship Science Program
Janet Lever, Department of Sociology, California State University, Los Angeles.
Address correspondence to: David Frederick, 1285 Franz Hall, 405 Hilgard Ave., Los Angeles, CA 90095.
Author website:
tion, [and] as synonymous with femininity. De-
spite the assumed importance of breast size and
shape to women’s views of their bodies, surpris-
ingly little research has systematically examined
how women’s breast satisfaction might influence
women’s overall body satisfaction in populations
beyond college students and breast augmenta-
tion patients. Further, information about men’s
actual satisfaction with their real-life partner’s
breasts is largely absent from research conducted
to date.
Women’s Attitudes Toward Their Own
Feminists and others have frequently claimed
that the media and many men treat women as
International Journal of Sexual Health, Vol. 20(3), 2008
Available online at
2008 by The Haworth Press. All rights reserved.
doi: 10.1080/19317610802240170
David A. Frederick et al. 201
if they exist simply to provide sexual gratifi-
cation for men (Bordo, 1993; Fredrickson &
Roberts, 1997). Fredrickson and Roberts (1997)
formalized this idea in Objectification Theory,
which proposes that women’s bodies are fre-
quently scrutinized and evaluated by men. One
consequence of these evaluations is that women
internalize an observer’s perspective on their
bodies and assess their own value as a func-
tion of how they believe others view their
Women’s breasts, perhaps more than any
other aspect of women’s bodies, are widely
presented for evaluation in television, movies,
and popular magazines (e.g., Seifert, 2005). The
media are often criticized for contributing to
women’s dissatisfaction with their breasts, and
there is some empirical evidence that women
who a re more regular consumers of media that
present idealized female bodies are more con-
cerned about their own breasts (e.g., Harrison,
2003). A further contributor to women’s at-
titudes about their breasts may be the con-
cern that their romantic partner would pre-
fer a woman with larger or “more shapely”
Consistent with the idea that women feel pres-
sure to possess large breasts, several studies have
found that many college women would like to
have larger breasts (e.g., Arkoff & Weaver, 1966;
Forbes & Frederick, 2008; Harrison, 2003; Ja-
cobi & Cash, 1994; Jourard & Secord, 1955;
Tantleff-Dunn & Thompson, 2000; Thompson
& Tantleff, 1992). In an illustrative study of 123
college women, 46% of the participants reported
that they desired larger breasts (Forbes, Jobe,
& Revak, 2006). Similarly, in a study of 587
college women (Forbes & Frederick, in press),
most women desired larger breasts (61%) while
a minority desired smaller breasts (14%) or no
change in their breast size (25%). Overall, 25%
of the women reported being often to always dis-
satisfied with their breast size, and women who
reported an A cup size were most likely to
feel this way (50%) and to desire larger breasts
(90%). Research also shows that women who are
dissatisfied with their breasts reported greater
general body dissatisfaction (Forbes & Freder-
ick, in press; Jourard & Secord, 1955; Koff &
Benavage, 1998). This appears to be true not
only for women who would like larger breasts,
but also for the minority of women who de-
sire smaller breasts (e.g., Koff & Benavage,
One clear indication of women’s dissatis-
faction with their breasts is the growing num-
ber of women seeking to change their breasts
with surgical interventions. By one estimate,
as many as 2 million women in the United
States had obtained breast implants in the years
prior to 2000 (Sarwer, Nordmann, & Herbert,
2000), and over 1 million (1,782,041) received
breast implants between 2000 and 2006 (Amer-
ican Society of Plastic Surgeons, 2007). In
2006, 329,000 women had breast augmentation
surgery, making it the most popular cosmetic
surgery for the first time (American Society
of Plastic Surgeons, 2007). Breast augmenta-
tion is most often pursued by women in their
20s or early 30s (Rohrich, Adams, & Potter,
2007). Further, not all women wish to have
larger breasts. For both cosmetic and health
reasons, some women elect to have breast re-
duction surgery. In 2006, 103,990 breast reduc-
tion surgeries were performed, making this the
fourth most popular reconstructive surgery that
year (American Society of Plastic Surgeons,
In addition to concerns about the size of
their breasts, women may also worry about the
shape of their breasts. The cultural icon Barbie’s
breasts are not only large, but also firm and perky.
Breasts that sag or droop (i.e., “breast ptosis”)
deviate from prevailing ideals of beauty. As a
consequence, some women now pursue breast
lifts (mastopexy) in order to make their breasts
appear less droopy. In 2006, at least 101,122
women had a breast lift surgery in the U.S.
(American Society of Plastic Surgeons, 2007).
Although it is likely that breasts become droop-
ier with age, breast lifts were performed on
women of all ages. To our knowledge, little re-
search has systematically examined satisfaction
with this aspect of breast shape among a cross-
section of women.
Men’s Attitudes Toward Women’s Breasts
In several studies, many men report a prefer-
ence for women with larger rather than smaller
breasts (e.g., Harrison, 2003; Thompson &
Tantleff, 1992), although not all research finds
this pattern of results (e.g., Furnham, Swami, &
Shah, 2006). One important limitation of these
studies is that they asked men to characterize
their breast preferences in the abstract, rather
than assessing men’s beliefs about the breasts of
their current or past romantic partners. It is pos-
sible, for example, that even if some men prefer
women with large breasts, they might also find
women with smaller breasts very attractive and
be very satisfied with their romantic partner’s
smaller breast size. Further, some men may pre-
fer women with a smaller breast size. Finally,
although some research has examined men’s at-
titudes towards breast size, researchers have not
assessed men’s satisfaction with other aspects
of their romantic partner’s breasts, particularly
breast droopiness.
The Present Study
The present study reports findings from a
large-scale survey about body image among
adults ages 18 to 65. The first goal of this sur-
vey was to examine women’s overall satisfac-
tion with their breast size and droopiness. Two
unusual features of this project are noteworthy.
First, because our sample was large and ranged
in age across the lifespan, we were able to test
whether breast concerns differed by age. Given
changes in women’s bodies and breasts as they
age, we predicted that younger women would be
more concerned with size and that older women
would be more concerned with droopiness.
Another unusual feature of this data set was
the inclusion of a standardized approximation
of body fat level, the Body Mass Index (BMI),
which enabled us to assess the association be-
tween weight and breast concerns. Past research
has shown that heavier women tend to have
larger breasts as assessed by bra cup size (e.g.,
r= .36, Hall et al., 1999; r= .46, Forbes &
Frederick, in press). Therefore, we predicted that
thinner women, who have smaller breasts, would
be more likely than heavier women to desire
larger breasts. In contrast, heavier women would
be more likely to desire smaller breasts or to re-
port that their breasts were too droopy.
The second goal of this study was to exam-
ine whether women who reported dissatisfaction
with their breasts were more likely to experience
general dissatisfaction with their bodies. In par-
ticular, do women who are dissatisfied with their
breasts rate themselves as less attractive and feel
less comfortable in public venues in which their
body might be evaluated by others (e.g., when
wearing a swimsuit in public)?
The third goal of this study was to examine
whether these concerns regarding body exposure
also extend to the bedroom. Are women who
are dissatisfied with their breasts less willing to
reveal their bodies to their sexual partner? In
particular, are they less willing to undress in front
of their partner and more likely to try to conceal
their breasts from their partner during s ex?
Our fourth goal was to investigate men’s
attitudes towards their partner’s breast size
and droopiness. Given that one likely cause
of women’s breast dissatisfaction is a concern
that their male dating partners prefer partners
with larger breasts, it is important to document
whether men actually are dissatisfied with their
partner’s breasts.
A 27-item survey was posted on the and websites in February
of 2003. Participants were visitors who volun-
teered for a “Sex and Body Image Survey. To
prevent individuals from responding to the sur-
vey more than once, a computer program pre-
vented multiple responses from any given com-
puter. The present study is based on secondary
and more detailed analyses of this large dataset.
Participants and Demographics
Most respondents (98%) were from the website and only 2% were from
the website. The analyzed sample con-
sisted of 25,524 heterosexual men and 26,703
heterosexual women between the ages of 18 to
65, weighing 90 to 295 pounds, with body mass
index scores ranging from 14.5 to 40.5, and
heights ranging from 5
to 6
for women
and 5
to 6
for men. Individuals outside of
David A. Frederick et al. 203
these age, weight and height ranges were ex-
cluded because of small sample sizes. For more
details regarding the sample, refer to Frederick,
Peplau, and Lever (2006). We were forced to
exclude lesbian participants from the analyzed
samples because the wording of the breast satis-
faction question precluded us from determining
whether lesbians were indicating their attitudes
about their own breasts or about their female
partner’s breasts.
The mean age of participants was 33.5 (SD =
10.9) for women and 36.9 (SD = 11.8) for men.
Women and men were fairly well represented
across the age spectrum. For some analyses, age
groups were created. The percentages of women
and men in each category were as follows: 18–
25 (30% of men, 20% of women), 26–35 (31%,
29%), 36–45 (22%, 24%), 46–55 (14%, 18%),
and 56–65 (3%, 8%).
The mean height was 5
(SD = 2.7
women and 5
(SD = 2.8
) for men. The
men and women in this sample were about an
inch taller in height than the national data pro-
vided by the National Center for Health Statis-
tics (2004). This may reflect actual differences
in height between the samples, or it indicates
that the participants in our sample exaggerated
slightly when self-reporting their own height.
Body Mass Index (BMI)
BMI is commonly used as an estimate of
body fat, although other factors beside body fat
level can influence BMI scores (e.g., muscular-
ity). BMI is calculated by dividing a person’s
weight in kilograms by their squared height in
meters. A BMI score was computed for each
respondent. The mean BMI of participants was
24.2 (SD = 4.8) for women and 26.6 (SD =
4.0) for the men. Standard BMI cut-off points
described in the National Health and Nutrition
Examination Survey (2000) were used to cre-
ate four categories: Underweight (14.5–18.49),
Healthy Weight (18.5–24.99), Overweight (25–
29.99), and Obese (30–40.5).
Psychological Measures
Breast satisfaction
Breast satisfaction was assessed with a single
item, Are you satisfied with the size of your
own (or your partner’s) breasts?” Participants
could select one of four response options re-
flecting either satisfaction with their breasts or
dissatisfaction with their breast size or shape:
Satisfied (“yes, I like everything about them),
Desire Larger (“no, I wish they were bigger”),
Desire Smaller (“no, I wish they were smaller”),
or Too Droopy (“yes, I’m okay with the size but
unhappy they droop”). This variable was treated
as a categorical (nominal) variable in all analy-
ses. For some analyses, the Desire Larger, De-
sire Smaller, and Too Droopy categories were
collapsed into one category (“Dissatisfied”) to
create a dichotomous variable where Dissatis-
fied = 0 and Satisfied = 1.
Body exposure concerns
Respondents were asked about their possible
concerns with showing their body to a roman-
tic partner. Subjects without a current partner
were instructed to answer the questions think-
ing about the last partner they had. One question
asked,“Do you undress in front of your partner?”
with the response options being yes or no. Most
women (82%) reported undressing in front of
their partner. For some analyses, undressing in
front of one’s partner was coded as 1 and not
undressing was coded as 0. Another question
asked,“Do you ever try to hide a least favorite
physical feature during sex? Select all that ap-
ply. One of the six response options was “yes,
my breasts/chest. This response was selected
by 9% of women. For some analyses, reveal-
ing one’s breasts was coded as 1 and concealing
one’s breasts was coded as 0.
Body image: Self-rated attractiveness
Satisfaction with one’s appearance, or “body
image, was assessed with the item, “How do
you feel about your body?” Response options
were scored on the following Likert scale: 4 =
Great (“I have a great body”), 3 = Good (“I
have a good body”), 2 = Okay (“My body is just
okay”), and 1 = Unattractive (“I find my body
unattractive”). We elected to treat this variable
as interval for several reasons. First, we rea-
soned that participants would view these four
response choices as different from each other at
roughly equal intervals. Second, responses were
normally distributed (skewness < 1.0): The per-
centage of women responding in each category
was Great (5%), Good (38%), Okay (36%), and
Unattractive (21%). Third, in a separate sample
of 313 college women, responses to this one-
item measure of body image were strongly corre-
lated with Cash’s (2000) widely-used seven-item
Appearance Evaluation scale (Pearson’s r= .75,
p< .01; Frederick, Peplau, & Lever, 2006). This
strong correlation provided increased confidence
in this item as a measure of body satisfaction.
Body image: Comfort in a swimsuit
Body image satisfaction was also assessed
with the item, “How do you think you look in
a swimsuit?” Response options were scored on
the following Likert scale: 3 = Good (“Good;
I’m proud/not at all embarrassed to be seen in a
swimsuit”), 2 = Okay (“Okay; I don’t flaunt it
but my self-consciousness doesn’t keep me from
wearing a swimsuit”), and 1 = Uncomfortable
(“So uncomfortable that I avoid wearing one in
public”). For the reasons stated above, this vari-
able was also treated as interval. The percent-
age of women responding in each category was:
Good (12%), Okay (57%), and Uncomfortable
(31%). This measure was also significantly cor-
related with the Appearance Evaluation Scale
in the aforementioned study of college students
(r = .58, p<.01).
In the following sections, we first examine
women’s overall satisfaction with their breast
size and droopiness and whether satisfaction is
related to age, weight (BMI), body dissatisfac-
tion, and concerns with body exposure during
sexual activity. Finally, we report findings about
men’s satisfaction with their partner’s breasts.
Because of our large sample size, we established
p<.001 as our criterion for significance, and
we report effect sizes (Cohen’s d) where appro-
priate. By convention, dvalues of .2, .5, and .8
correspond roughly to small, medium, and large
effects (Cohen, 1988). When reporting results
in percentages, we do not report the results of
all possible Chi Square tests because with our
large sample size, even miniscule effects reach
statistical significance, limiting their usefulness
for identifying important differences. Statistics
on specific comparisons are available from the
Women’s Breast Satisfaction: Associations
with Age and BMI
Among this large and diverse sample of
women, breast dissatisfaction was widespread.
As shown in Table 1, fully 70% of women were
not satisfied with some aspect of their breasts.
Most women who were dissatisfied wanted less
droopy breasts (33%) or larger breasts (28%). A
small minority (9%) of women desired smaller
breasts. Overall, less than one woman in three
was satisfied with her breasts.
TABLE 1. Women’s and men’s breast satisfaction across age groups
Women Men
Satisfied Desire Desire Too Satisfied Desire Desire Too
% Larger % Smaller % Droopy % % Larger % Smaller % Droopy %
Age Group
18–25 33 38 7 22 63 24 2 11
26–35 29 27 9 35 53 24 3 20
36–45 26 23 9 42 51 21 4 24
46–55 30 18 10 42 58 15 5 22
56–65 31 11 11 47 61 11 7 21
Overall 30 28 9 33 56 20 4 20
David A. Frederick et al. 205
As shown in Table 1, the percentage of women
satisfied with their breasts was similar across age
groups (range = 26%–33%). However, as pre-
dicted, age was related to specific breast con-
cerns. Younger women were most likely to ex-
press a desire for larger breasts, while older
women were most likely to indicate that their
breasts were too droopy. To examine the rela-
tionship between age and type of breast concern
in more detail, the percentage of women desir-
ing breasts that were larger and those wishing
for breasts that were less droopy was calculated
for each age. As shown in Figure 1, the desire for
larger breasts was greatest among young women
while concerns about breast droopiness were
greatest among successive age groups. Starting
at about age 30, concerns with droopiness ex-
ceeded concerns with size.
Body fat level (BMI)
We also predicted that thinner women would
be more concerned with the size of their breasts
compared to heavier women, while heavier
women would be more concerned about their
breast droopiness. As shown in Table 2, the per-
centage of women who were satisfied with their
breasts was similar among underweight, healthy,
and overweight women (28%–33%), but the per-
centage who were satisfied was substantially
lower among obese women (19%). Women’s
specific breast concerns also differed by body
fat level. More than half of underweight and a
third of the healthy weight women desired larger
breasts, compared to only 15% of overweight
women and 9% of obese women. In contrast,
overweight and obese women were considerably
more likely to desire smaller breasts or to view
their breasts as too droopy.
Women’s Breast Satisfaction and Overall
Body Image
The second goal of this study was to test
the association between breast satisfaction and
women’s general appraisal of their body. To
compare the body image of women differing
FIGURE 1. Percentage of women indicating that they desired larger breasts or thought their breasts
were too droopy as a function of age. Note. Younger women were more likely to desire larger breasts,
while older women were more likely to desire less droopy breasts.
18 23 28 33 38 43 48 53 58 63
Percent of Women
Desire Larger Breasts Breasts Too Droopy
TABLE 2. Percentage of women who chose each breast satisfaction category by
weight (BMI) category
Breast Satisfaction
BMI Satisfied % Desire Larger % Desire Smaller % Too Droopy %
Underweight 30 53 3 14
Healthy Weight 33 33 6 28
Overweight 28 15 13 44
Obese 19 9 19 53
Overall 30 28 9 33
in breast satisfaction (Satisfied, Desire Bigger,
Desire Smaller, and Too Droopy), two one-way
ANOVAs were conducted with self-rated attrac-
tiveness and comfort in a swimsuit as the de-
pendent variables. There was a significant main
effect of breast satisfaction on both self-rated
attractiveness, F (3, 26699) = 900.82, p<.001,
and comfort in a swimsuit, F (3, 26699) =
506.24, p<.001.
We then conducted pairwise comparisons
(LSD) to determine whether women who were
satisfied with their breasts reported better body
image than other women. As predicted, these
comparisons revealed that women who were sat-
isfied with their breasts rated themselves as sig-
nificantly more attractive than women who de-
sired smaller (d = .51), larger (d = .29), or less
droopy breasts (d = .69; all ps < .001). Sim-
ilarly, comparisons for women’s comfort in a
swimsuit revealed that women who were sat-
isfied with their breasts felt significantly more
comfortable in a bathing suit than women who
desired smaller (d = .66), larger (d = .17), or
less droopy breasts (d = .51; all ps < .001).
These findings may be partially a product of
the fact that breast shape and size differ ac-
cording to age and BMI. However, even when
age and BMI were entered as covariates in
the ANOVA, women who were satisfied with
their breasts still reported higher attractiveness
and comfort in a swimsuit, all ps < .001. The
marginal means are reported in Figure 2. As pre-
dicted, these comparisons revealed that women
who were satisfied with their breasts rated
themselves as significantly more attractive than
women who desired smaller (d = .54), larger
(d = .50), or less droopy breasts (d= .48; all
ps < .001). Similarly, comparisons for women’s
comfort in a swimsuit revealed that women
who were satisfied with their breasts felt signif-
icantly more comfortable in a bathing suit than
women who desired smaller (d = .35), larger
(d = .32), or less droopy breasts (d = .33; all
ps < .001).
Women’s Breast Satisfaction and
Concerns about Body Exposure to their
Sexual Partner
A third goal was to examine the association
between women’s views of their breasts and their
attitudes toward revealing their body to their ro-
mantic partner. As shown in Table 3, the majority
of women reported undressing in front of their
partner and revealing their breasts during sex.
Women who were dissatisfied with their breasts,
however, were more likely than other women to
conceal their breasts, either when undressing or
during sexual activity. Across all body fat lev-
els, women who were satisfied with their breasts
were more likely to report undressing in front
of their partner and less likely to report con-
cealing their body during sexual activity. An ex-
ception to this pattern, however, was that under-
weight women who felt that their breasts were
too droopy were just as likely to undress in front
of their partner as underweight women who were
satisfied with their breasts. Interestingly, under-
weight women who desired larger breasts were
most likely conceal their breasts during sex, per-
haps reflecting an increased concern with not
having large, “feminine” breasts.
These observed associations, however, do
not take into account the fact that breast
David A. Frederick et al. 207
FIGURE 2. Women’s mean self-ratings of body attractiveness and comfort in a swimsuit as a func-
tion of their satisfaction or concern with their breasts. Note. Higher mean scores indicate more
positive self-ratings. Women who were satisfied with their breasts reported greater self-rated at-
tractiveness and comfort in a swimsuit than other women.
dissatisfaction, overall self-rated attractiveness,
BMI, and age are intercorrelated. Is breast size
dissatisfaction predictive of concerns with body
exposure during sex above and beyond these
other factors? To examine this question, we stan-
dardized these measures (z-scored) and coded
the breast satisfaction variables as women who
were dissatisfied (0) versus satisfied (1). These
variables were entered as predictors of willing-
ness to undress in front of one’s partner and to
reveal one’s breasts during sexual activity. As
shown in Table 4, even when controlling for
TABLE 3. Percentage of women who undress in front of a partner and who hide their
breasts during sex by breast satisfaction and weight (BMI) category
Breast Satisfaction
Satisfied Desire Larger Desire Smaller Too Droopy
Undress in Front of Partner? % Yes
BMI Category
Underweight 88 84 76 89
Healthy Wt. 90 84 81 84
Overweight 86 75 76 77
Obese 81 65 66 68
Overall 88 82 75 79
Hide Breasts during Sex? % Yes
BMI Category
Underweight 2 26 12 18
Healthy Wt. 1 18 11 10
Overweight 1 12 7 6
Obese 1 7 9 5
Overall 1 17 9 8
TABLE 4. Breast satisfaction predicts concerns with body exposure during sex when
controlling for other variables
Undress in Front of Partner? Hide Breasts During Sex?
Odds Ratio p Odds Ratio P
Breast Satisfaction 1.31 .000 9.95 .000
Self-Rated Attractiveness 2.19 .000 1.45 .000
BMI 1.03 .061 1.84 .000
Age 1.03 .137 1.29 .000
Model df, Total N 4,27368 4,27368 .000
Model Chi-Square 2398 .000 1796 .000
Cox & Snell / Nagelkerke
.08/.14 .000 .06/.14 .000
Note. When controlling for other variables, women who were satisfied with their breasts were 1.31 times more likely to report
undressing in front of their partner and 9.95 times more likely to reveal their breasts during sexual activity.
other variables, women who were satisfied with
their breasts were 1.31 times more likely to re-
port undressing in front of their partner and 9.95
times more likely to reveal their b reasts during
sexual activity than women who were not satis-
fied with their breasts.
Men’s Satisfaction with the Size and
Shape of their Partner’s Breasts
A fourth goal was to investigate the extent
of men’s satisfaction with their partner’s breast
size and shape. These results are summarized in
Table 1. The majority of men (56%) were satis-
fied with their partner’s breasts. Men who were
dissatisfied were equally split between those de-
siring a partner with larger breasts (20%) and
those desiring a partner with less droopy breasts
(20%). Only 4% of men wished that their part-
ner had smaller breasts. The percentage of men
who were satisfied with their partner’s breasts
was fairly similar across all age groups. Paral-
lel to findings for women, the type of breast
dissatisfaction expressed by men differed with
age. The percentage of men wishing their part-
ner had larger breasts declined steadily across
the age groups. Dissatisfaction with droopiness
had a weaker association with age. Few men in
the youngest age group (18–25) reported dissat-
isfaction with the droopiness of their partner’s
breasts; among men ages 26–65, the degree of
dissatisfaction with droopiness was higher (20–
24% of men) but fairly similar across all other
age groups.
Women’s Breast Satisfaction: Associations
with Age and BMI
In this large and diverse sample, a majority of
women (70%) expressed discontent with their
breasts, suggesting that this is a pervasive con-
cern for women. A strength of this research was
our ability to carefully examine the association
of breast satisfaction with both age and body fat
level. Age proved to be a significant factor. Al-
though the percentage of women who were dis-
satisfied was similar across age groups, the pri-
mary concerns of these dissatisfied women dif-
fered by age. As predicted, younger women were
more likely than older women to express dissat-
isfaction with breast size, while older women
were more likely to report concerns with the
droopiness of their breasts. This pattern is likely
tied to the changes that occur in women’s bodies
and breasts as they age. Surprisingly, however,
breast droopiness was cited as a concern among
women in all age groups. In addition to age, body
fat level as assessed by BMI was also an impor-
tant predictor of breast concerns among women.
In particular, underweight and healthy weight
women were most likely to report concerns about
their breasts being too small, while ove rweight
and obese women were most likely to feel that
their breasts were too large or too droopy. This
is likely reflective of the fact that thinner indi-
viduals are more likely to have smaller breasts
(Forbes & Frederick, in press; Hall et al., 1999).
David A. Frederick et al. 209
Women’s Breast Satisfaction: Associations
with Body Image and Sexuality
Women who were satisfied with their breasts
rated themselves as more attractive and were
more comfortable in a swimsuit than women
who were unhappy with their breast shape or
size, and this was true even when controlling for
age and level of body fat. All but one of the 12 ef-
fect size calculations showed that the differences
between the satisfied women and the dissatisfied
women were small to moderate (ds = .32–.69;
in the exception, d = .17). Many of these com-
parisons were similar in magnitude to the widely
known and notable differences between men and
women in overall body dissatisfaction (d = .52;
Feingold & Mazzella, 1998). This suggests that
breast dissatisfaction may be an important factor
that contributes to overall body dissatisfaction.
Consistent with past research showing that
overall body dissatisfaction is linked to sexual
esteem and anxiety (Weaver & Byers, 2006), in
this study both body and breast dissatisfaction
were related to women’s body concerns during
sex. Women who were not satisfied with their
breasts were more likely to avoid undressing in
front of their partner and to hide their breasts dur-
ing s exual activity. This pattern generally held
true regardless of a woman’s level of body fat, al-
though underweight women who desired larger
breasts were the group most likely to hide their
breasts during sexual activity. The overt sexu-
alization of women’s breasts and the resulting
concerns that women have regarding how their
breasts are evaluated may be one reason that
women who are dissatisfied with their breasts
attempt to conceal them from their partner. It is
important to note, however, that the majority of
women did undress in front of their partner and
reveal their breasts during sex.
Men’s Satisfaction with the Size and
Shape of their Partner’s Breasts
An important contribution of this research
was to assess men’s satisfaction with their part-
ner’s breasts. In contrast to women’s overwhelm-
ing dissatisfaction, the majority of men (56%)
were satisfied with their partner’s breasts. De-
spite pervasive images of large-breasted women
in the media and past research suggesting that
most men rate large breasts as ideal (e.g.,
Tantleff-Dunn & Thompson 2000), only 20% of
men in our sample cited bigger breasts as their
top concern regarding their partner’s breasts.
This suggests that regardless of the breast size
that men rate as “ideal” in the abstract, the major-
ity of men are satisfied with their actual partner’s
breast size. When men did express dissatisfac-
tion, they typically reported that they preferred
their partner’s breasts to be larger or less droopy;
fewer than 1 in 20 wished their partner’s breasts
were smaller. Young men were most likely to
wish that their partner’s breasts were larger. It is
unclear whether this is because young men have
grown up in an era where breast augmentation is
widely available or because breast droopiness is
less common among younger women. Although
most men in this sample reported satisfaction
with their partner’s breasts, a substantial minor-
ity reported some level of dissatisfaction. The
dissatisfaction reported by these men may be an
important factor contributing to the dissatisfac-
tion that many women feel about their breasts.
An intriguing finding from this research
was the discrepancy between the frequency of
women’s and men’s breast concerns. Although
most women in our sample were dissatisfied
with their breasts, a majority of men were sat-
isfied with their partner’s breasts. This finding
fits a larger pattern of results in the body im-
age literature suggesting that people overesti-
mate the importance of various physical traits
to the other sex (e.g., Frederick, Fessler, &
Haselton, 2005; Jacobi & Cash, 1994). For ex-
ample, women overestimate the degree of thin-
ness (e.g., Fallon & Rozin, 1985) and the breast
size (Tantleff-Dunn, 2001) preferred by men.
In addition, nearly half of men are dissatisfied
with their penis size despite the fact that the vast
majority of women report being very satisfied
with their partner’s penis size (Lever, Freder-
ick, & Peplau, 2006). In short, individuals may
be much more self-critical of their bodies than
they need to be. Thus one source of women’s
breast dissatisfaction may be an overestimation
of the breast size preferred by their romantic
partners, or an overestimation of the impor-
tance that their partners place on breast size.
Further research about systematic discrepancies
between men’s and women’s beliefs about their
bodies is needed. Studies assessing the view-
points of both partners in couples would be es-
pecially informative.
Limitations of the study should be mentioned.
To increase participation rates, the survey was
necessarily short and relied on single-item mea-
sures of key variables. However, it is important
to note that this limitation is shared by most
other research on breast concerns, which has
also relied on one-item measures of breast sat-
isfaction (e.g., Forbes, Jobe, & Revak, 2006;
Harrison, 2003; Jacobi & Cash, 1994; Koff &
Benavage, 1998; Tantleff-Dunn & Thompson,
2000; Thompson & Tantleff, 1992; for an excep-
tion, see Forbes & Frederick, in press). Because
our project was based on secondary analysis and
the items had not been constructed by the au-
thors, several of the items had less than ideal
wording and psychometric properties. For exam-
ple, although we can document the percentage of
women who are not satisfied with their current
breasts, we cannot draw conclusions about the
intensity of their dissatisfaction. Further, women
were only given the opportunity to select one of
the breast dissatisfaction options (desire smaller,
desire larger, or too droopy). Although this had
the advantage of isolating women’s primary con-
cern, we were unable to examine the percentage
of women who were dissatisfied with both the
size and droopiness of their breasts.
Concluding Comments
Past research on body image has suggested
that the intense sexualization and objectifica-
tion of women’s breasts may result in many
women b eing dissatisfied with their breasts.
The present research demonstrated that con-
cerns about breast size and shape are indeed
widespread among women, to the point that
many women try to conceal their breasts from
their sexual partners. Additional research is
needed to document the intensity of this dissat-
isfaction and the degree to which these concerns
interfere with women’s e njoyment of their sex
life and detract from their psychological well-
being. It will also be important to identify in-
terventions on both a societal and personal level
that may be effective in reducing women’s dis-
satisfaction with their breasts without resorting
to elective breast surgery.
For additional papers and information, please
contact David Frederick at
or visit his website at
We thank Elle magazine for access to the data
from the ELLE/ Sex and Body Im-
age Surve y. The authors are grateful to the
UCLA Graduate Division, the Center for Cul-
ture, Brain, and Development, and the depart-
ment of Psychology, for providing financial sup-
port for the first author. We are also grateful to the
National Institute of Health, who supported the
first author, Grant # 1F31MH072384-01. Thanks
also to Carol Edwards, who helped create the
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RECEIVED: 5/14/07
ACCEPTED: 11/14/07
... 4,5 These sociocultural standards often persuade women that their worth, femininity and sexuality are dictated by their body and breast appearance. 6 The frequent portrayal of desirable and feminine icons as women with large breasts and a disproportionally thin figure, which is anthropometrically scarce, 7 generates further discourse in self-perception and a failure to meet societal standards of 'normality'. 5,6 It is therefore not surprising that researchers examining breast dissatisfaction among women from 40 nations (Western and non-Western) reported that only 29.3% of women were satisfied with their breasts (47.5% of women wanted larger breasts and 23.2% wanted smaller breasts). ...
... 5,6 It is therefore not surprising that researchers examining breast dissatisfaction among women from 40 nations (Western and non-Western) reported that only 29.3% of women were satisfied with their breasts (47.5% of women wanted larger breasts and 23.2% wanted smaller breasts). 2 Specifically, only 28% of womens in Australia reported satisfaction with their breast size. 2 These elements are key factors influencing perceived body image among women, 2,7 and central to understanding how variations in breast appearance affect a woman's breast satisfaction. ...
... Our finding that women with larger breasts were significantly less satisfied with their breasts conflicts with societal standards and beliefs that suggest large breasts are congruent with femininity, beauty and sexual attractiveness. [5][6][7] Previous research has reported women with perceived large breasts have greater breast satisfaction compared to their counterparts with perceived small breasts. 6 It is noted, however, that breast size in this study was objectively quantified, with participants in this study representing a wide range of breast sizes (48-2,789 mL per breast) and with ~10% of participants (n = 37) having hypertrophic breasts (breast volumes > 1,200 mL). ...
Full-text available
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... The Satisfaction with Racially Salient Appearance Features (SAT-R; Warren, 2014), is comprised of 32 items across eight subscales for measuring respondents' degree of dissatisfaction with their Overall Body (global scale), Lower Body, as well as a number of individual body features (skin, nose, facial structure, eyes, hair, and lips) on a five-point Likert-type scale from "very dissatisfied" to "very satisfied." We used Lower Body subscale was used, as it includes areas of the curvaceous ideal (e.g., buttock size, buttock shape, and hip size) that are generally overlooked in body image research (Forbes & Frederick, 2008;Frederick et al., 2008). Additionally, we used the Overall Body subscale to extend the majority of the extant body image literature that relies on weight and BMI (see Cordero & Gutierrez, 2016;Viladrich et al., 2009). ...
Latinx women face a myriad of unique pressures to meet unrealistic standards of beauty that are not captured in the dominant, Eurocentric framework of beauty and body image in the U.S. The majority of the extant body image literature represents the experiences of White women and overlooks salient body areas that women of color may experience dissatisfaction with. The present researchers employed a convergent-parallel mixed methods design to examine demographic differences as well as the lived experiences of Latinx women’s relationship with beauty and their bodies. Quantitative results from 118 participants revealed that Latinx women with an annual income< 60k (54.2%) reported a higher discrepancy between their actual and ideal buttock size compared to Latinx women with an annual income> 60k (45.8%). Furthermore, a thematic analysis revealed four emergent themes that reflected the unique perceptions and lived experiences of 98 Latinx women’s experiences with body image. Findings may assist clinicians working with Latinx women, as they will be able to better understand and integrate relevant cultural aspects of body dissatisfaction when working with Latinx clients.
... Men and women also have specific concerns with sexually-dimorphic aspects of their bodies that could impact sexuality-related body image that should be measured. For example, many women are concerned with the size or shape of their breasts (Forbes & Frederick, 2008;Frederick, Peplau, & Lever, 2008) and genitals (Amos & McCabe, 2016), and many men are concerned with their penis size (Johnston, McLellan, & McKinlay, 2014;. People who are dissatisfied with their genitals tend to report lower sexual satisfaction (see Gillen & Markey, 2018). ...
Body image is a critical component of an individual’s sexual experiences. This makes it critical to identify demographic and sociocultural correlates of sexuality-related body image: the subjective feelings, cognitions, and evaluations related to one’s body in the context of sexual experience. We examined how sexuality-related body image differed by gender, sexual orientation, race, age, and BMI. Four items assessing sexuality-related body image were completed by 11,620 U.S. adults: self-perceived sex appeal of their body, nude appearance satisfaction, and the extent to which they believed that body image positively or negatively affected their sexual enjoyment and feelings of sexual acceptability as a partner. Men reported slightly less nude appearance dissatisfaction and fewer negative effects of body image on sexual enjoyment and sexual acceptability than women, but did not differ in reported sex appeal. Poorer sexuality-related body image was reported by people with higher BMIs, not in relationships, who had sex less frequently, among White compared to Black women and men, and among gay compared to heterosexual men. Data also revealed a subgroup of respondents who reported that their body image had a positive impact on their sex lives. The findings highlight a need for interventions addressing sexuality-related body image.
... Over the past 20 years, most national studies in the United States focusing on affective body image have relied on one-item measures of key constructs (Frederick & Essayli, 2016;Frederick et al., 2006;Frederick et al., 2008;Frederick, Garcia, et al., 2020;Krueger et al., 2008;Lever et al., 2006;Lever, Frederick, Laird & Sadeghi-Azar, 2007;Peplau et al., 2009;Swami et al., 2015). This provided useful information, but body image is a multidimensional construct consisting of cognitive, behavioral, affective, and perceptual factors (Banfield & McCabe, 2002). ...
We examined how gender, body mass, race, age, and sexual orientation were linked to appearance evaluation, overweight preoccupation, and body image-related quality of life among 11,620 adults recruited via Mechanical Turk. Men were less likely than women to report low appearance evaluation, high overweight preoccupation, negative effects of body image on their quality of life, being on a weight-loss diet, and trying to lose weight with crash diets/fasting. Racial differences were generally small, but greater appearance evaluation was reported by Black men versus other groups and Black women versus White women. Across all measures, gay and bisexual men reported poorer body image than heterosexual men, with only small effect sizes observed for sexual orientation differences among women. Body mass, but not age, was strongly associated with body image. The prevalence of poor body image highlights the need for interventions. On the positive side, half of men and women reported high appearance evaluation. Examination of this group could identify factors promoting positive body image.
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We examined how demographic factors (gender, sexual orientation, racial group, age, body mass) were. linked to measures of sociocultural appearance concerns derived from objectification theory and the tripartite influence model (McKinley & Hyde, 1996; Schaefer et al., 2015) among 11,620 adults. Men were less likely than women to report high body surveillance, thin-ideal internalization, appearance-related media pressures, and family pressures; did not differ in peer pressures; and reported greater muscle/athletic internalization. Both men and women expressed greater desire for their bodies to look “very lean” than to look “very thin”. Compared to gay men, heterosexual men reported lower body surveillance, thin-ideal internalization, peer pressures, and media pressures. Black women reported lower thin-ideal internalization than White, Hispanic, and Asian women, whereas Asian women reported greater family pressures. Being younger and having higher BMIs were associated with greater sociocultural appearance concerns across most measures. The variation in prevalence of sociocultural appearance concerns across these demographic groups highlights the need for interventions.
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The current study examined the prevalence and correlates of over 50 sexual practices in a national survey of heterosexual and lesbian women in relationships. Coarsened exact matching was used to create comparable samples of heterosexual (n = 2510) and lesbian (n = 283) women on six demographic factors, including relationship length. Heterosexual and lesbian women were equally likely to be sexually satisfied (66% heterosexual women vs. 68% lesbian women). Compared to heterosexuals, lesbians were more likely to report having sex 0–1 times per month (11% vs. 23%) and were less likely to report having sex greater than once per month (89% vs. 77%). Among women who had been in relationships for longer than 5 years, heterosexual women were less likely than lesbian women to report having sex 0–1 times per month (15%; 42%). This steeper drop in sexual frequency among lesbian women than heterosexual women has pejoratively been labeled lesbian bed death. Rather than accept the label “lesbian bed death” as characterizing these sexual relationships, we turn our attention to what we call lesbian bed intimacies: the myriad ways that lesbian women incorporate behaviors promoting emotional connection, romance, and mood setting, as well as relying on a wide variety of specific sexual acts (e.g., use of sex toys) and sexual communication. Compared to heterosexual women, lesbian women were more likely to usually to always receive oral sex during sex in the past month (28%; 47%) and to use sex toys in the past year (40%; 62%). In their last sexual encounter, lesbian women were more likely to say “I love you” (67%; 80%), have sex longer than 30 min (48%; 72%), and engage in gentle kissing (80%; 92%). These intimacies likely help explain why sexual satisfaction was similar in these groups despite notable differences in sexual frequency.
... Aesthetics N/A Five VAS's assessed bra style, the look of the bra, bra coverage, how the patient felt in the bra and the shape of the breasts in the bra [42][43][44][45][46]. VAS = Visual Analogue Scale. ...
Background and Purpose: Breast pain is a common condition presented at breast care clinics and bras are often recommended to reduce symptoms, although criteria and pathways for obtaining appropriate bras are limited. This multi-study, randomised controlled trial (RCT) aimed to establish criteria and performance variables to prescribe bras for breast pain patients, to implement this bra prescription, and evaluate whether, compared to standard care alone, the bra prescription improves breast pain and quality of life (QoL). Materials and methods Eighteen breast pain patients from a UK hospital were assigned to standard care or bra prescription groups and completed the study. Bra prescription patients were prescribed a bra to wear every day for eight weeks. Patient Global Impression of Change (PGIC), breast pain intensity, QoL, and adherence were assessed. Results Between-groups there were no differences in baseline breast pain or QoL and no differences in PGIC or breast pain following the intervention. Within-groups, improvements in QoL within bra prescription patients were identified. Conclusion This study developed a framework for bra prescription for breast pain patients and the intervention demonstrated improvements in QoL.
Background:. Little is known about how satisfied women are with their breasts and which factors influence breast satisfaction. Therefore, the aim of this study was to elucidate this by collecting data on breast satisfaction from the general population in relation to age, body mass index, lifestyle, psychological, and physical well-being. Method:. This study was a cross-sectional population survey performed in 2019 in the north of the Netherlands, among randomly selected women between 20 and 80 years. Breast satisfaction was measured in the 1334 participants with the preoperative reconstruction BREAST-Q module. Other applied questionnaires were the Hospital Anxiety and Depression Scale, Short Form Survey (SF-36), and a custom-made questionnaire on lifestyle and baseline characteristics. Representativeness was assessed by comparing the participants with Dutch normative data. Possible factors influencing “satisfaction with breasts” were analyzed using multivariate linear regression analyses. Results:. The median (IQR) BREAST-Q score for “satisfaction with breasts” was mediocre: 63 (58–79) on a 0–100 scale. Higher age and higher SF-36 scores had a positive effect on breast satisfaction (P < 0.001 and P < 0.001, respectively) and a higher body mass index, smoking and anxiety score greater than 8 were negatively associated (P < 0.001, P = 0.013 and P < 0.001 respectively, multivariate linear regression analyses). Conclusion:. These data are the first European normative data and can serve as a reference in future population and patient-based studies regarding breast satisfaction.
The goal of this study was to examine breastfeeding behavior and attitudes as predictors of women’s body image and weight control behavior. This study extends past research by focusing on positive body image variables including body appreciation and perceived body functionality. Women (N = 597) from the United States who had recently birthed biological babies ages 0–12 months participated in an online study. Current breastfeeding rates were high (86 %), and average breastfeeding duration was approximately 3 months. Women who were currently breastfeeding indicated more positive body images and less likelihood of engaging in maladaptive weight control behaviors than women who were no longer breastfeeding or had never breastfed their baby. Women’s positive attitudes toward breastfeeding were associated with awareness and appreciation of body functionality and fewer maladaptive weight control behaviors. These findings extend research on the health benefits of positive body image and suggest that breastfeeding may occur within a constellation of beliefs and behaviors indicative of positive body image.
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This article offers objectification theory as a framework for understanding the experiential consequences of being female in a culture that sexually objectifies the female body. Objectification theory posits that girls and women are typically acculturated to internalize an observer's perspective as a primary view of their physical selves. This perspective on self can lead to habitual body monitoring, which, in turn, can increase women's opportunities for shame and anxiety, reduce opportunities for peak motivational states, and diminish awareness of internal bodily states. Accumulations of such experiences may help account for an array of mental health risks that disproportionately affect women: unipolar depression, sexual dysfunction, and eating disorders. Objectification theory also illuminates why changes in these mental health risks appear to occur in step with life-course changes in the female body.
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This study looked at the contribution of body weight, breast size and waist-to-hip ratio (WHR) in ratings of female attractiveness, femininity, health and fecundity. One hundred and fifty eight participants rated 36 line drawings that varied 2 levels of breast size, 3 of body weight and 6 of WHR. Whilst there was evidence of some differences between the four ratings there was a clear pattern. Effect sizes were higher for WHR (0.34–0.52) than body weight (0.14–0.31), whilst there were no main effects for breast size. The body weight×WHR interactions were marginally significant while WHR×breast size interactions had effect sizes ranging from 0.16 to 0.23. Work in this area appears to yield different results and conclusions depending on the stimulus materials used and the data analysis method employed.
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The media equate a man's penis size with his power and masculinity. Views about penis size were assessed in an Internet survey of 52,031 heterosexual men and women. Most men (66%) rated their penis as average, 22% as large, and 12% as small. Self-reported penis size was correlated positively with height and negatively with body fat level. Whereas 85% of women were satisfied with their partner's penis size, only 55% of men were satisfied with their penis size, 45% wanted to be larger, and 0.2% wanted to be smaller. Satisfaction did not vary across age groups from 18 to 65. Men reporting a larger-than-average penis rated their appearance most favorably, suggesting a possible confidence effect of perceived large penis size. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Perceived breast size, breast size satisfaction,body image (body satisfaction and generalized appearancesatisfaction) and psychological functioning(self-esteem, self-consciousness, and generalizedappearance preoccupation), as well as stereotyping ofbreast size, were examined in 166 Caucasian and AsianAmerican college women. Caucasian women reportedslightly larger perceived and ideal breast sizes, but no significant group differences for any of theother variables were found; groups were combined forsubsequent analyses. Both large and small breastednesswere associated with lower breast size satisfaction. Hierarchical regression analyses, controllingfor body size (assessed indirectly by a weightpreoccupation measure) and including the interaction ofperceived breast size and breast size satisfaction,yielded main effects for weight preoccupation,perceived breast size, and satisfaction with breastsize, but no interactions. Over and above the effect ofweight preoccupation, smaller perceived breast size was associated with lower breast size satisfactionand with more positive body image, while larger size wasassociated with higher breast size satisfaction and withless positive body image. Lower self-esteem was associated with lower breast sizesatisfaction but not with perceived breast size, whilehigher public self-consciousness, social anxiety, andappearance preoccupation were associated with a mismatch between ideal and perceived size, regardless ofwhether ideal size was smaller or larger than perceivedsize. Implications of these findings are discussedwithin the broader cultural context.
It has been speculated that the prevalence of eating disorders in women has risen because of increases in women's body dissatisfaction. We conducted a meta-analysis of gender differences in attractiveness and body image using 222 studies from the past 50 years. The analysis shows dramatic increases in the numbers of women among individuals who have poor body image. Moreover, these trends were found across multiple conceptualizations of body image, including self-judgments of physical attractiveness.
Using a measure of body image consisting of schematic figures of males and females differing only in chest/breast (CB) size, 73 female and 57 male undergraduates estimated their own CB size, selected their ideal conception of CB, and rated the size they thought reflected the average male's and female's preference for CB. Ss also made ratings based on the size that they thought best characterized descriptors of the figures. Overall, findings reflected a bias for large CB sizes. Both S groups rated their own CB size as significantly smaller than all other ratings. Men's conception of an ideal breast was larger than women's conception. Both genders said that the average male prefers a larger chest and breast than does the average female. Positive descriptors were consistently associated with larger size ratings. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Testing self-discrepancy theories of body image, this investigation examined self-perceived and idealized physical attributes among 66 men and 69 women, who were white, heterosexual college students. Physical attributes included body size, weight, height, muscularity, hair color and length, eye color, and female breast size. Physical ideals included personal ideals, assumptions about the other sex's ideals for one's own sex, and actual other-sex ideals. Both sexes expressed significant self-ideal discrepancies on most attributes, whether ideals were assessed from personal or perceived other-sex standpoints. The sexes' discrepancies were often comparable in magnitude if the direction of discrepancy was ignored. Both sexes frequently exaggerated their assumptions of what the other sex idealized in the subjects' own sex. Particular self-ideal discrepancies predicted subjects' global body image. The applied and empirical implications of these findings were considered for both social and clinical contexts.
Problems related to negative body image are very common among young women. In this study, we examined the relationship between women's body image and their sexual functioning over and above the effects of physical exercise and body mass index (BMI) in a sample of 214 university women. Low situational body image dysphoria and low body dissatisfaction were associated with high sexual assertiveness and sexual esteem, low sexual anxiety, and fewer sexual problems. Positive body image was significantly associated with better sexual functioning, even after controlling for BMI and exercise. Although related to body image, BMI and exercise did not predict sexual functioning. These results were interpreted as indicating that a woman's subjective body image is significantly related to her sexual functioning beyond the effects of actual body size and level of physical exercise.
Most studies on women with breast cancer indicate that obesity is positively associated with late-stage disease. Some results have shown a similar relationship between breast size and stage. A recent study found that the association between body mass index (BMI) and stage was limited to cancers that were self-detected, suggesting that the BMI-stage relation may be due to delayed symptom recognition. We examined the relationships between stage and both BMI and breast (bra cup) size, stratified by method of detection, using data from a population-based case-control study of 1,361 women (ages 20–44 years) diagnosed with breast cancer during 1990–1992. Height and weight measurements and information on bra cup size, method of cancer detection and other factors predictive of stage at diagnosis were collected during in-person interviews. A case-case comparison was conducted using logistic regression to estimate odds of regional or distant stage rather than local stage in relation to BMI and bra size. Odds of late-stage disease were increased with higher BMI [adjusted odds ratio (OR) for highest to lowest tertile = 1.46, 95% confidence interval (CI) 1.10–1.93] and larger bra cup size (OR for cup D vs. cup A = 1.61, 95% CI 1.04–2.48). These relationships were not modified by the method of detection. Differences in etiologic effects, rather than differences in detection methods, may explain the relations observed between stage and both BMI and breast size. Int. J. Cancer 82:23–27, 1999. © 1999 Wiley-Liss, Inc.