Senses of body image in adolescents in elementary school.

OBJECTIVE: To comprehend the perception of body image in adolescence.
METHODS: A qualitative study was conducted with eight focus groups with 96 students of both sexes attending four public elementary school institutions in the city of Rio de Janeiro, Southeastern Brazil, in 2013. An interview guide with questions about the adolescents' feelings in relation to: their bodies, standards of idealized beauty, practice of physical exercise and sociocultural influences on self-image. In the data analysis we sought to understand and interpret the meanings and contradictions of narratives, understanding the subjects' context and reasons and the internal logic of the group.
RESULTS: Three thematic categories were identified. The influence of media on body image showed the difficulty of achieving the perfect body and is viewed with suspicion in face of standards of beauty broadcast; the importance of a healthy body was observed as standards of beauty and good looks were closely linked to good physical condition and result from having a healthy body; the relationship between the standard of beauty and prejudice, as people who are not considered attractive, having small physical imperfections, are discriminated against and can be rejected or even excluded from society.
CONCLUSIONS: The standard of perfect body propagated by media influences adolescents' self-image and, consequently, self-esteem and is considered an unattainable goal, corresponding to a standard of beauty described as artificial and unreal. However, it causes great suffering and discrimination against those who do not feel they are attractive, which can lead to health problems resulting from low self-esteem.

INTRODUCTION

Issues relating to body image are becoming more and more apparent in the field of health and influence the way the subject constructs their identity, as well as the way they perceive their own body and what they view as healthy. Research into body image shows its relationship with pathologies such as depression and eating disorders, associated with the negative side of body image, expressing the subject’s dissatisfaction with their own body. , , Moreover, sociocultural influences, such as idealized figures in the media, diets, the way being thin is valued and personal insults from peers on being overweight are recognized risk factors for increased dissatisfaction with the body. ,

Evaluating the development and expression of body image is very relevant to public health, especially in the period of adolescence, when dissatisfaction with the body is highly prevalent. , Adolescence is a period in which the individual undergoes significant, potentially negative, bio-psycho-social changes and is “morbidly preoccupied with how they appear to others”. However, the majority of research on body image is conducted with adults and is of a quantitative nature, which does not the allow process through which the studied groups’ perceptions, attitudes and social representations are constructed to be studied. ,

The aim of this study was to understand the perception of body image in adolescents.

METHODOLOGICAL PROCEDURES

This was a qualitative study conducted with adolescents from four public educational institutions in Rio de Janeiro, RJ, Southeastern Brazil, in the first semester of 2013. Students of both sexes from the eighth and ninth grade participated.

As research suggests that adolescents in the south of Rio de Janeiro city – the area with the highest purchasing power – are those most represented in the media, private and public schools in this geographic area were listed. The team only obtained permission to carry out the research in municipal schools, where group meetings were conducted. The schools, located in the Laranjeiras, Gávea and Vidigal neighborhoods, were selected based on a list provided by the municipal education coordinator.

Two focus groups, one of male and one of female students, were set up after hours in each school making a total of eight focus groups. It was decided to conduct the discussion groups separated by sex as previous research suggested that body image norms and rules differ for males and females. The number of focus groups followed the criterion of saturation for the topics approached.

The discussions, led by a pair of researchers, followed a pre-established script containing topics that provided the basis of the debate and about which the adolescents were invited to express their feelings. The discussions centered on body image and its importance in day-to-day life; on the factors that can influence adolescents’ feelings regarding their bodies (parents, peers, the media…); on the ideal of beauty presented by the media and by society; and on exercise and the standard of beauty idealized by adolescents. The meetings were recorded and later transcribed in order to classify the topics. The data were analyzed using the method proposed by Minayo, creating categories, taking into account the understanding of the text and its contradictions, seeking to understand the group’s internal logic.

The schools visited were well-structured for teaching, with appropriate facilities and computer and multi-media equipment. Classes had between 28 and 32 students. Ninety-six adolescents aged 13 to 18 participated in the study, 51 males and 45 females, with a mean of 12 participants/focus group. The meetings lasted between 50 min and an hour and were conducted in privacy. Of the 96 students, 47 were in the eighth grade (23 males and 24 females) and 49 were in the ninth grade (28 males and 21 females. There were two groups per school, composed of students in the same year and separated by gender. In the majority of the groups, the debates began timidly, soon becoming more heated with the most uninhibited participants dominating, so that the researcher had to intervene several times to avoid parallel discussions and to guarantee that everyone participated.

All of the students interviewed showed concern about self-image in their narrative. Even in those who denied such concern, contrary to their affirmations, it was possible to observe explicit care in the way they dressed, their hair and accessories, using hair dye, colorful sneakers, large and exotic earrings, among other things. This concern can also be seen in the comments they made about their own appearance and that of other participants.

At the end of the study, the results obtained were shown to the focus group participants, aiming for valid and reliable data produced in the research.

The study was approved by the Research Ethics Committee of the Universidade do Estado do Rio de Janeiro (CEP/HUPE: 2957/2011 – CAAE: 0106.0.228.000-11) and by the Municipal Secretariat Coordinator of Education, Rio de Janeiro (Process 07/006499/2012). The institutions involved, and the parents of the adolescents signed informed consent forms.

ANALYSIS OF RESULTS AND DISCUSSION

The students’ narratives were classified and interpreted based on the research assumptions, and three main categories resulted: influence of the media on body image, importance of a healthy body and the relationship between standards of beauty and discrimination.

Media influence on body image

The participants recognized the existence of a standard of physical appearance considered by society to be the ideal, and described it in detail. Thus, the perfect male body was reported to be tall, muscular and tanned, with broad shoulders, defined biceps and a “6-pack” stomach. The idealized female body was slim yet curvy, and of medium height. We observed detailed representations on the body characteristics most valued in women, especially in the discourse of the female students, something that was not seen in relation to the male body. This finding, that female adolescents are generally more detailed in their criticism, is in agreement with the research conducted by Manderson et al, which shows that in interview situations women tend to respond in detail and are more enthusiastic about telling “their story”, whereas men tend to be more succinct and direct in their arguments.

On the other hand, adolescents of both sexes were unanimous in criticizing obesity and being overweight, deeming this state to be incompatible with the model of male or female beauty and considering it as something undesirable. The greater demand for women to have a slim body partly results from the media exhibiting and broadcasting images of ideal female beauty in relation to masculine figures. This accumulated message subjectively pressures women to fit into the dominant standard of beauty , with the above characteristics related by the adolescents. Moreover, there are more magazines with a substantial amount of advertising on diet and exercise aimed at women than at men. These experiences may contribute to women’s increased concern in achieving beauty ideals.

This difference between sexes was verified in research by Halliwell & Dittmar in which women tended to view their bodies as made up of distinct parts, whereas men are more prone to view their physical structure as one single and complete entity. Another study, by Hargreaves & Tiggemann, revealed that men may view physical appearance as a topic they should not discuss, as this could be considered a “gay” or “feminine” issue and make them appear more sensitive or vulnerable. In consequence, male adolescents may feel uncomfortable and be less accustomed to describing in detail what they consider to be ideal beauty in a man.

Although there was consensus within the group about the beauty standards they desired to achieve, the participants were also aware that these standards were unattainable and artificial. The adolescents reported how it was very difficult for one woman to have both a flawless face and a perfect body, just as the hypertrophied muscles of certain men were unnatural. Thus, the adolescents reported that such a perfect physical form was only possible for a woman through plastic surgery, and for a man through use of anabolic steroids, attitudes which they rejected.

Another relevant issue was criticism of the way images broadcast by the media were manipulated. The predominant idea was that the images of so-called perfect bodies were retouched using a computer and do not correspond to the way people are in real life. They recognized that there was a hidden intention, believing that the aim of using icons of beauty in commercials and advertising was to sell products. In clothing commercials, the veiled message of the company to its potential customers can be interpreted and summed up as one of the participants puts it:

“buy this clothing and you’ll look slim like this”.

Wood-Barcalow et al found very similar results in a piece of research conducted with university students, who criticized the ideals of extremely thin women, photo re-touching and, finally, the way the media transformed women into and object of consumption.

To summarize, this category shows that the adolescents’ concern with self-image follows the pattern of gender socializing in society, in which it is more part of a woman’s role than a man’s to care more for appearance. On the other hand, despite their criticism of the standards of beauty propagated by the media and deeming them manipulated and idealized, they struggled to follow them, showing the power of the media over them.

Importance of a health body

Having a healthy body stood out in the students’ narratives as the main objective for doing physical exercise. Although the beauty ideal for men consisted of an athletic body and that of women a slim but curvy physical structure, the students reported that their main goal for doing physical exercise was not to achieve these ideals. The valued bodily aesthetic is obtained as a consequence of exercises that provide physical health. The ideal of well-developed muscles was accepted by the adolescents when it mean masculinity, being in good physical condition and athletic, and was rejected when the body became too muscular, as in the findings of Pope et al.

Muscular mass and tone were considered significant results of doing physical activity by male participants, who associated well defined musculature as being in shape and healthy, as well as defining male beauty:

“... being in shape, toned, healthy and athletic...”

The boys valued physical activity mainly as a way to achieve being fit and not for the aesthetic aspect, even in cases where the aim of physical activity is specifically to lose weight. In contrast to women, the males did not refer to dieting to lose weight. According to research conducted by Brownmiller, dieting is generally perceived as female behavior, whereas for men, restricting food intake as a means of losing weight is not a popular topic.

Other data relevant to physical activity was its relationship with free-time activities in groups with other adolescents. The students engaged more easily in sports, games and exercise in company with other young people. More specifically, the participants found that the main incentive for doing physical activity was to have fun and to encourage healthy behavior with friends and peers, with improving appearance a background motive. These findings are in agreement with those of other studies using focus groups. , According to Prichard & Tiggemann, exercise motivated only by improving physical appearance has been associated with having a worse body image, especially in women.

Peers’ opinions on doing exercise in order to have a healthy, beautiful body affected the boys more than the models shown in the media, in contrast to the female students who saw themselves reflected in media celebrities more easily. Thus, based on the growing findings of qualitative and quantitative research, , the mass media appear to influence body image less in male adolescents than in females. The preference of the boys who participated in this research was to have a slim but moderately muscular body, in contrast to the females, who also sought a slim body, albeit with curves instead of muscles, which was consistent with previous studies by Grogan & Richards e Ridgeway & Tylka.

There are various hypotheses to explain these findings, requiring further research in order to be proven. Perhaps it is not acceptable for males to admit that they are influenced by messages about their bodies. Male adolescents do not perceive these messages, or may be reluctant to talk about their bodies, or it may be because the volume of messages aimed at boys is smaller than that aimed at girls. ,

Some studies , have shown the effects of sociocultural influences on body image in female adolescents, with weight loss being this age group’s main objective. However, for our interlocutors, the exaggerated search for slimness was viewed negatively and associated with disease, being generally criticized and not forming part of this group’s culture. For the adolescents, especially girls, thinness is associated with excessive, uncontrolled concern with having a slim body, incompatible with their standard of beauty, as thinness was highlighted as something negative. This exhaustive search culminates in neglecting health and with a body that has exceeded the aesthetic limits of attractive and healthy. Physical activity was reported as a tool for achieving a “normal”, “beautiful” and healthy body. Many adolescents reported that to achieve beauty and health, a woman’s body should be “normal” or meet “one single standard”, defined by them as being “neither fat nor thin: neither overweight nor underweight”.

Relationship between standards of beauty and discrimination

The participants discussed discrimination, recognizing that there was discrimination against individuals considered unattractive or having minor physical defects. The adolescents stated that individuals were rejected and even excluded when it was perceived that they made no effort to improve their appearance. This shows the pressure that discriminated adolescents feel from the group to meet pre-conceived standards of beauty. Dissatisfaction with body image means that the individual who is not accepted socially seeks alternatives (gym, plastic surgery taking medicine, among others) in order to correct what some perceive as a defect. According to Costa, for adolescents, physical appearance outside the so-called norms comes to mark the individual, distinguishing them from others in a negative way. Only one aspect or attribute is noticed, making this difference an exception and these individuals come to be viewed through this difference, which may lead to social segregation.

From these conceptions, it can be seen that young people who do not fit in or who do not attempt to achieve beauty ideals are discriminated against, marginalized by their classmates or summarily excluded from social interaction and even attacked both morally and physically. This is illustrated in the following excerpt:

“If the guy is ugly but dresses well, has good sneakers, smells good… I try to forget his ugliness… I tolerate it… if not, a friendly hug!”

Nicknames are often used and often serve to emphasize negative characteristics that the young person would rather conceal. According to Silva, those who are stigmatized are easy prey for prejudice, especially as it is impossible to achieve a determined standard of beauty. Many adolescents who are overweight are socially marginalized and depressive symptoms linked to distorted body image are commonly found in school-aged girls.

The young people’s narratives indicate that the culturally transmitted models frequently have a negative impact on the perception the adolescents have of themselves, showing that, if they are not to be excluded, they must live according to imposed aesthetic standards and they lose themselves in the search for their own identity. Discriminated individuals may believe that improving their physical appearance will lead to improved self-esteem and acceptance by the group and often engage in initiatives such as beauty treatments for the skin and hair, weight loss treatments, dental treatment and cosmetic surgery, among other procedures related to improving the perceived defect. , Although it is common for adolescents to have some degree of dissatisfaction with their body image, those who are extremely dissatisfied with their appearance may be suffering from a psychological disorder known as body dysmorphic disorder. , , In such cases, cosmetic surgery to improve body image is doomed to fail, as there is no actual deformity and the surgery may perhaps not cure concerns, which will always change with appearance.

At the end of the research, a synthesis of the results was produced and presented to the participants. Reflexive analysis on the perceptions revealed there showed that they recognized themselves in the texts presented, but were being politically correct when they emphasized they were against discrimination and claimed that they never bullied anyone with a defect, in school or in any other place.

Our study indicates that the students interviewed perceived that the media constructs models of beauty that are difficult to achieve. And that, although the adolescents attempted to follow the models, they demonstrated their own opinions and moderation in condemning excess in the search for idealized beauty. They recognized the existence of discrimination and prejudice against those who were considered unattractive. These results need to be further explored in order to construct prevention and intervention programs aimed at adolescents so as to avoid problems with body image and behavior associated with health risks.

We emphasize that this is a qualitative study, the aim is not to be numerically representative but rather to gain an in-depth understanding of the facts, and we highlight that our research was conducted with a convenience sample of adolescent students in public schools, restricting the results. Another limitation was that the focus groups were led by female researchers, as males are perhaps more likely to discuss body image concerns with other males. Despite these limitations, the study enables the constructs composing the concept of “standards of beauty” and its repercussions on this group to be identified, contributing to understanding health problems stemming from these constructs.