Motivation and emotion/Book/2019/Body image and emotional well-being

Overview
This chapter evaluates the effect of body image on emotional well-being. The effect of age, gender, and body mass on body image will be reviewed. The World Health Organisation (1947), defines health as a state of well-being where physical, mental and social well-being interact, and where these components are supported and secure. The promotion of individual health requires the consideration of emotional well-being; this perspective provides insight into the way people think, feel and behave within their environments. When a person is emotionally well, the capabilities to interact with their environment and prosper is more likely. It is the aim of this chapter to provide insight into how the relationship between body image and emotional well-being can be affected. In order to promote this, the reader is encouraged to interact with the quizzes and case study available, as this will reinforce the information provided within this text, and encourage practical learning.


 * Focus questions:


 * 1) What is body image and emotional well-being?
 * 2) What effect does negative/positive body image have on emotional well-being?
 * 3) What are the leading theories of emotional well-being and body image?
 * 4) How can theories of emotion be applied to the analysis of well-being?



Sofia is an 18-year-old girl, who is experiencing disturbances in her perception of body image. Whilst she is of a healthy size for her age, Sofia views herself as overweight, as she often compares herself to her peers, and the ‘ideal’ representations of women which are seen in the media. Sofia has begun to recognise that her negative body image is affecting her overall well-being, as she has consistently low self-esteem, and has begun to feel depressed and anxious. She is concerned that the consistent presence of these emotions is placing her at risk for developing more serious mental health and eating disorders.

After voicing her concerns to family and friends, Sofia has been encouraged to seek ways to increase her emotional well-being. Check back in on Sofia at the end of the chapter to learn more about her development!

Body image
Colman (2015) identifies body image as the individual value placed towards physical appearance, which is influenced by self-perception and the responses of peers. The individualistic configuration of body image is developed in accordance with a persons’ unique environment. A person is unable to sustain constant positivity for their physical appearance; however, negative body image can be a persistent presence which is detrimental to emotional well-being. Individuals who are challenged by their perceptions of body image are recognised as being at a higher risk of developing eating disorders, such as anorexia nervosa and bulimia nervosa (Farrell, Shafran & Lee, 2006).

Establishing a balanced relationship between positive and negative body image is most constructive to long-term emotional well-being, and the proposal of body image flexibility is reflective of this opinion. According to Pellizzer, Waller and Wade (2018), body image flexibility is the experience of the highs and lows of self-esteem and personal physical regard. The ability to feel both positive and negative emotions regarding body image is normal, however a continuous dissatisfaction with body image is damaging to emotional well-being (Swami, Weis, Barron & Furnham, 2017).

The possession of a negative perspective towards body image is not uncommon. In a study conducted by The Butterfly Foundation (2017), it was found that 40% of people were unhappy with their physical appearance, and a significant 73 percent of surveyed individuals stated that if they could, they would change how they looked. As referenced prior, prolonged dissatisfaction with body image puts people at risk of developing mental health issues and eating disorders. Encouraging positive body image promotes healthy emotional well-being.

Emotional well-being


At each moment, an individual is experiencing an emotional feeling that corresponds to the environment or situation of which they are involved in. Emotions help individuals make sense of their contexts, and place thought processes into feelings (Barrett, Mesquita, Ochsner & Gross, 2007). These emotions can be conveyed internally or demonstrated through vocalisations and/or facial expressions (figure 1). The experience of positive, neutral and negative emotions at any given stage is normal, however, continuous negative emotional well-being is damaging to psychological health.

Physical, social and mental well-being are significant components of the widely recognised definition of health, that was proposed by the World Health Organisation (1978). In order to determine an individual’s state of well-being, their unique experiences with the factors of well-being must be considered. It has been established that low emotional well-being is linked to the development of depression, anxiety and other mental illnesses (Swami, Weis, Barron & Furnham, 2017). As a result of this study, it can be recognised that having a positive body image perspective is healthy, and acts as a protective factor against the development of mental health disorders.

The promotion of healthy emotional well-being is correlated with positive regard for self-esteem. A study conducted by Paradise and Kernis (2002), found that by encouraging levels of high self-esteem, the development of positive social relationships, personal growth and self-acceptance is promoted. This is reinforced by Nelis et al. (2011), who state that improving emotional well-being is beneficial for psychological heath, whilst additionally encouraging the growth of positive social interactions and relationships.

Quiz
To ensure absorption of knowledge - and to make sure you've been paying attention! - the following quiz will test what you have learnt so far!



{What is body image?


 * type=""}

- A picture of a body. + A mental representation of a person’s physical appearance, with influence from the self, and others. - The way different people perceive others' bodies. - A test of physical attractiveness. }

Objectification theory


Objectification theory was proposed by Fredrickson and Roberts (1997), and suggests that women develop their perceptions of body image from the opinions of their peers and the broader society. In this theory, there is a focus on the sexual objectification of women; this is highlighted through the social influence on body image ideals, which is recognised as being primarily imparted by media organisations, that advertise and encourage thin frames whilst shaming fuller-figured bodies (figure 2). The consistent presence of the media, and the promotion of ‘ideal’ body types is damaging to emotional well-being and body image.

This theory was originally developed to investigate the objectification of female body image, however, a modern focus on gender inclusivity has encouraged researchers to account for male objectification. Davids, Watson and Gere (2018), further emphasise the role of the media in promoting ideals of body image. This research study shows that heterosexual males are influenced by magazine advertisements which promote muscular body types, and discourage overweight or underweight figures.

In this theoretical proposal, the objectification of body image causes detriment to emotional well-being, and places an individual at risk of developing depression, anxiety and eating disorders (Calogero, 2012). The objectification of a female or male body can cause feelings of shame to arise; this influences the desire to change physical appearance, with the aim of conforming to societal expectations and ideals.

James-Lange theory of emotion
The development of body image is unique, as each perspective is influenced by an individuals’ personal context. The influence of social learning is evident in this regard, as the opinions of the media, friends and family can impact the progression of normal, or disordered emotional thought processes; this indicates that learning or the development of behaviour occurs in response to experiences (Bandura, 1977). Social learning theory in correlation with the James-Lange theory of emotion, which posits that emotions arise from physiological reactions to environmental stimuli (James, 1884). It is evident that any experiences can influence opinions on body-image and consequently, emotional well-being.

The media has been recognised as being a negative factor for body image and emotional well-being; however, the social media movement of body positivity has assisted in encouraging body confidence and promoting psychological health. Social learning encounters with ideals of body image are important in the construction of personal opinions towards body image. Research conducted by Cohen, Fardouly, Newton-John and Slater (2019), employed female participants to follow #BoPo on Instagram. It was found that viewing body positive content improved the participants satisfaction and attitudes towards their own body types.

Subjective well-being
Evaluations of well-being are subjective, this indicates that there is an influence from a person’s unique environments. The individual’s judgement of their situations as either ‘good or bad’ is significant, as the prevalence of either of these evaluations indicates whether a perspective of subjective well-being will be high or low (Diener, Suh & Oishi, 1997). According to this perspective, positive or negative experiences with body image will influence attitudes.



In reference to the James-Lange theory of emotion and social learning theory, a person may feel upset when they compare themselves to a model advertised in a magazine, as they may view themselves as being physically larger or overweight. In response to this emotion, the person may use their feelings of sadness to motivate themselves to change their physical appearance in order to conform with the proposed body ideal. As a result, the individual will equate losing weight or a change their appearance, with feelings of happiness.

Maslow's hierarchy of needs
Abraham Maslow (1943), proposed the hierarchy of needs, which suggests that to achieve fulfilment in life - known as self-actualisation - a series of base needs must be met. According to the hierarchy of needs, humans possess an innate desire for social acceptance (Table 1). Maslow asserts that a deficit in the third stage of belonging can result in the development of mental health issues. In order to ensure progression through the base needs, the promotion of healthy emotional well-being must be encouraged, as positive emotional well-being has been established to encourage the formation of social relationships, self-acceptance and personal growth (Paradise & Kernis, 2002). This theory of motivation is relevant to emotion and body image, as it demonstrates how individuals will adapt their behaviour in order to conform, and gain social acceptance.

Table 1.

Abraham Maslow's hierarchy of needs.

Age
Evolutionary theory identifies social conformity as a survival mechanism. This perspective is applicable to adolescent development, as failure to belong can consequent in social alienation (Morgan & Laland, 2012). Adolescents are highlighted as being the group most at risk for developing low body image issues, which have been recognised to be related to low emotional well-being; it is characteristic of this age group have a desire to belong, and this inherent need for conformity is associated to ideals of body image and physical appearance. Broderick, (2000), references the transitional nature of this developmental stage, and suggests that adolescents seek to conform in order to avoid social isolation. In order to promote ‘fitting in’, it is shown that adolescents are at higher risk for developing eating disorders and mental illnesses in the pursuit of achieving ideal body standards and the desired physical appearance (Bhatti & Haq, 2017). Consideration must be taken for adolescents, in the promotion of healthy body ideals and emotional well-being, as this is a critical stage of development. Encouraging positive beliefs during this period is predictive of healthy psychological well-being in later life.

Weight
Variations in body weight and body mass have an effect on the development of body image; Individuals who have a higher body-mass index have been found to be more likely to possess negative emotional well-being in relation to body image (Doll, Petersen & Stewart-Brown, 2000). Early adolescents are identified as being particularly at risk, due to their increased pressure to conform socially (EisenbergI, Neumarksztainer, Haines & Wall, 2006). In reference to this resource, children who are teased by their peers for their weight are more likely to report lower self-esteem and body-image. The gender of participants, in association with weight is also significant in predicting emotional well-being; A survey conducted by Jorm et al. (2003), found that female participants who were clinically overweight or obese demonstrated higher rates of depression and anxiety. Further, these participants attributed their perception of low body image to social ideals and their personal deviation from the desired physical aesthetics. The maintenance of a healthy BMI is recommended in order to encourage positive emotional well-being. Additionally, the involvement in body positive movements - such as the aforementioned #BoPO study (Cohen, Fardouly, Newton-John & Slater, 2019) - is recommended to promote body image ideals and emotional well-being.

Gender
Muth and Cash (1997), assert that women are affected more significantly by ideals of body image than men; this perception of body image is recognised to impact emotional well-being negatively. According to this resource, the increased focus directed to female body-image and negative emotional well-being can be attributed to the hyper-concentration on perfection as perpetuated by the media.

The factor of gender can be criticised, as there is more research and data available about body image and emotional well-being for women. Consideration of this criticism must be taken when comparing body image across genders, in order to ensure reliability. Whilst research to female risk of body image issues is important, it must still be highlighted that men are also notably affected by distortions of body image. Women more commonly report these experiences of body image dissatisfaction, which indicates to the increased availability of data for women, and attributes to the discrepancy amongst the research between genders (Brennan, LaLonde & Bain, 2010).

Therapeutic techniques
Low emotional well-being and negative body image places people at risk of developing mental illnesses and eating disorders such as depression, anxiety, anorexia nervosa and bulimia nervosa (Farrell, Shafran & Lee, 2006). Improving emotional well-being is beneficial for psychological health, and the willingness of individuals to seek out help enhances the prospect of therapeutic success. Cognitive behaviour therapy is used to teach individuals to transform destructive behaviours and processing into constructive thoughts and emotions (Butters & Cash, 1987). Butters and Cash used therapeutic techniques and homework to challenge previously established perceptions about body image, and transform these beliefs to become more constructive. In addition to increasing emotional well-being in regard to body image, the participants additionally demonstrated increased desire to engage in social interaction and physical activity. Research indicates that physical activity can decrease depression and anxiety, which increases emotional well-being and reduces beliefs about negative body image (Fisher & Thompson, 1994). Supporting studies highlight the relationship between physical and psychological health, and posit that the chemical release provided by exercise enhances mood, and promotes the development of self-esteem and body positivity (Scully, Kremer, Meade, Graham & Dudgeon, 1998). Cognitive behaviour therapy and exercise based treatments for body image disturbances can be used concurrently to enhance the efficacy of the programs.

Recently, Acceptance and Commitment Therapy (ACT) has begun to be utilised to improve body image. ACT promotes non-judgmental awareness and acceptance of patients' negative body image, rather than attempting to suppress or alter their negative thoughts and feelings about their body (Griffiths et al., 2018). It also improves body image-related emotional well-being, as patients gradually form a less critical self-image through their practice of non-judgemental acceptance. Furthermore, ACT has been shown to improve more general aspects of emotional well-being, including quality of life and general mental health (Fogelkvist et al., 2020) To date, ACT has been successful in improving body image in eating disorder patients, participants in weight loss programs, and non-clinical individuals with body dissatisfaction (Fogelkvist et al., 2020; Griffiths et al., 2018).



Following advice from her friends and family, Sofia sought assistance from a counsellor, who utilised therapy in person, and designated homework. Sofia was asked to keep a diary, which was aimed to gain insight towards her though processes and perspective on body image. This provided Sofia with understanding into the origins of her beliefs, and Cognitive Behavioural Therapy was further used to change her negative perspective towards body image, which promoted positive thinking and encouraged healthy emotional well-being.

Whilst there are many strategies to improve emotional well-being in relation to body image, it should be clarified again that body image and emotional well-being are individualistic, and will affect people to varying degrees. Additionally, treatment strategies may be applicable to some patients, while ineffective for others. From a general viewpoint, the major factors of Cognitive Behavioural Therapy, exercise and mindfulness are most effective, but will need to be manipulated in order to be applicable to each person.

Conclusion
Body image influences the development of emotional well-being. This article primarily highlighted the negative relationship between body image and emotional well-being, as the majority of research concentrates on the negative correlation between these two factors. Research is aimed at identifying the risk factors for developing mental illnesses; this is significant, as it provides insight into the prevention of low emotional well-being and body image beliefs. Body image is a subjective opinion, which is influenced by the unique environments of individuals. Emotional well-being is the experience of positive, negative and neutral emotions in response to contextual stimuli. Experiencing different emotions in response to the environment is a fundamental human experience, however the continuous feeling of sadness or anxiety is detrimental to psychological health. The innate desire to belong to groups is related to body image, as females who are slender, and males that are muscularly defined are recognised as being the accepted ideal. The media plays a significant role in promoting these beliefs, however the rise of the body positive social media campaigns is encouraging confidence and self-acceptance for people of all body types and sizes.

Objectification theory, Social learning theory, and the James-Lange theory of emotion were recognised as the most significant theories for explaining body image and emotional well-being. The influence of experiential learning was important, and showed how previous encounters with different ideals can shape personal beliefs about body image. People who experience low emotional well-being and negative body image are at a higher risk of developing mental illness and eating disorders. Cognitive behavioural therapy and exercise therapy were discussed as the leading treatments for increasing psychological well-being. It is evident that there is a relationship between body image and emotional well-being; it is recommended that further research be undertaken to contrast positive and negative body image and the effect on emotional well-being, to provide a more thorough evaluation into this subject.