Body Image 9 (2012) 201–208

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Body Image
journal homepage: www.elsevier.com/locate/bodyimage

Body image satisfaction among Norwegian adolescents and young adults:

A longitudinal study of the influence of interpersonal relationships and BMI
Ingrid Holsen a,∗ , Diane Carlson Jones b , Marianne Skogbrott Birkeland a
a
University of Bergen, Bergen, Norway
b
University of Washington, Seattle, WA, USA

a r t i c l e i n f o a b s t r a c t

Article history: This study used a latent growth curve modeling approach to examine body image satisfaction in 1132
Received 10 June 2011 Norwegian adolescent and adult males and females measured at six times between ages 13 and 30. An
Received in revised form 17 January 2012 additional model examined the long term influence of parent–child relationship, peer relationship (both
Accepted 19 January 2012
relationships assessed at age 13), and BMI (measured at each interval) to the patterns of change. The
results showed a linear growth in body image satisfaction through adolescence followed by a stabilizing
Keywords:
of the latent curve in adulthood for both genders. There were gender and developmental variations in
Body image satisfaction
the relative contributions of parents and peers for the slope and quadratic growth and in the contribu-
Longitudinal study
Adolescence
tion of BMI to body image satisfaction. When controlling for BMI, initial parent–child relationships and
Early adulthood peer relationship predicted the variance in slope growth for males. Parent–child relationship predicted
Parents quadratic growth for males. Among females, only initial peer relationships predicted linear growth. No
Peers effect was found for quadratic growth. BMI had an additional negative effect on body image satisfaction
BMI during adulthood.
© 2012 Elsevier Ltd. All rights reserved.

Introduction
Body image satisfaction is frequently defined in the litera-
ture as the degree to which individuals are satisfied with their
physical appearance, especially weight and shape. Conceptions
and evaluations of body image are evident across the life span
for males and females and are core aspects of the representa-
tion of self for children, adolescents, and adults (Harter, 1990;
Tiggemann, 2004). Body image evaluations have been of major
importance in the psychological functioning and social rela-
tionships of individuals. Body image dissatisfaction has been a
prospective factor in predicting depression, eating disorders, low
self-esteem, and health-compromising behaviors (Holsen, Kraft,
& Røysamb, 2001; Neumark-Sztainer, Paxton, Hannan, Haines,
& Story, 2006; Paxton, Neumark-Sztainer, Hannan, & Eisenberg,
2006; Stice & Bearman, 2001; Thompson, Heinberg, Altabe, &
Tantleff-Dunn, 1999; Wertheim, Koerner, & Paxton, 2001).
Given the prospective contributions of body image to mental
health and well-being, an important research priority has been
to investigate the development of body image satisfaction across
∗ Corresponding author at: Research Center for Health Promotion and Devel-
opment, Department of Psychology, University of Bergen, Christiesgate 13, 5020
Bergen, Norway. Tel.: +47 55 58 32 18; fax: +47 55 58 98 87.
E-mail address: Ingrid.holsen@psyhp.uib.no (I. Holsen).
the life span and identify protective factors that contribute to it
(Fenton, Brooks, Spencer, & Morgan, 2010; Frisén & Holmquist,
2010; Markey, 2010). The goal of this study was to expand knowl-
edge about the development of body image among adolescents
and young adults through an analysis of body satisfaction begin-
ning at age 13 and ending at age 30. This age range captures the
critical years of adolescent change and extends into the emerg-
ing and formative years of adulthood. We will apply the analytical
technique of random coefficient growth modeling, Latent Growth
Modeling (Bollen & Curran, 2006; Muthén & Muthén, 2000), a pow-
erful method for modeling individual variation in development and
for examining the influence of background variables in explaining
this variation.
We are guided in our study by the biopsychosocial model.
Research based in this model has identified multiple factors that
impact the development of body image (Jones, 2004; Ricciardelli
& McCabe, 2004; Stice & Whitenton, 2002). Based on the previous
research, we examine body mass index (BMI) as a foundational bio-
logical characteristic as well as relationships with parents and peers
as the central social characteristics that are expected to influence
the nature of body image development. We also consider gender to
be a primary sociocultural factor that shapes the experiences and
development of body image. Taken together, these biopsychosocial
factors have been prominent in the literature for their contri-
butions in accounting for differences in body image satisfaction
development.

1740-1445/$ – see front matter © 2012 Elsevier Ltd. All rights reserved.
doi:10.1016/j.bodyim.2012.01.006
202 I. Holsen et al. / Body Image 9 (2012) 201–208
Gender Differences in Body Image Satisfaction
Culture and gender are implicated in the specific nature of body
image self-evaluation. In Western cultures, females are more likely
to evaluate themselves primarily on weight whereas the body
image of males has been related to both weight and muscularity
(Jones & Crawford, 2005; McCabe & Ricciardelli, 2003). In addition,
males have repeatedly scored higher on body satisfaction compared
to females across adolescence and adulthood (Bearman, Presnell,
Martinez, & Stice, 2006; Holsen et al., 2001; Rauste-von Wright,
1989; von Soest & Wichstrøm, 2009).
Longitudinal research has provided insights into the devel-
opmental pattern of gender differences during adolescence and
adulthood. Several studies have generally confirmed that nega-
tive body image evaluation is heightened during the middle school
years for both boys and girls (Bearman et al., 2006; Cole et al.,
2001; Presnell, Bearman, & Stice, 2004; Rauste-von Wright, 1989;
Rosenblum & Lewis, 1999; von Soest & Wichstrøm, 2009). Although
body satisfaction is at its lowest during early adolescence for both
girls and boys, gender differences in the mean levels of body satis-
faction have been persistent in that boys report greater body image
satisfaction than girls.
After early adolescence, gender differences in developmental
patterns have typically diverged. For boys, body satisfaction has
increased into the later adolescent years (Bearman et al., 2006; Cole
et al., 2001; Rauste-von Wright, 1989; Rosenblum & Lewis, 1999;
von Soest & Wichstrøm, 2009) presumably because the maturing
male physique corresponds to the muscular ideal associated with
masculinity. However for girls, physical maturity frequently has
been associated with deviations from the thin ideal connected to
femininity. Body dissatisfaction then has tended to decline during
the high school years among girls (Bearman et al., 2006; Crespo,
Kielpikowski, Jose, & Pryor, 2010; Eisenberg, Neumark-Sztainer, &
Paxton, 2006; Espinoza, Penelo, & Raich, 2010; Jones, 2004; Ohring,
Graber, & Brooks-Gunn, 2002; Paxton, Eisenberg, & Neumark-
Sztainer, 2006; Presnell et al., 2004).
There are variations in these dominant developmental themes.
In some cases, there has been a slight increase in satisfaction
among girls either in high school (Cole et al., 2001; Ohring et al.,
2002) or around 18 years (Holsen et al., 2001; Rauste-von Wright,
1989). There is also research that has confirmed increased body
dissatisfaction among older adolescent boys and young adult men
(Eisenberg et al., 2006; Jones, 2004; Paxton, Eisenberg, et al., 2006).
As noted earlier, regardless of the similarities and differences in the
developmental trajectories for body image satisfaction, males have
reported greater body image satisfaction than females across the
adolescent and young adult years.
The developmental patterns and inconsistencies between stud-
ies have been most likely due to several factors. There has been
great variation in the measures used to assess body satisfaction and
in the ages included in the research. The studies have also varied
in the number of assessments which have ranged from two mea-
surements (Jones, 2004; Paxton, Eisenberg, et al., 2006; Presnell
et al., 2004), to three (Holsen et al., 2001; Ohring et al., 2002;
Rosenblum & Lewis, 1999; Stice & Bearman, 2001), or four points in
time (Rauste-von Wright, 1989). The range of time intervals has also
varied from 9 months (Presnell et al., 2004) to 8 years (Ohring et al.,
2002). These measurement and methodological limitations mean
that there continues to be a need for a more coherent overview of
the development of body image.
Interpersonal Factors and Body Image Satisfaction
Humans are fundamentally social-relational beings who strive
for attachments and acceptance by others, primarily through
relationships with parents and peers. Previous research has
documented that these relationships are core social connections
that influence body image.
Parent–child relationships. The general finding in the litera-
ture has been that characteristics of parent–child relationships and
interactions have made similar contributions to body image satis-
faction for boys and girls. Parental support has been confirmed as a
prospective contributor to body image satisfaction during adoles-
cence for both genders (Bearman et al., 2006). Parental messages
and feedback about body size and shape have also been signif-
icant predictors of body satisfaction for girls and boys (Helfert
& Warschburger, 2011; McCabe & Ricciardelli, 2003; Vincent &
McCabe, 2000). Furthermore, parent–child interactions have been
linked to other behaviors and attitudes aligned with body image,
such as dieting (Huon & Walton, 2000) and body change strate-
gies (McCabe & Ricciardelli, 2003). Overall, the evidence supports
gender similarities in the contributions of parental relationships to
body image satisfaction. There has been some evidence for gender
differences, however, when quality of familial relationships are of
primary interest. In these instances, parent–child relationships are
more likely to be related to body image for girls (Barker & Galambos,
2003; Crespo et al., 2010).
Developmental age also appears to impact the relationship
between parent–child relationships and body satisfaction. In later
adolescence, parental support has not as frequently been a signifi-
cant prospective factor in changes in body dissatisfaction for either
girls or boys (Presnell et al., 2004).
Peer relationships. Relationships with peers have been another
important interpersonal context for the development of body
image. In this research, we focused on the quality of friendships and
acceptance rather than friends’ specific behaviors. The perception
of being accepted by peers and friends and the qualities of these
friendships have tended to be concurrently associated with body
image among adolescents and college students (Gerner & Wilson,
2005; Paxton, Schutz, Wertheim, & Muir, 1999; Schutz & Paxton,
2007; Shroff & Thompson, 2006).
The prospective contribution of friendship quality for body
image has been confirmed in a longitudinal study of early ado-
lescent boys and girls. For these students, loss of friendships over
a school year predicted decreases in body esteem, but not in any
other dimension of self-esteem. These findings have confirmed the
importance of perceived acceptance by friends for a positive body
image for both girls and boys and verified a connection between
quality of friendships and acceptance for conceptions of the embod-
ied self (Keefe & Berndt, 1996).
BMI
One of the most robust findings in the literature is the positive
relationship between BMI and body dissatisfaction. For both girls
and boys, higher BMI has been associated with greater body dissat-
isfaction in concurrent and longitudinal research (Jones & Crawford,
2005; Jones, Vigfusdottir, & Lee, 2004; McCabe & Ricciardelli, 2003;
Paxton, Eisenberg, et al., 2006). Furthermore, increases in BMI
across time have been identified as contributing to heightened body
dissatisfaction during adolescence and early adulthood (Eisenberg
et al., 2006). The consistency of these findings has confirmed the
centrality of weight in the development of body image and the
importance of including BMI in research on body image.
The Current Study
In the present study we will examine the influence of initial
parent–child relationships and peer relationships, and the biolog-
ical characteristic of BMI to explain the variations in body image
growth over time both for girls and boys (see Fig. 1).
 I. Holsen et al. / Body Image 9 (2012) 201–208
body90
body13
I
S
Q
par13 peer13 bmi13
Fig. 1. Latent growth curve model of parent–adolescent relationship (par13) and peer relationship (peer13) as time-invariant covariates, and BMI as time-varying covariates
predicting body image satisfaction.
We evaluated two models. Model 1 assessed the level and
growth of body satisfaction longitudinally from age 13 to age 30
years. Based on previous findings from adolescence and young adult
years (e.g., Davison & McCabe, 2006; Jones, 2004; Paxton, Neumark-
Sztainer, et al., 2006), we expected to find gender differences such
that males would consistently report higher levels of body satisfac-
tion over time. For males, we predicted a trajectory that would have
a positive growth trend through adolescence followed by a slower
growth in adulthood. For females, we hypothesized a decline in
body satisfaction in mid-adolescence, followed by a slow growth
over time.
We also expect to find individual variances in initial level and
growth for both males and females. Model 2 investigated the contri-
butions of early parent–child relationships and peer relationships
at age 13 to the variance in level and growth of body image. The rela-
tionships were treated as time-invariant predictors. In this model
we included BMI as a time varying-covariate. The analyses were
guided by 3 questions: To what extent do initial relationships with
parents and peers predict the variance in growth over time along
with BMI measured at various ages? Does the pattern vary by
gender? How does the association between BMI and body image
satisfaction vary across different ages? We expected to find that
both relationships to parents and peers were significant predic-
tors of level and growth for both genders during adolescence, but
predicted that peers would have greater impact in the later years
(Presnell et al., 2004). Based on previous findings, we also expected
BMI to have an increasing impact on body image through adoles-
cence and into adulthood.
Method
Participants
Data stem from the Norwegian Longitudinal Health Behaviour
Study (NLHB), a cohort longitudinal study started among seventh
graders (13 year olds) in Hordaland County, Norway, in 1990.
Data collections in the NLHB study have been performed in 1990,
1991, 1992, 1993, 1995, 1996, 1998, 2000, and 2007. The ini-
tial sample of 1195 adolescents was drawn from 130 urban and
rural schools, out of which 22 schools were selected to participate.
203
body15 body18 body21 body23 body30
bmi15 bmi18 bmi21 bmi23 bmi30
Written informed consent was obtained from 927 students and
their parents. Refusals from parents (n = 222, 18.6%), refusals from
students (n = 46, 3.8%) and students with obvious inconsistent
answers (n = 3, 0.3%), resulted in a sample in 1990 of 924 partici-
pants (participation rate = 77%). In 1992 new students in the classes
were invited to participate. The total number of participants in the
NLHB study was then 1242.
In the present study we used data from the collections in 1990
(mean age 13.3), 1992 (mean age 15.3), 1995 (mean age 18.3), 1998
(mean age 21.3), 2000 (mean age 23.3), and 2007 (mean age 30.3).
These are the years when the body image instrument was included
in the survey. The number of respondents was 963 in 1992, 779 in
1995, 634 in 1998, 627 in 2000, and 542 in 2007. When applying
the statistical software Mplus with full maximum likelihood esti-
mation, we were able to use all information possible in our data set.
Thus the final sample that provided information for the measure-
ments for this study was 1132 participants (54.3% males and 45.7%
females).
Procedure
For the first three data collections, the participants responded
to a questionnaire, which was administrated during school hours
by the researchers and trained staff. The data collections in 1998,
2000, and 2007 were completed by mail.
Attrition
We examined attrition effects between measurements by com-
paring the body image measure for adolescents who participated
in the study at age 13 to those who did not participate at each time
of measurement using ANOVA in PASW statistics 18. The only sig-
nificant attrition effect was that those who did not participate at
age 30 had a lower body image mean level at age 13 (p < .05).
Measures
Body image satisfaction. Body image was measured by a four-
item scale tapping general satisfaction/dissatisfaction with body
and appearance (Alsaker, 1992; Friestad & Rise, 2004; Holsen et al.,
204 I. Holsen et al. / Body Image 9 (2012) 201–208

2001). The items included “I would like to change a good deal about
my body (reverse coded),” “By and large, I am satisfied with my
looks,” “I would like to change a good deal about my looks (reverse
coded),” “By and large, I am satisfied with my body.” Response cat-
egories for the body image items were (1) does not apply at all; (2)
does not apply well; (3) applies somewhat; (4) applies fairly well;
(5) applies well; and (6) applies exactly. Responses were summed
with higher scores indicating a more positive body image. Cron-
bach’s alphas for the scale at different ages were .84 (age 13), .86
(age 15), 89 (age 18), .90 (age 21) .91 (age 23), and .91 (age 30).
BMI. Weight and height were self-reported at ages 13, 15, 18,
21, and 30 years. We created the BMI variable using the formula
BMI = kg/m2 . Previous research has established that self-reported
weight and height are reliable (Bearman et al., 2006; Rosenblum &
Fig. 2. Latent growth curve of body image satisfaction from age 13 to age 30 separate
Lewis, 1999).
for males and females.
Peer relationships. Seven items tapped the perceived qual-
ity of relationships with friends and classmates. Examples of the
In Model 2, background variables were included to explain the
items included “I am doing fine with others at my age,” “My peers
variance around the means, that is, the individual differences in
seem to like me,” “I think most of my classmates like me,” and “If I
growth. Consequently, body image was regressed not only on the
come to a new school it would be easy for me to get new friends”
growth factors, but also on parent–child and peer relationships
(Alsaker, Dundas, & Olweus, 1991; Lien, Jacobs, & Klepp, 2002). The
variables. BMI was included as a time varying covariate, as a con-
response categories were the same as for the body image scale. Item
trol, but also provided additional information on the variation in
responses were recoded so that higher numbers reflected positive
the outcomes beyond the growth factors.
relationships. Cronbach’s alpha in 1990 was .84
The fit of each model was estimated with multiple indicators:
Parent–child relationship. Six items assessed three aspects of
the 2 likelihood ratio test, the Comparative Fit Index, CFI (values
parent–child relationships: closeness, cohesion and understand-
greater than .90 are considered adequate fit, but values equal to
ing. Item examples include “There is positive cohesiveness in my
or greater that .95 are preferred), the Root Mean Squared Error of
family, “My parents give me encouragement,” “My mother under-
Approximation, RMSEA (value less than .06 indicate acceptable or
stands me well,” and “My father understands me well” (Alsaker
good fit), and the Standardized Root Mean Squared Residuals, SPMR
et al., 1991; Lien et al., 2002). The 6 response categories for three of
(value less than .08 indicate acceptable or good fit) (Hu & Bentler,
the items were the same as above. The response categories for the
1999).
three remaining items ranged from “1” (very often) to “6” (rarely
or never). The items were recoded so a positive number reflect a
Results
positive relationship. Cronbach’s alpha in 1990 was .83.

Descriptive statistics, correlations and means for body image

at various ages are presented in Table 1. Estimated means are also
Analytic Procedures
given (see also Fig. 2). Examination of the observed means over time
revealed that boys’ body satisfaction increased gradually until age
The initial data analyses were performed with PASW Statistics
21, then leveled off in adulthood. Girls showed a similar trend, but
18, 2010. We used Mplus Version 5.2 (Muthén & Muthén, 2007) to
there was a small decrease observed at age 15. Over all, females
model change in body image over time and to investigate whether
reported lower levels of body satisfaction than males at all ages.
growth in body image was related to parent–adolescent relation-
ship, peer relationship, and BMI. One of the advantages of Mplus is
Model 1: Latent Growth Curve
that it deals with incomplete data and uses Full Information Max-
imum Likelihood (FIML) estimation to handle missing data, using
In the first latent growth curve analysis the aim was to examine
all available information from all cases (Muthén & Muthén, 2000).
intercept and growth in body image from early adolescence age 13
In latent growth curve modeling, random effects are used to cap-
to adulthood age 30. We performed the initial analysis introduc-
ture individual differences in development. The random effects are
ing gender as a covariate. The latent growth curve model indicated
reconceptualized as continuous latent variable growth factors and
significant differences in intercept between boys and girls (girls
treated as variables in the study. Thus, the intercept and growth fac-
reporting lower body image mean levels), but not in slope and
tors (i, s and q) have their own means and variances/covariances.
quadratic growth factors. Thus boys and girls started off with differ-
Body image at different ages is the outcome parameter (see Fig. 1).
ent mean levels, and both genders had change in the growth factors
The intercept shows the initial mean level of the respective vari-
over time. In subsequent analyses we generated separate estimates
ables, the growth factor means express the typical growth in the
for boys and girls. The latent growth curves showing both observed
sample, and the variance around the means represent the individ-
and estimated mean values are presented in Fig. 2.1
ual differences in growth.
The model with the best fit was the model including the
In Model 1, we first examined an intercept and slope growth
quadratic growth factor, 2 (26, N = 597 boys, 495 girls) = 56.10,
model only. The loadings of the variables on the growth factors
p < 001, CFI = .97. RMSEA = .04, and SPMR = .05. The estimated means
across the six time points were fixed to 0, .2, .5, .7, 1.0, and 1.7
for intercepts, slope and quadratic factor in males were 16.42, 3.01,
according to the number of years between the measurements.
Given the shape of the curve (see Fig. 2), we tested a quadratic
growth model with intercept, slope, and quadratic growth fac-
1
tors. The slope growth factor measured linear change over time, Due to the shape of the growth curve and particularly the drop in mean level for
girls at age 15, we also tested a cubic growth model. The cubic model had a slightly
while the quadratic growth factor described the leveling off and better fit for girls than the linear and quadratic model (which was not the case for
the upturn and downturn over time beyond what is predicted by boys), but the cubic growth was not significant. Thus, we proceeded with the linear
the linear factor. and quadratic model for both genders.
 I. Holsen et al. / Body Image 9 (2012) 201–208 205

Table 1
Descriptive statistics and correlations between body image at different ages separate for males and females.

Variable Males Females

1 2 3 4 5 6 1 2 3 4 5 6

1. B Image 13 − −
2. B Image 15 .57** − .47** −
3. B Image 18 .41** .52** − .42** .59** −
4. B Image 21 .30** .46** .62** − .36** .56** .63** −
5. B Image 23 .16* .34** .64** .66** − .37** .49** .57** .68** −
6. B Image 30 .28** .36** .51** .51** .51** − .31** .45** .47** .51** .67** −

Means
(Range 4–24) 16.3 17.2 17.7 18.3 18.0 18.4 14.3 13.4 14.5 15.7 15.9 16.3
SD 4.3 4.5 3.8 3.9 4.0 3.8 4.8 5.1 4.8 4.8 4.8 4.8
*
p < .05.
**
p < .01.

and −1.12, respectively, indicating an upward slope growth and a Table 2

Model including effect of initial interpersonal relationships (time-invariant covari-
leveling off quadratic growth. The covariance between intercept
ates) and BMI (time-varying covariates) predicting body image satisfaction
and slope was negative (Estimate −.56, p < .001) indicating that (N = 1132, 54.3% males, 45.7% females).
boys with lower initial level of body satisfaction showed greater
Parameters Standardized coefficients
rate of increase. As for females, the estimated mean levels for
intercept, slope and quadratic factor were 13.52, 2.78, and −0.70, Males Females
respectively, indicating an upward slope and a leveling off of the Time-invariant covariates
curve. The negative covariance between intercept and slope (Esti- Parent–child relations → intercept .30*** .42***
mate −.28, p < .05) indicated that females with lower initial scores Peer relations → intercept .39*** .26***
tend to have higher rates of growth. Parent–child relations → slope growth −.25** ns
Peer relations → slope growth −.22* −.25*
Significant variance existed in intercept, slope, and quadratic Parent–child relations → quadratic growth .25* ns
growth (all ps < .001) for both genders indicating that adolescents Peer relations → quadratic growth ns ns
differ in their status and growth over time. Therefore, it was appro- Time-varying covariates
priate to add covariates to better explain the variance in intercepts BMI13 → Body13 −.08* .11*
BMI15 → Body15 −.07* ns
and growth factors.
BMI18 → Body18 −.09** −.09*
BMI21 → Body21 −.14*** −.18**
BMI23 → Body23 −.18*** −.29***
Model 2: The Influence of Interpersonal Relationships and
BMI30 → Body30 −.36*** −.38***
BMI
Note. See whole model in Fig. 1.
*
p < .05.
The next aim of the present study was to investigate whether **
p < .01.
the initial assessment of parent–adolescent relationship and peer ***
p < .001.
relationships at age 13 would explain the variation and growth in
body image over time. BMI at each age was included as a time-
varying covariate. years and to examine the influence of parent–child relationships,
The fit measures for the model were very good; 2 (84, N = 644 peer relationships, and BMI to the patterns of change. This work
boys, 543 girls) = 113.17, p < .05, CFI = .98, RMSEA = .02, SPMR = .05. contributes to the literature in three ways. First, it provides evi-
The analyses also allowed an evaluation of the relative contribu- dence on gender differences and similarities in the developmental
tions of the parent–adolescent and peer relationships variables and trajectories of body image satisfaction. Second, the results demon-
BMI. The results are presented in Table 2 (see also Fig. 1). Among strate that the quality of early relationships have an impact on
males, the covariates parent–child and peer relationships were sig- the development of body image. Finally, it highlights the contribu-
nificant contributors to the intercept and slope. The influence of tion of BMI to the development of body image satisfaction across
parent–child relationship on quadratic growth was also significant. adolescence and early adulthood.
Among females, both interpersonal variables contributed signifi-
cantly to the intercept, but only peer relationships was related to
Gender and the Development of Body Image Satisfaction
the slope growth. Neither of the relationship variables influenced
quadratic growth in body satisfaction for females.
As predicted, males have more positive body image than
For males, BMI predicted body image at all ages. For all of the
females. Regardless of age, females continue to be at a disad-
assessments, males who had higher BMI reported lower body sat-
vantage in their body image self-appraisals. Although this is a
isfaction.
well-replicated finding, the duration of our longitudinal study from
Females who claimed to have higher BMIs reported lower body
adolescence into early adulthood is unique and provides clear evi-
satisfaction with two notable exceptions. Young adolescents (age
dence that this expected gender difference does not diminish with
13) with higher BMI reported more positive body satisfaction, but
age.
in the next assessment (age 15), there was no relationship between
Although gender influences the level of body satisfaction, the
BMI and body satisfaction.
developmental trajectories of body image satisfaction appear to be
independent of gender. Both boys and girls are gradually more sat-
Discussion isfied with their bodies until age 21 after which the growth curves
stabilize. These findings provide additional support regarding the
The current research is one of the few studies to trace the devel- stability of body image satisfaction during adulthood (Tiggemann,
opment of body image satisfaction from adolescence into the adult 2004), and in particular, contribute to the literature by locating the
206 I. Holsen et al. / Body Image 9 (2012) 201–208
emergence of stability during the early adulthood years for both
men and women.
The result for girls during adolescence is contrary to our expecta-
tions and the general findings in extant literature. Previous research
has generally found a decrease in body image satisfaction for ado-
lescent girls during the middle school or early high school years.
Although we did note a decrease during this time period (see Fig. 2),
the decline was not significant. The present result of a positive
developmental trend is compatible though with more recent lon-
gitudinal research of adolescents. Other studies report that during
the adolescent years either a relatively stable growth trajectory in
body image with a small increasing slope or no significant changes
in appearance satisfaction for boys or girls from age 13 to age 21
(Morin, Maïano, Marsh, Janosz, & Nagengast, 2011; von Soest &
Wichstrøm, 2009). These findings taken together suggest a more
positive trend in body image development during later adoles-
cence for both girls and boys. Still it is important to note that two
of the three studies demonstrating positive trends in body image
are based on Norwegian samples and thus the trend awaits further
verification in other sociocultural and economic contexts.
Interpersonal Relationships Predicting Level and Growth in
Body Image Satisfaction
Our results regarding the relative contribution of parent–child
and peer relationships demonstrate the importance of the quality
of social connections for body image satisfaction after controlling
for BMI. Furthermore, these results provide additional evidence
regarding gender similarities and differences in body image devel-
opment.
As predicted, gender similarity is evident in that relationships
with parents and peers were significant predictors of the initial
level of body image satisfaction (intercept) for both boys and girls.
Adolescent boys and girls who initially report lower quality rela-
tionships with parents and peers also express initial lower body
image satisfaction. These findings are consistent with previous lit-
erature and highlight anew the relevance of social relationships
for the evaluation of physical self (Bearman et al., 2006; Gerner &
Wilson, 2005; Paxton et al., 1999; Schutz & Paxton, 2007; Shroff &
Thompson, 2006).
The impact of the quality of relationships is also evident for
the developmental trajectories. In this regard, the current research
expands on existing knowledge by providing a more detailed
description of the interconnections between relationship quality
and patterns of growth. Adolescent boys and girls with high levels of
positive relationships show less growth in body image satisfaction,
while adolescents with relatively less positive relationships have
a steeper growth in body image satisfaction. This pattern suggests
that perceptions of supportive relationships are connected to more
consistent and positive self-appraisals of body image independent
of gender. These individuals then do not appear to experience the
declines in body image satisfaction that are often associated with
adolescence. Although this pattern may reflect other factors such
as general self-esteem, the results provide additional evidence on
the effects of consistency in positive relationships for body image
satisfaction (Keefe & Berndt, 1996) among both boys and girls.
Importantly, the individuals who initially report lower quality
relationships recover from the negative effects in early adolescence
and enter adulthood with more positive self-perceptions. Rather
than being a period of stability, there is clear evidence of posi-
tive change in body image across adolescence for these individuals.
Although it is impossible to know if the increases in body image sat-
isfaction are related to more positive interpersonal relationships
later in adolescence or to other factors, these findings contribute
to the literature by demonstrating the long-term significance of
relationship quality on the development of body image for males
and females.
The results also revealed gender differences in the specific rela-
tionships that were related to growth in body image satisfaction.
For males, both parent–child and peer relationship remained signif-
icant predictors of variance in linear growth of body image whereas
only parent–child relationships predicted quadratic growth. Thus,
the quality of relationships with parents during early adolescence
retained relevance for males above that of peers into adulthood.
Although adolescents and young adults spend less time with their
parents compared to peers as they get older, the early adolescent
attachment and close relationship to parents seem to matter for
development of body image satisfaction among males.
Our hypothesis that initial peer relationships would be a sig-
nificant indicator of the changes in later body image satisfaction
held for both males and females. Initial relationship to peers pre-
dicted the slope trend in body image, that is, the growth in body
image satisfaction into early adulthood. However, in adulthood (age
23–30), neither of the relationship variables retained significance
for women. It appears that additional dynamic processes occurring
in adulthood for women are important for their bodies and body
image. It remains for future research to determine if other rela-
tionships such as romantic partners or other experiences such as
pregnancy are more relevant determinants of body image satisfac-
tion for women during adulthood.
Overall, the results highlight the importance of relation-
ship quality during adolescence for later adulthood functioning.
Whether it is parents or peers, lower initial quality of primary
relationships appear to influence the growth in body satisfaction
several years later. It is also possible that the residual impact of early
relationships function as markers for relationships later in time.
However, since relationships were only measured initially, adoles-
cent with positive relationships may establish a trajectory toward
more positive relationships in general. A task for future research is
to include assessments of relationship quality for each time period
to better understand the prospective and concurrent contributions
of relationships to the development of body image satisfaction.
BMI Predicting Body Image Satisfaction at Various Ages
As we had expected, BMI, beyond the initial effects of interper-
sonal relationships, predicts body image over time for both genders
with the exception of early adolescent girls. However, the overall
trend is clear. BMI is important for body image development as the
adolescents grow into adults. This result confirms previous findings
by Eisenberg et al. (2006) and adds new insight into the increased
significance of BMI for adolescents and adults. No doubt, as BMI
increases across time, it continues to influence the perception of
bodies and appearance among both adult men and women.
Strengths and Limitations
The major strength of the present study is the modeling of a
trajectory of change in body image satisfaction in a relatively large
sample of adolescents and adults. The use of a multivariate analyti-
cal technique of random coefficient modeling, and Full Information
Maximum Likelihood estimation for handling missing data made it
possible to unravel some methodological challenges in longitudinal
research.
At the same time, the study has some limitations that need to
be considered when interpreting the findings. These analyses can-
not rule out the possibility of other factors being associated with
the variables over time and influencing the growth in body image.
Previous research has pointed to puberty and maturational tim-
ing (Alsaker, 1992), teasing about appearance (Barker & Galambos,
2003), and self esteem (Morin et al., 2011) as important factors for
 I. Holsen et al. / Body Image 9 (2012) 201–208
body image development. However, we have attempted to address
the enduring effects of well-established predictors of body image
satisfaction such as close parent–adolescent relationships, positive
peer relationships, and BMI.
Additionally, the study took place in Norway, which is a rela-
tively ethnically homogeneous Western country. Studies on ethnic
differences in body image point to variations in ideal body types and
in the level of body dissatisfaction (Jones & Smolak, 2011). Further-
more, there may be characteristics in the Norwegian culture such
as greater gender and income equality that may have influenced
the precise nature of the developmental trajectories. Thus, there
remains the need to test the generalizability of the development
patterns in body image satisfaction across cultures and ethnicities.
Despite some limitations, the present study extends our knowl-
edge of the development of body image satisfaction and its
predictors. Our findings provide information from a relatively large
sample of adolescents who were followed into adulthood. For both
boys and girls, the initial positive linear growth in body image
satisfaction during adolescence levels off in adulthood and stabi-
lizes. The results confirm that males report more positive body
image satisfaction than females from ages 13 to 30. Future research
will need to examine body image at younger ages in order to
document the emergence of gender differences in body image
satisfaction. The results also confirm that the quality of interper-
sonal relationships and BMI are important factors for body image
development. Additionally, adolescents who initially report lower
quality interpersonal relationships and greater body image dissat-
isfaction demonstrate positive change in body image growth over
time.
One of the unexpected findings is that the results do not reveal
a significant decline in body image satisfaction in mid-adolescence
for girls. In future investigations, it seems crucial to explore if the
classification of individuals into different latent groups may pro-
vide an even more nuanced picture of body image development.
Acknowledgments
We appreciate the work done by Fransoice Alsaker and Dan
Olweus in the development of the scales for the NLHB study. We
also like to thank Tore Tjora and Alexandre Morin for useful discus-
sions regarding latent growth curve modeling.
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