Body Image 32 (2020) 34–52

Contents lists available at ScienceDirect

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

A systematic review on the effects of media disclaimers on young

women’s body image and mood
Sarah E. McComb ∗ , Jennifer S. Mills
Department of Psychology, York University, 4700 Keele St, Toronto, ON, M3J 1P3, Canada

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

Article history: The purpose of this systematic review was to determine the effectiveness of media disclaimers in
Received 23 May 2019 protecting women’s body image and mood after exposure to thin ideal media. The keywords “warn-
Received in revised form 31 October 2019 ing*” OR “disclaimer*” AND “body image” OR “body dissatisfaction” were searched in the PsycINFO and
Accepted 31 October 2019
MEDLINE/PubMed databases. Inclusion criteria included being a peer-reviewed, primary source article
available in English, which had examined the impact of media disclaimers on women’s body image.
Keywords:
Articles published prior to February 22nd , 2019 were included. In total, 15 experimental studies were
Disclaimer
included. Overall, disclaimers were ineffective at reducing women’s body dissatisfaction and negative
Warning
Body image
affect following exposure to thin ideal images, and in some cases were actually harmful to women’s
Body dissatisfaction body image. For women high in trait body dissatisfaction and thin ideal internalization, warning labels
Mood increased body dissatisfaction after exposure to thin ideal images. For women high in trait social and
Media appearance comparison specific disclaimers that outlined how the images had been altered resulted in
increased body dissatisfaction after exposure to thin ideal images. Therefore, overall, disclaimers were
ineffective at ameliorating the negative effects of exposure to thin ideal media. Future research should
examine the impact of media disclaimers on the body image of adolescents and men.
© 2019 Elsevier Ltd. All rights reserved.

1. Introduction
Negative body image, particularly body dissatisfaction, is expe-
rienced by many people and a disproportionate number of young
women (Fallon, Harris, & Johnson, 2014; Neighbors & Sobal, 2007).
Upwards of 90 % of adult women report some level of dissatisfaction
with their bodies (Runfola et al., 2013). The prevalence of nega-
tive body image and body dissatisfaction among young women is a
significant mental health issue, given that body dissatisfaction has
been shown to precede the development of eating disorders and
is the most consistent and robust predictor of the development
of clinical eating disorders (Neumark-Sztainer, Paxton, Hannan,
Haines, & Story, 2006; Stice, Marti, & Durant, 2011), in addition to
being independently associated with depressed mood (Choi & Choi,
2016) and suicidality (Crow, Eisenberg, Story, & Neumark-Sztainer,
2008). High levels of body dissatisfaction and poor body image
among women are attributed to sociocultural factors, with the
media being the most powerful and impactful sociocultural trans-
∗ Corresponding author.
E-mail addresses: mccombs@yorku.ca (S.E. McComb), jsmills@yorku.ca
(J.S. Mills).
mitter of beauty ideals (Groesz, Levine, & Murnen, 2002) through
the use of images of unrealistically thin female models.
Current beauty ideals emphasize thin and toned female bodies,
which over time have increasingly become thinner and more toned
in the media (Bozsik, Whisenhunt, Hudson, Bennett, & Lundgren,
2018; Spitzer, Henderson, & Zivian, 1999; Sypeck, Gray, & Ahrens,
2004). The ubiquitous depiction of the thin and fit ideal leads
women to believe that this body type is highly desirable and attain-
able for the average woman, when in fact models represented in
the media are often seriously underweight and even thinner than
the weight criterion for anorexia nervosa (Rodgers, Ziff, Lowy, Yu,
& Austin, 2017; Wiseman, Gray, Mosimann, & Ahrens, 1992). For
example, a recent survey conducted with fashion models from the
2016 New York Fashion Week found that 81 % of the models had
a BMI below 18.5 and were severely underweight (Rodgers et al.,
2017). Exposure to images of very thin models has for years been
pointed to as a background risk factor and situational trigger for
increased drive for thinness among women (Mills, Polivy, Herman,
& Tiggemann, 2002). In the past two decades, it has become rou-
tine to digitally alter photographs of models appearing in the media
to clear and lighten skin, to trim fat off body parts, and to elongate
body parts or overall body images (Bennett, 2008), thus making the
thin ideal even thinner and less attainable for the average woman.
According to the sociocultural model of body dissatisfaction, fre-

https://doi.org/10.1016/j.bodyim.2019.10.010
1740-1445/© 2019 Elsevier Ltd. All rights reserved.
 S.E. McComb, J.S. Mills / Body Image 32 (2020) 34–52
quent exposure leads to the internalization of the thin ideal as
beautiful and desirable. Social comparison to the thin ideal in the
media causes women to feel dissatisfied with their own bodies
when they realize they cannot attain this ideal body type (Frederick,
Daniels, Bates, & Tylka, 2017; Tiggemann & Pickering, 1996). Past
research has confirmed that exposure to thin-ideal images in mag-
azines and television has been associated with poorer body image
among young women (Frederick et al., 2017; Harrison & Cantor,
1997; Naumann, Tuschen-Caffier, Voderholzer, Schafer, & Svaldi,
2016; Tiggemann & Pickering, 1996).
To address the widespread prevalence of body dissatisfaction
and its consequences, governments and policy makers around the
world have begun to try to find cost-effective solutions that can be
easily implemented and will reach a large audience. One strategy
that has been adopted is to add disclaimers to media images that
have been digitally altered. In 2009, the Australian National Advi-
sory Group on Body Image released a Voluntary Industry Code of
Conduct, which outlined several strategies for reducing body dis-
satisfaction and negative body image caused by media images, one
of which was the use of such disclaimers (Tiggemann, Slater, Bury,
Hawkins, & Firth, 2013). In 2012, Israel became the first country to
pass legislation that obligated the advertising industry to include
disclaimers on all photographs that had been digitally altered to
make models appear thinner (Krawitz, 2014). In 2017, France fol-
lowed suit and made it law that all images of models that had
been digitally altered to appear thinner or larger must be accompa-
nied by a disclaimer that read “photographie retouchée” (retouched
photograph; Eggert, 2017). In 2018, Canadian provincial parliament
politicians also put forth a bill that would require disclaimers be dis-
played on any advertisement that features models whose images
have been digitally altered (Breen, 2018).
Proponents of the use of disclaimers have assumed that dis-
claimers will be a positive strategy to prevent body dissatisfaction
that results from viewing thin-ideal images. The underlying
assumption is that media disclaimers inform the consumer that the
image, and the body within that image, are unrealistic, and there-
fore are not an appropriate or realistic target of comparison for the
consumer to use. It is then assumed if the media image is perceived
to be an unrealistic target of comparison, that the consumer is less
likely to engage in social comparison to the image, and therefore
body dissatisfaction will be avoided (Charrlson, 2014; Tiggemann
et al., 2013). While it has been assumed that media disclaimers are a
positive strategy to protect women’s body satisfaction, it is unclear
whether there is empirical support for the idea that policies that
encourage the use of media disclaimers actually mitigate the neg-
ative outcomes of thin-ideal media on women’s body image and
mood.
The current study aimed to systematically review the avail-
able literature on media disclaimers and women’s body image
and mood. This was accomplished by examining the main effect
of disclaimers on young women’s mood and several body image
variables, as well as examining the moderating effect of numerous
individual difference variables. The purpose of the current review
was to determine the evidence base of media disclaimers in pro-
tecting women’s body image and mood after exposure to thin-ideal
images. A systematic review was deemed to be more feasible and
meaningful than a meta-analysis due to wide variability in the
dependent variables and psychological moderators used in the pub-
lished research. This is the first paper in the literature to contribute
a systematic review on the impact of media disclaimers on young
women’s body image and mood. Such a review is needed so that
research about media disclaimers can be amalgamated in order to
determine whether they are an effective strategy for preventing
body dissatisfaction caused by exposure to thin-ideal images. Fur-
ther, this review is needed so that if media disclaimers are found
to be effective, it is known which types of disclaimers are most
35
effective, under what contexts, and for which types of women. This
information will help to guide policy maker’s decisions about dis-
claimers and will inform evidence-based body image interventions.
2. Method
This systematic review was conducted in accordance with
the Preferred Reporting Items for Systematic Reviews and Meta-
Analyses (PRISMA) checklist (Moher, Liberati, Tetzlaff, Altman, &
Group, 2009).
2.1. Eligibility criteria
Studies were eligible for inclusion if the following criteria were
met: (a) peer-reviewed article, (b) English language, (c) reported
results from a primary source, (d) experimental study, and (e)
examined the effect of a disclaimer or warning label on some type
of media on young women’s body image. Studies were excluded if
they did not meet all of the eligibility criteria listed above.
2.2. Search procedure and study selection
The following terms were searched in the databases PsycINFO
and MEDLINE/PubMed under keywords: “warning*” OR “dis-
claimer*” AND “body image” OR “body dissatisfaction.” Databases
were searched up until February 22nd , 2019. Study screening and
selection was conducted by the first author (SM) and a gradu-
ate level research assistant. Each article’s title and keywords were
searched to identify eligible studies. Articles that met initial screen-
ing criteria were then assessed at the abstract level. A full-text
examination was conducted on studies that appeared eligible for
inclusion, or in instances where it was uncertain if a study met
inclusion criteria. The reference lists of included articles were also
cross-referenced for other relevant articles not found in the elec-
tronic literature search. Search and screening procedures can be
found in Fig. 1. In total, 15 experimental studies were included in
the current review.
2.3. Data extraction and risk of bias
Data extraction was performed by the first author. The informa-
tion extracted from each study was as follows: the study design;
sample size; age range and mean age of sample; the sex/gender
of the sample; measures used to assess outcomes; the country
where participants lived; types of media images used; tools used to
measure studied variables; a description of the experimental con-
ditions in each study; and overall findings in regard to the effect of
media disclaimers or warnings on young women’s body image or
mood (see Table 1). The risk of bias within each individual study
was measured with a quality assessment that was conducted using
the American Dietetic Association Quality Criteria Checklist (QCC).
This measure has been used to conduct quality assessments of body
image research before (Santhira Shagar, Harris, Boddy, & Donovan,
2018). The quality assessment was conducted independently by
two raters (the primary author and a graduate level research assis-
tant). The QCC includes 10 items that appraise the scientific validity
of each study. As per QCC scoring instructions, quality attributes
of each study were categorized as positive, neutral, or negative. A
study was given a negative overall score if six or more items on
the checklist were answered as ‘no.’ A study was given a positive
overall score if the following items were answered as ‘yes,’ plus
one additional item was also answered as ‘yes’: the selection of
study subjects was free from bias (Item 2), study groups were com-
parable (Item 3), the study procedure was described in adequate
detail (Item 6), the outcomes were clearly defined and measure-
ments were valid and reliable (Item 7). A neutral score was given if
36 S.E. McComb, J.S. Mills / Body Image 32 (2020) 34–52
Fig. 1. PRISMA flow-diagram of search and screening procedures of disclaimer articles.
the answers to questions 2,3,6, and 7 did not indicate that the study
was particularly strong.
3. Results
3.1. Sample characteristics
Sample characteristics of all studies can be found in Table 1.
All of the studies were experimental in nature. Studies were pub-
lished between 2006-2018. Seven of the studies were conducted
on samples from the United States (Ata, Thompson, & Small, 2013;
Bissell, 2006; Fardouly & Holland, 2018; Frederick, Sandhu, Scott,
& Akbari, 2016; Harmon & Rudd, 2016; Harrison & Hefner, 2014;
Kwan, Haynos, Blomquist, & Roberto, 2018), seven were conducted
on Australian samples (Bury, Tiggemann, & Slater, 2016; Bury,
Tiggemann, & Slater, 2017; Bury, Tiggemann, & Slater, 2016; Slater,
Tiggemann, Firth, & Hawkins, 2012; Tiggemann & Brown, 2018;
Tiggemann et al., 2013; Tiggemann, Brown, Zaccardo, & Thomas,
2017), and one was conducted on a sample from the Netherlands
(Veldhuis, Konijn, & Seidell, 2014). Eleven of the studies used female
undergraduate participants (Ata et al., 2013; Bissell, 2006; Bury
et al., 2016a, 2016b, 2017; Harmon & Rudd, 2016; Kwan et al., 2018;
Slater et al., 2012; Tiggemann & Brown, 2018; Tiggemann et al.,
2017, 2013), two used female samples recruited through Mechani-
cal Turk (Fardouly & Holland, 2018; Frederick et al., 2016), one used
a female adolescent community sample (Veldhuis et al., 2014), and
one used an adolescent sample of both girls and boys in which par-
ticipants were exposed to same-sex images (Harrison & Hefner,
2014). Eight studies used magazine advertisements as the media
stimuli (Ata et al., 2013; Bury, Tiggemann, & Slater, 2014, 2016a,
2016b; Harmon & Rudd, 2016; Kwan et al., 2018; Tiggemann &
Brown, 2018; Tiggemann et al., 2013, 2017), two used fashion pho-
tography images (Slater et al., 2012; Tiggemann et al., 2017), one
used photos of women from public Instagram accounts (Fardouly
& Holland, 2018), one used self-taken photos of college volunteers
(Harrison & Hefner, 2014), and three used images of female swim-
suit models (Bissell, 2006; Frederick et al., 2016; Veldhuis et al.,
2014). Of the three that used female swimsuit models, two did not
identify where the images were found from (Bissell, 2006; Veldhuis
et al., 2014), and one identified the images as coming from a Google
search (Frederick et al., 2016). Nine studies used visual analogue
scales to measure body dissatisfaction or body image (Ata et al.,
2013; Bury et al., 2016a, 2016b; Fardouly & Holland, 2018; Slater
et al., 2012; Tiggemann & Brown, 2018; Tiggemann et al., 2013,
2017), three used the Multidimensional Body-Self Relations Ques-
tionnaire (Ata et al., 2013; Harmon & Rudd, 2016; Kwan et al., 2018),
two used the Eating Disorder Inventory (Bissell, 2006; Veldhuis
et al., 2014), two used the Objectified Body Consciousness Scale
(Harrison & Hefner, 2014; Veldhuis et al., 2014), one used the Body
Image States Scale (Frederick et al., 2016), and one used self-made
Likert-type questions (Harmon & Rudd, 2016).
3.2. Types of disclaimers used
Altogether, six different categories of media disclaimers
were used in the studies presented here, which can be
classified as follows: generic disclaimers, specific disclaimers,
warning/consequence disclaimers, subvertising disclaimers, infor-
mational disclaimers, or graphic disclaimers. It is important to note
that even though the disclaimers from each study can be organized
into these categories, that each study had slight variations in how
the disclaimers were worded for each category (see Table 3).
3.2.1. Generic disclaimers
Altogether, 12 of the 15 studies presented here used generic
disclaimers (see Table 3). Generic disclaimers were warnings that
simply informed participants that the image presented to them
Table 1
Summary of study characteristics and findings.

Authors Target Population Country Types of Images Outcome Measures Conditions Findings

Ata et al., 2013 342 female United States Magazine Multidimensional Body-Self Exposure to model with Exposures to models did not cause any changes
undergraduate advertisements of Relations disclaimer in body dissatisfaction, anger or depression,
students thin female models Questionnaire-Appearance either with or without a warning or disclaimer.
Evaluation Subscale (trait Body Only the car control condition experienced
dissatisfaction) changes (decreases) in body dissatisfaction.
Aged 18-37 years Visual analogue scale for state Exposure to model with Regardless of condition participants
(M = 19.58, SD = body image and mood warning experienced decreased anxiety over time; no
2.06) unique effect for disclaimers or warnings
Sociocultural Attitudes Exposure to model only No effect of disclaimers or warnings on intent
Towards Appearance (control 1) to diet post-exposure; no sig. differences
Questionnaire—Internalization- between four conditions
General
Subscale
Physical Appearance Exposure to car Higher levels of trait body dissatisfaction and
Comparison Scale advertisements (control 2) baseline internalization predicted higher
post-exposure body dissatisfaction in the
warning condition only

S.E. McComb, J.S. Mills / Body Image 32 (2020) 34–52

Social appearance comparison was not a sig.
moderator between condition and body
dissatisfaction
Bissell, 2006 124 female United States Images of female Eating Attitudes Test Exposure to swimsuit model There were no differences between the three
undergraduate swimsuit models with disclaimer conditions on bulimia, anorexia, drive for
students thinness, or body dissatisfaction scores
Aged 18-24 years Eating Disorder Inventory Exposure to swimsuit model
without disclaimer
Experimenter made Likert type Exposure to images without
questions to assess: swimsuit model or disclaimer
(control)
Feelings of similarity to models
Desire to be similar to models
Thinness and attractiveness of
each model
Bury et al., 2016a 378 female Australia Magazine Visual analogue scales for body No disclaimer, neutral No main effect of disclaimer on state
undergraduate advertisements of dissatisfaction instructions to just look at add appearance comparison or body dissatisfaction
students thin female models
Aged 18-30 years Physical Appearance No disclaimer, distractor Main effect of instructions on body
(M = 20.10, SD = Comparison Scale instructions to rate appeal of dissatisfaction, such that those in the social
2.90) advertisement comparison condition experienced more body
dissatisfaction than those in the neutral or
distractor conditions, irrespective of disclaimer
type
3 questions for state No disclaimer, social No interaction between disclaimer and
appearance comparison comparison instructions instructions for state appearance comparison
or body dissatisfaction
Generic disclaimer, neutral Trait appearance comparison did not moderate
instructions the effect of either disclaimer label or
instructions on state appearance comparison
Generic disclaimer, distractor Three-way interaction between disclaimer,
instructions instructions, and trait appearance comparison.
For women in the distractor condition who saw
specifically worded disclaimers, those high on
trait appearance comparison experienced
increased body dissatisfaction, but those low
on trait appearance comparison experienced
reduced levels of body dissatisfaction

37
 38
Table 1 (Continued)

Authors Target Population Country Types of Images Outcome Measures Conditions Findings

Generic disclaimer, social

comparison instructions
Specific disclaimer, neutral
instruction
Specific disclaimer, distractor
instructions
Specific disclaimer, social
comparison instructions
Bury et al., 2016b 120 female Australia Magazine Tobii eye tracking Exposure to thin models with Participants attended to the disclaimer more in
undergraduate advertisements of no disclaimer the specific than generic disclaimer condition
students thin women
Aged 18-30 years Visual analogue scales for state Exposure to thin models with Those in the specific disclaimer condition had
(M = 20.51, SD = body dissatisfaction generic disclaimer more fixations on target body areas of the
3.03) models (arms, breasts, waist, legs) than those
in the other two conditions, and more time
spent looking at target body areas than the

S.E. McComb, J.S. Mills / Body Image 32 (2020) 34–52

generic disclaimer condition
Physical Appearance Exposure to thin models with No difference between two disclaimer
Comparison Scale specific disclaimer conditions in time until gaze first reaches
disclaimer
3 questions for state Was a higher percentage of those in the
appearance comparison specific disclaimer condition, than those in the
generic condition, who directed their gaze to
the target body areas of the models after first
looking at the disclaimer
Irrespective of disclaimer condition
participants showed a moderate increase in
body dissatisfaction after viewing ads
For those in the specific disclaimer condition
more fixations and time spent looking at target
areas on model, as well as looking at target
areas right after first looking at disclaimer, was
associated with greater increases in
post-induction body dissatisfaction. This was
not true for the generic condition.
State and trait appearance comparison both
did not moderate the relationship between
condition and body dissatisfaction
Bury et al., 2017 280 female Australia Fashion magazine Visual analogue scales for state Control pre-exposure message, Increase in body dissatisfaction over time
undergraduate advertisements of body dissatisfaction no disclaimer irrespective of whether there was a disclaimer
participants thin women or type of pre-exposure warning message; no
significant interactions so no effect of
disclaimer or message type on body
dissatisfaction
Aged 18-30 years Physical Appearance Control pre-exposure message State appearance comparison did not
(M = 20.42, SD = Comparison Scale with disclaimer moderate relationship between conditions and
2.99) body dissatisfaction
3 questions for state Digital alteration pre-exposure
appearance comparison message, no disclaimer
Four items to assess perceived Digital alteration pre-exposure
realism of models’ bodies message, disclaimer
Table 1 (Continued)

Authors Target Population Country Types of Images Outcome Measures Conditions Findings

Fardouly & 164 women United States Pre-selected Visual analogue scales for body Image of women only Those who viewed the images of attractive
Holland, 2018 recruited by photos of attractive dissatisfaction, mood, and women experienced more body dissatisfaction
Mechanical Turk women from public impressions of Instagram than control condition, but did not differ on
Instagram profiles women body dissatisfaction from each other; so
disclaimer had no effect on body dissatisfaction
Aged 18- 25 years Internalization-Thin/ Low Body Image of women + disclaimer Internalization of thin ideal did not moderate
(M = 23.09, SD = Fat subscale of Sociocultural relationship between condition and body
1.69) Attitudes Toward Appearance dissatisfaction
Questionnaire-4
Physical Appearance Travel images only (control Appearance comparison tendency moderated
Comparison Scale-Revised condition) relationship between condition and body
dissatisfaction, such that women high on
appearance comparison reported more body
dissatisfaction after exposure to image+
disclaimer and image only, relative to control
condition; no difference if disclaimer or not.
Women low in appearance comparison
reported similar body dissatisfaction
regardless of which of the three conditions

S.E. McComb, J.S. Mills / Body Image 32 (2020) 34–52

they were in.
No differences between three conditions on
changes in negative mood.
Internalization of thin ideal and appearance
comparison did not moderate relationship
between condition and negative mood
Frederick et al., 1303 women United States Slender women Drive for Thinness Scale Disclaimer condition No effect of condition on body dissatisfaction,
2016 recruited via modeling bikinis at drive for thinness, or state social comparison
Mechanical Turk the beach,
retrieved from
Google search
Aged 18-65 (M = Body Image States Scale Subvertising condition
34, SD = 11)
Physical Appearance Trait and Unaltered image condition
State Scale
State Social Comparison No image condition
measure
Harmon & Rudd, 71 female United States Fashion magazine Likert type scales for body Image only Those who viewed the disclaimer experienced
2016 undergraduate advertisements of image and mood an increase in their body satisfaction after
students thin women exposure to the images, relative to the control
group
Aged 18-24 years Rosenberg Self-Esteem Image + disclaimer Disclaimer had no effect on mood or
(M = 20, SD = 1.39) Inventory self-esteem
Body Area Satisfaction subscale
of Multi-Dimensional
Body-Self Relations
Questionnaire
Harrison & Hefner, 393 adolescents United States Photographs of Sociocultural Attitudes Unretouched image condition Regardless of gender, those in the retouched
2014 (262 females, 130 same-gender Towards Appearance aware condition experienced more objectified
males) college-aged Questionnaire body consciousness than those in the other
students taken by three conditions
the researchers and
professionally
edited
Aged 14-18 (M = Likert-type questions to asses Retouched image condition, no Regardless of gender, those in the retouched
15.46, SD = 1.32) model attractiveness awareness of retouch aware condition experienced less physical
self-esteem than those in the control or
retouched conditions

39
 40
Table 1 (Continued)

Authors Target Population Country Types of Images Outcome Measures Conditions Findings

Objectified Body Retouched-aware condition Sociocultural attitudes towards appearance did

Consciousness Scale not moderate the relationships between
experimental condition and self-esteem or
body consciousness
Physical Self-Description No-exposure control condition
Questionnaire (physical
self-esteem)
Kwan et al., 2018 118 female United States Fashion magazine Total kilocalories consumed Image only Warning labels had no short-term effects on
undergraduate advertisements of negative affect, momentary body
students thin women dissatisfaction, or momentary snack
consumption.
Aged 18-25 years Eating Disorder Examination Image + warning Those exposed to the warning labels reported
(M = 20.54, SD = Questionnaire liking the images less than those who were not
2.13) exposed to a warning
Multidimensional Body-Self Restrictive eating habits moderated the
Relations Questionnaire- relationship between condition and snack

S.E. McComb, J.S. Mills / Body Image 32 (2020) 34–52

Appearance Scales consumption, such that those high on
restrictive ate fewer kilocalories in the
warning condition than the control condition
Likert type questions to assess Appearance orientation increased from
affect baseline to the 4-week follow-up for those
exposed to the warning, but did not change for
those in the control condition
Slater et al., 2012 102 female Australia Fashion shoot Visual analogue scales to assess Generic disclaimer condition Disclaimers had no effect on negative mood;
undergraduate images of thin mood and body dissatisfaction none of the conditions differed on negative
students women mood
Aged 18-35 years Internalization subscale of Specific disclaimer condition Body dissatisfaction was higher in the image
(M = 20.31, SD = Sociocultural Attitudes only condition, than in the conditions that had
3.65) Towards Appearance a disclaimer, and there was no difference in
Questionnaire body dissatisfaction between the two
disclaimer conditions
Image only Thin-ideal internalization did not moderate
the relationship between condition and body
dissatisfaction
Tiggemann & 340 female Australia Fashion magazine Visual analogue scales to Image only Label type had no effect on body
Brown, 2018 undergraduate advertisements of measure mood and body dissatisfaction; the five conditions did not sig.
students thin women dissatisfaction differ from one another in body dissatisfaction
Aged 18-30 years Perceived Realism Scale Image + generic disclaimer Those who saw a consequence or informational
(M = 20.22, SD = label perceived the images to be more realistic
2.75) than those in the no label condition
State Appearance Comparison Image + consequence label Those who saw a consequence or informational
Scale label engaged in more appearance comparison
than those in the no label condition; there was
no sig. difference between appearance
comparison in the no label, graphic label, or
disclaimer label conditions
Physical Appearance Image + informational label
Comparison Scale Revised
Image + graphic label
Tiggemann et al., 320 female Australia Fashion shoot Visual analogue scales to Product control condition Warnings had no effect on body
2017 undergraduate images of thin measure mood and body dissatisfaction; no differences between any of
students women dissatisfaction warning conditions
Table 1 (Continued)

Authors Target Population Country Types of Images Outcome Measures Conditions Findings

Aged 18-30 years Perceived Realism Scale
(M = 20.25, SD =
2.61)
State Appearance Comparison
Scale
Physical Appearance
Comparison Scale Revised
Thin-Low Body Fat subscale of
Thin images, no warning Disclaimer labels has no sig. effect on state
appearance comparison
Thin images, small warning Trait appearance comparison did not moderate
effect of warning label on body dissatisfaction
Thin images, large warning Sig. interaction between warning label and
internalization on body dissatisfaction, such
that internalization not related to body
dissatisfaction in the product control group,
large and very large label conditions, but for
the no label and small label conditions those
high on internalization experienced greater
body dissatisfaction
Thin images, very large

S.E. McComb, J.S. Mills / Body Image 32 (2020) 34–52

Sociocultural Attitudes warning
Towards Appearance
Questionnaire
Tiggemann et al., Experiment 1: Australia Magazine Visual analogue scales for body Product image control Those who viewed thin images experienced
2013 advertisements of dissatisfaction condition more body dissatisfaction than those in the
thin women control condition, but disclaimers had no effect
on body dissatisfaction.
120 female Likert type questions for state Thin image only In experiment 1, those exposed to a disclaimer
undergraduate appearance comparison and engaged in more appearance comparison than
students perceived self-relevance those in the image only condition, with no
difference between the generic and specific
condition. In experiment 2, no sig. differences
in state appearance comparison between any
of the conditions who viewed thin images.
Aged 18-35 years Physical Appearance Thin image + generic Women higher on trait social comparison
(M = 20.90, SD= Comparison Scale disclaimer experienced increased body dissatisfaction in
5.30) the specific warning label condition.
Experiment 2: Thin image + specific Trait appearance comparison moderated
disclaimer relationship between condition and body
dissatisfaction, such that this relationship was
strongest for women in the specific disclaimer
condition. For women low on trait appearance
comparison little difference in body
dissatisfaction between the three conditions,
but for women high on trait appearance
comparison experienced most body
dissatisfaction when in the specific disclaimer
condition.
114 female
undergraduate
students
Aged 18-30 years
(M = 20.00, SD=
2.70)

41
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Table 1 (Continued)

Authors Target Population Country Types of Images Outcome Measures Conditions Findings

Veldhuis et al., 178 adolescent Netherlands Available digital Eating Disorder Inventory- Thin model, no label Body shape of the model interacted with
2014 girls photos of media Body Dissatisfaction subscale condition, such that combining thin media
models in bikinis models with information labels resulted in less
body dissatisfaction than the thin models with
no label or a warning label (which did not
differ from one another). However, body
dissatisfaction did not differ between the label
groups for the normal weight models.
Aged 12-18 years Objectified Body Consciousness Thin model, warning label Body shape of the model, participant
(M = 14.54, SD = Scale for Preadolescent and self-esteem, and condition all interacted with
1.45) Adolescent Youth one another to predict body dissatisfaction
such that for girls with lower self-esteem in
the thin model condition who saw an
information label, their body dissatisfaction
was significantly lower than those who saw

S.E. McComb, J.S. Mills / Body Image 32 (2020) 34–52

Social Comparison to Models
and Peers Scale
Rosenberg’s Self-Esteem Scale
Thin model, information label
Normal weight model, no label
Normal weight model, warning
label
Normal weight model,
information label
the thin models with no label or a warning
label. For girls with high self-esteem no effect
was found for labels on thin model images.
There was no difference in body dissatisfaction
between the conditions exposed to a normal
weight model in girls with either low or high
self-esteem.
Body shape of the model, participant
self-esteem, and condition all interacted with
one another to predict body objectified
consciousness, such that for girls with lower
self-esteem, using an information label on thin
media images resulted in lower levels of
objectified body consciousness, compared to
the warning label and no label (which did not
differ from one another). For normal weight
images, no differences in body consciousness
were found between the labels conditions for
girls with either low or high self-esteem.
Body shape of the model, participant
self-esteem, and condition all interacted with
one another to predict body comparison, such
that for girls with low self-esteem who saw
normal weight models with an information
and warning label (no differences between the
two) body comparison was lower compared to
those who saw the images with no label. No
differences between the conditions were found
for girls with high self-esteem. No differences
between labels for girls who saw thin models,
and who had either low or high self-esteem.
 S.E. McComb, J.S. Mills / Body Image 32 (2020) 34–52
had been digitally altered or enhanced. Unlike specific disclaimers,
generic disclaimers did not specify how the images had been
altered.
3.2.2. Specific disclaimers
Specific disclaimers were used in 4 of the 15 studies presented
here, and explained to participants exactly how an image had
been altered. In particular, specific disclaimers explained which of
the model’s body parts had been lengthened, trimmed of fat, or
smoothed during digital alteration.
3.2.3. Warning/consequence disclaimers
Four of the 15 studies also used a warning or consequence
disclaimer, which can be differentiated from the other types of dis-
claimers through the inclusion of a warning about the potential
for harm. More specifically, these disclaimers warned participants
about the harm or consequences that could come to their body
image or health through comparing themselves to the model fea-
tured in the image.
3.2.4. Information disclaimer
Two studies used an information disclaimer, which provided
weight information to the participant about the model featured in
the images presented. The disclaimers either provided information
to the participants that the featured model was underweight, or of
a normal weight.
3.2.5. Subvertising disclaimer
Two studies used subvertising disclaimers (Fardouly & Holland,
2018; Frederick et al., 2016), which are social commentary added
to an image with the purpose of undermining the message por-
trayed by the image. In the case of thin-ideal images, the purpose
of the subvertising disclaimer would be to challenge the unrealistic
nature of the image that is featured, although the two studies that
utilized subvertising disclaimers differed slightly in their intent.
Frederick et al. (2016) used subvertising labels to achieve the fol-
lowing: (1) challenge the objectification of the women featured, (2)
highlight that the image had been digitally manipulated, (3) high-
light how most women have to change their bodies to be models,
and (4) attempt to make the model a less desirable target for com-
parison. Alternatively, the captions used by Fardouly and Holland
(2018) seemed to be intended to: (1) challenge the realness of the
model’s appearance and lifestyle on social media, (2) highlight how
much effort was expended on changing or improving the model’s
appearance for a photo, and (3) ultimately making the model a less
desirable target for comparison by highlighting how uninspiring
the photos were. It is important to note that while Fardouly and
Holland (2018) did not specifically classify the disclaimers they
used in their study as subvertising labels, we believe that the dis-
claimers used in that study fit the definition of a subvertising label
better than any other type of disclaimer, and have therefore classi-
fied the disclaimers as such.
3.2.6. Graphic disclaimer
Only Tiggemann and Brown (2018) used the graphic disclaimer.
This disclaimer was not a verbal disclaimer like the other types of
disclaimers, but instead featured an image of a paintbrush with the
word “retouched” underneath.
3.3. Risk of bias within studies
Results of the quality assessment for each study can be found
in Table 2. Overall, 13 of the 15 studies were found to be of high
quality, and two were rated to be of neutral quality. Several of
the studies failed to include inclusion and exclusion criteria for
43
their samples, and the majority of studies had predominantly Cau-
casian and highly educated samples. Therefore, there is a risk that
samples were biased and not representative of young women in
general. All but two of the studies (Frederick et al., 2016; Harrison
& Hefner, 2014) had comparable experimental conditions prior to
the manipulation, and therefore results can be assumed to be due
to the effects of the independent variables and not pre-existing dif-
ferences between groups. All of the studies blinded participants to
what condition they were in, helping to reduce the likelihood of
response bias (i.e., demand characteristics). All studies used valid
and reliable measures of body image. A minority of studies failed
to control for relevant covariates in their statistical analyses, failed
to indicate whether assumptions of statistical tests were met, or
used statistical analyses even though assumptions were violated.
It is difficult to determine whether a funding bias existed within
studies, as many studies did not indicate whether the research was
funded.
3.4. Main effects of disclaimers on body image and mood
3.4.1. Body dissatisfaction
Altogether, all 15 studies examined the impact of thin-ideal
images with disclaimers on young women’s body dissatisfaction.
With respect to a disclaimer versus no disclaimer comparison,
the majority of studies found that disclaimers had no impact on
young women and girls’ level of body satisfaction. Among the seven
studies that compared exposure to an image-only condition to
an image + disclaimer condition, five did not find any differences
in post-manipulation body dissatisfaction between young women
exposed to a thin-ideal image with no disclaimer and young women
exposed to the same thin-ideal image with a disclaimer (see Table 3
for a summary of the specific disclaimers used in each study; Bissell,
2006; Bury et al., 2017, ␩2 p < .01; Fardouly & Holland, 2018; Kwan
et al., 2018; Tiggemann et al., 2017, ␩2 p < .01). However, it is difficult
to interpret whether there were any negative effects within these
studies for the disclaimers to actually mitigate. Three of the above
studies (Bissell, 2006; Fardouly & Holland, 2018; Tiggemann et al.,
2017) did not report whether there were any significant changes in
body dissatisfaction from pre to post image exposure, and therefore
it cannot be determined if the thin-ideal images caused any changes
in body dissatisfaction that the disclaimers might have had a chance
of mitigating. One study conducted by Bury et al. (2017) did find
that body dissatisfaction increased from pre to post image exposure
in both the image-only and the disclaimer condition, which sug-
gests that in this case the researchers can be sure that the disclaimer
failed to mitigate the increases in body dissatisfaction since those
in the disclaimer condition experienced similar amounts of body
dissatisfaction as those in the control condition. Conversely, Kwan
et al. (2018) did not find any pre to post changes in momentary body
dissatisfaction in either the image-only or disclaimer condition.
Since no changes in body dissatisfaction occurred in the control
(image-only) condition, it seems there was no negative effect for
the disclaimer to mitigate, which likely explains why disclaimers
were found to be ineffective in the study.
With respect to a generic versus specific disclaimer, no signifi-
cant differences were found between young women exposed to a
thin-ideal image with no disclaimer, those exposed to a thin-ideal
image with a generic disclaimer, or those exposed to a thin-ideal
image with a specific disclaimer in four out of five studies (Bury
et al., 2016a, ␩2 p = .01, 2016b, ␩2 p = .01; Tiggemann & Brown, 2018,
␩2 p < .01; Tiggemann et al., 2013, d = 0.04-0.06). Two of these stud-
ies (Bury et al., 2016a; Tiggemann et al., 2013) did not report pre
to post changes in body dissatisfaction, and therefore it cannot be
determined if there were any changes in body dissatisfaction to
actually mitigate. However, Bury et al. (2016b) and Tiggemann and
Brown (2018) did find that body dissatisfaction increased from pre
 44
Table 2
Quality assessment of reviewed studies using the Quality Criteria Checklist (QCC).

Study Clear research Sample Comparable Participant Use of Clear Clearly defined, Appropriate Conclusions Unlikely Overall quality
question selection free study groups withdrawals or blinding description of valid, reliable statistical supported by funding bias rating
from bias response rate data collection outcomes analysis results
described procedures

S.E. McComb, J.S. Mills / Body Image 32 (2020) 34–52

Ata et al., 2013 + + + N/A + + + + + Unclear +
Bissell, 2006 + ∅ + N/A + + + ∅ ∅ Unclear +
Bury et al., 2016a + ∅ + N/A + + + + + Unclear +
Bury et al., 2016b + ∅ + N/A + + + + + + +
Bury et al., 2017 + ∅ + N/A + + + + + + +
Fardouly & + ∅ + N/A + + + + + + +
Holland, 2018
Frederick et al., + + Unclear N/A + ∅ + ∅ + Unclear ∅
2016
Harmon & Rudd, – ∅ + N/A + + + ∅ + Unclear ∅
2016
Harrison & Hefner, + + Unclear + + + + + + + +
2014
Kwan et al., 2018 + + + + + + + + + + +
Slater et al., 2012 + ∅ + N/A + + + + + Unclear +
Tiggemann & + ∅ + N/A + + + + + + +
Brown, 2018
Tiggemann et al., + ∅ + N/A + + + + + + +
2017
Tiggemann et al., + ∅ + N/A + + + + + Unclear +
2013
Veldhuis et al., + + ∅ N/A + + + + + Unclear +
2014
 S.E. McComb, J.S. Mills / Body Image 32 (2020) 34–52 45

Table 3
Disclaimers used from each study organized by type of disclaimer.

Type of Disclaimer Authors that Used This Type of How Disclaimer Was Worded
Disclaimer

Ata et al., 2013 “Retouched photograph aimed at changing a person’s physical appearance.”
Bissell, 2006 “The image below has been digitally manipulated to enhance the model’s appearance.”
Bury et al., 2016a “Warning: This image has been digitally altered”
Bury et al., 2016b “Warning: This image has been digitally altered”
Bury et al., 2017 “Warning: This image has been digitally altered”
Frederick et al., 2016 “Warning: This photo has been PHOTOSHOPPED”.
Generic
Harmon & Rudd, 2016 “Warning: These images have been digitally enhanced.”
Harrison & Hefner, 2014 “After students were photographed, a professional photo retoucher refined the images
using a computer photo retouching program.”
Slater et al., 2012 “Warning: These images have been digitally altered”
Tiggemann & Brown, 2018 “Note: This image has been altered to enhance appearance”
Tiggemann et al., 2017 “Warning: These images have been digitally altered”
Tiggemann et al., 2013 “Warning: This image has been digitally altered”
Bury et al., 2016a “Warning: This image has been digitally altered to lengthen and thin legs”
Bury et al., 2016b “Warning: This image has been digitally altered to trim arms and waist”
Specific
Slater et al., 2012 “Warning: these images have been digitally altered to lengthen legs and trim inner
thighs.”
Tiggemann et al., 2013 “Warning: This image has been digitally altered to smooth skin tone and slim arms
and legs”.
Ata et al., 2013 “Warning: Trying to look as thin as this model may be dangerous to your health.”
Kwan et al., 2018 “Warning: This photograph has been altered in a manner that could promote
Warning/Consequence
unrealistic expectations of appropriate body image.”
Tiggemann & Brown, 2018 “Note: Viewing thin and unrealistic images of women can make you feel bad about
yourself”
Veldhuis et al., 2014 Thin condition: “These models are underweight. Unconsciously, exposure to media
models may negatively impact your self- image.”
Normal weight condition: “These models have a normal weight. Unconsciously,
exposure to media models may negatively impact your self-image.”
Tiggemann & Brown, 2018 “Note: This model is underweight”
Information
Veldhuis et al., 2014 Thin condition: “These models are underweight”
Normal weight condition: ‘These models have a normal weight”
Fardouly & Holland, 2018 E.g.“I had acne here, this is a lot of makeup. I was smiling because I thought I looked
Subvertising
good. Happiness based on aesthetics will suffocate your potential here on earth”
E.g. “Not real life—I didn’t pay for this outfit, took countless photos trying to look hot
for Instagram.”
Frederick et al., 2016 E.g. “Why don’t you show that she is a person with a face and personality instead of
presenting her as a sexualized body part?”
E.g. “Photoshop made me ripped”
Graphic Tiggemann & Brown, 2018 Image of a paint brush with word “Retouched” underneath

to post exposure in both the control (image-only) and disclaimer
conditions, which suggests that the researchers can be confident
that the disclaimers actually failed to mitigate increases in body
dissatisfaction.
In the one study that did find that disclaimers mitigated
increased body dissatisfaction relative to the no label condition,
the effect size was moderate (␩2 p = .10, Slater et al., 2012), but sim-
ilar to other studies, this study showed that specific disclaimers
were no more effective than generic disclaimers (␩2 p = .002) in
mitigating body dissatisfaction (Slater et al., 2012). Specifically,
the researchers found that exposure to thin-ideal images caused
increased body dissatisfaction from pre to post for the image-only
condition, but they did not find any significant changes in pre to
post scores for either the generic or specific disclaimer conditions.
In other words, the results indicated that both types of disclaimers
were effective at preventing an increase in body dissatisfaction
caused by exposure to the thin-ideal images. Consequently, there
appears to be no added benefit to women’s body image from includ-
ing in a disclaimer specifically how an image was altered.
With respect to other types of disclaimer labels, no significant
differences in body dissatisfaction were found between women
who viewed thin-ideal images with no disclaimer compared to
women who viewed thin-ideal images with any type of disclaimer
label, including a warning disclaimer (e.g., “Warning: Trying to
look as thin as this model may be dangerous to your health”), a
generic disclaimer (e.g., “Note. This image has been digitally altered to
enhance appearance”), a consequence disclaimer (e.g., Note. Viewing
thin and unrealistic images of women can make you feel bad about
yourself.”), a graphic disclaimer (e.g., An image of a paintbrush
with the word “Retouched” underneath), or a subvertising dis-
claimer (e.g., Photoshop made me ripped.”) (Ata et al., 2013; Frederick
et al., 2016, ␩2 p = .004; Tiggemann & Brown, 2018). However,
results were mixed regarding the differential effects of informa-
tional disclaimers on women’s body dissatisfaction after viewing
thin-ideal images. Tiggemann and Brown (2018) found that body
dissatisfaction did not differ between undergraduate women who
were exposed to thin-ideal images with an information disclaimer,
consequence disclaimer, generic disclaimer, specific disclaimer,
graphic disclaimer, or no disclaimer at all. However, Veldhuis et al.
(2014) found that adolescent girls who were exposed to thin-ideal
images with an information disclaimer had less body dissatisfaction
than those exposed to thin-ideal images with a warning disclaimer
or no disclaimer at all (␩2 p = .06), and this represented a medium
effect. The results from Veldhuis et al. (2014) suggests that in this
case informational disclaimers were effective at mitigating body
dissatisfaction after exposure to thin-ideal images for adolescent
girls. Only two other studies found disclaimers to be effective in
preventing negative body image among young women, and these
represented medium effects. More specifically, it was found that
young women who were exposed to thin-ideal images with a dis-
claimer reported less body dissatisfaction than those exposed to the
same image without a disclaimer (Harmon & Rudd, 2016, ␩2 p = . 06;
Slater et al., 2012, ␩2 p = . 10).
Conversely, Harrison and Hefner (2014) found that regardless
of gender, adolescents who were exposed to retouched images of
college students labelled with a disclaimer stating that the images
46 S.E. McComb, J.S. Mills / Body Image 32 (2020) 34–52
had been professionally retouched reported greater body dissatis-
faction (␩2 p = .06) and lower physical self-esteem (␩2 p = .05) than
those who saw the untouched photos, those who saw the retouched
photos without a disclaimer, and those who saw no image at all;
these represented small-medium effects. This is the only study to
date that found that disclaimers could heighten body dissatisfaction.
Overall, 11 studies found that disclaimers were ineffective at
mitigating body dissatisfaction after exposure to thin-ideal images
(relative to no disclaimer), three studies found medium effects that
disclaimers were effective at mitigating increased body dissatisfac-
tion, and one study found a small-medium effect that disclaimers
actually heightened body dissatisfaction.
3.4.2. Eating behaviour
Eating behaviour in response to thin-ideal disclaimers has been
measured in three studies using intention-to-diet scales, measures
of eating pathology, and in vivo food consumption in the lab. In
two of three studies, it was found that viewing thin-ideal images
with disclaimers had no significant effect on young women’s eating
compared to viewing an image alone. Women who viewed thin-
ideal images with a disclaimer did not differ from those who saw
the images with no disclaimer on intention to diet (␩2 p = . 009,
Ata et al., 2013) or on anorexic or bulimic behaviours, as mea-
sured by the Eating Attitudes Test and Eating Disorder Inventory
(Bissell, 2006). However, in regard to eating behaviour, it was found
that those who were high on restrictive eating habits consumed
less kilocalories after exposure to a warning disclamer, relative
to those who were low on restrictive eating habits, and to those
who were exposed to the thin-ideal image alone (Kwan et al.,
2018). These results indicate that exposure to warning disclaimers
triggered more restrictive eating among those who were already
likely to exhibit restrictive eating habits. Therefore, young women’s
intentions to diet and their self-reported anorexic and bulimic
behaviours were not differentially impacted by exposure to thin-
ideal images with a disclaimer, relative to seeing the image alone,
but their actual in-vivo eating behaviour was negatively impacted
by exposure to a disclaimer if they were already restrictive eaters.
3.4.3. Drive for thinness
Two studies found that drive for thinness did not significantly
differ between women after viewing images of thin swimsuit mod-
els either with or without a disclaimer (Bissell, 2006; Frederick
et al., 2016, ␩2 p = .002). Therefore, when viewing images of swim-
suit models specifically, disclaimers are neither protective against
nor harmful to women’s desire to lose weight.
3.4.4. Appearance orientation
Only one study has examined the impact of disclaimers on
women’s appearance orientation, which reflects the relative impor-
tance and attention paid to physical appearance. Kwan et al. (2018)
found a small effect, whereby women’s ratings of the importance
of and attention paid to their physical appearance significantly
increased over the course of four weeks when they had previously
been exposed to thin-ideal images with a disclaimer (d = 0.25),
an effect which was not found in the image-only (no disclaimer)
condition (d = 0.09). Therefore, preliminary research suggests that
disclaimers on thin-ideal images make women more likely to place
greater importance on their appearance and focus more attention
on their appearance compared to viewing thin-ideal images with-
out a disclaimer.
3.4.5. State appearance comparison
Results regarding the effect of disclaimers on state appearance
comparison are mixed, with three studies finding no differences in
the degree of state appearance comparison between those exposed
to a thin-ideal image with either no disclaimer, a generic disclaimer,
or a specific disclaimer, and two studies finding that exposure
to certain disclaimers increased state appearance comparison. All
studies used the State Appearance Comparison Scale (Tiggemann &
McGill, 2004) to measure the degree of state appearance compari-
son made to the models (1 = no comparison to 7 = a lot of comparison).
When comparing the effect of specific versus generic disclaimers to
no disclaimers, Bury et al. (2016a) found no significant difference
in the degree of state appearance comparison between the three
conditions (␩2 p = .01). Additionally, Tiggemann et al. (2017) found
no significant differences in the degree of state appearance com-
parison between women exposed to an image with no disclaimer,
and women exposed to an image with either a small, large, or very
large disclaimer (␩2 p = .01). Similarly, in the first experiment of a
set of studies, Tiggemann et al. (2013) also found no significant dif-
ferences in the degree of state appearance comparison between
women who were aged 18–35 years and who were exposed to
an image with no disclaimer versus women exposed to an image
with either a specific or generic disclaimer (d = 0.08). In this first
experiment by Tiggemann et al. (2013) participants browsed the
thin-ideal images at their own pace, with no time limit on how
long they could look at the images. However, in a second experi-
ment with some procedural modifications, Tiggemann et al. (2013)
found a small-medium effect, whereby women that were exposed
to either a specific or generic disclaimer were more likely to engage
in a greater degree of appearance comparison than those exposed
to the image with no disclaimer (d = 0.46), with no significant dif-
ference between the generic and specific disclaimer conditions
(d = 0.03). In this second experiment, Tiggemann et al. (2013) used
a smaller age range for their sample (18–30 years instead of 18–35
years) and also limited exposure time to each thin-ideal image
to 45 s; it is possible that these procedural modifications account
for the mixed findings between these two experiments. Similarly,
while Tiggemann and Brown (2018) found that there were no sig-
nificant differences in the degree of state appearance comparison
between those exposed to an image with no disclaimer, a generic
disclaimer (␩2 p = .01), or a graphic disclaimer (␩2 p < .01), they did
find that women exposed to a consequence disclaimer (␩2 p = .02) or
an informational disclaimer (␩2 p = .03) engaged in a greater degree
of state appearance comparison as compared to the image only
control group; however, these were very small effects. Therefore,
it remains unclear what effect media disclaimers have on state
appearance comparison.
3.4.6. Mood
Results consistently reflected that the effect on state mood was
no different for the disclaimer groups than for the image-only
groups. All five studies that examined the effect of disclaimers on
mood found that there were no significant differences between the
image-only conditions and image + disclaimer conditions on nega-
tive mood (Fardouly & Holland, 2018; Harmon & Rudd, 2016; Kwan
et al., 2018; Slater et al., 2012, ␩2 p = .05) or anxiety (Ata et al., 2013).
Ata et al. (2013) and Kwan et al. (2018) both found that negative
affect decreased from pre to post exposure in both the image-only
and disclaimer conditions, with no differences between the con-
ditions. These results allow the researchers to be confident that
disclaimers had no greater impact on reducing negative affect than
did just seeing the images. However, Slater et al. (2012) found that
the images had very little effect on negative affect pre to post expo-
sure in either the image-only or disclaimer conditions; participants’
levels of negative affect remained virtually the same as baseline lev-
els after seeing the thin-ideal images in all conditions. Since there
were no changes in negative affect in the control (image-only) con-
dition it cannot be concluded that the disclaimers were ineffective
at mitigating increased negative affect.
In summary, the majority of experimental research on the
effects of various types of disclaimers suggests that they are nei-
 S.E. McComb, J.S. Mills / Body Image 32 (2020) 34–52
ther protective nor harmful in terms of body image, mood, or
eating. They may in fact be harmful in terms of appearance ori-
entation and state appearance comparison. Visual inspection and
comparison of the variability between experimental versus control
groups in the studies reviewed above revealed equivalent indices
of variance. Nevertheless, research targeting potential individual
difference moderators has been conducted and is reviewed next.
3.5. Individual difference moderators
3.5.1. Trait body dissatisfaction
One study found that levels of trait body dissatisfaction mod-
erated the relationship between experimental condition and body
dissatisfaction, such that those who were higher in trait body dis-
satisfaction and who were exposed to a warning label reported
higher post-exposure body dissatisfaction than the other condi-
tions (␤ = −.06), whereas those low in trait body dissatisfaction in
the warning condition did not differ in post-exposure body dis-
satisfaction from the other conditions (Ata et al., 2013). Therefore,
women high in trait body dissatisfaction are at risk for experiencing
even greater body dissatisfaction following exposure to thin-ideal
images with warnings about the dangers of trying to look like the
models, while women low in trait body dissatisfaction are not at an
increased risk for greater state body dissatisfaction.
3.5.2. Thin-ideal internalization
Results regarding the role of thin-ideal internalization as a
moderator of the relationship between experimental disclaimer
condition and body dissatisfaction are mixed; three studies found
that thin-ideal internalization did not significantly moderate the
relationship between disclaimer condition and body dissatisfac-
tion, while two studies did find it to be a significant moderator.
Both Slater et al. (2012) and Fardouly and Holland (2018) found
that thin-ideal internalization did not moderate the relationship
between disclaimer condition and body dissatisfaction. Similarly,
Harrison and Hefner (2014) investigated whether sociocultural
attitudes towards appearance moderated the relationship between
disclaimer condition and body consciousness. In this study, socio-
cultural attitudes towards appearance consisted of attitudes that
reflected not only internalization of the thin ideal, but also accep-
tance of the media as a source of information about appearance and
perceived pressure to conform to media ideals. Similar to the results
found by Slater et al. (2012) and Fardouly and Holland (2018), socio-
cultural attitudes towards appearance were not found to moderate
the relationship between disclaimer condition and body conscious-
ness (Harrison & Hefner, 2014).
However, Ata et al. (2013) found a small effect, whereby higher
baseline internalization predicted greater post-exposure body
dissatisfaction in the warning label condition (␤ = .06), whereas
women low in internalization did not experience higher body
dissatisfaction after exposure to the image + warning label. These
results by Ata et al. (2013) suggest that warning disclaimers may
put women who are high in thin-ideal internalization at greater
risk of body dissatisfaction after looking at thin-ideal images than
generic or specific disclaimers or no disclaimers at all. Tiggemann
et al. (2017) also found that thin-ideal internalization moderated
the relationship between size of disclaimer used and body dis-
satisfaction, such that women high in thin-ideal internalization
who saw the image only or the image + small-sized disclaimer
experienced greater post-exposure body dissatisfaction, whereas
thin-ideal internalization was not related to body dissatisfaction in
the control condition, or in the large and very large-sized disclaimer
conditions. These results by Tiggemann et al. (2017) indicate that
when a disclaimer is not present or is less visible, women high on
thin-ideal internalization experience greater body dissatisfaction
than when the disclaimer is larger in size. Given the mixed results
47
of these studies, it remains unclear whether thin-ideal internaliza-
tion moderates the effect of disclaimers on body dissatisfaction and
for what type of disclaimer.
3.5.3. Trait appearance comparison
Seven studies examined trait appearance comparison tendency
as a potential moderator of the effects of disclaimers. All seven
studies used a version of the Physical Appearance Comparison
Scale (Schaefer & Thompson, 2014; Thompson, Heinberg, & Tantleff,
1991) to measure how often (1 = never to 5 = always) participants
generally compared their appearance to others in different social
contexts. Four studies found that trait appearance comparison
tendency did not moderate the relationship between disclaimer
condition and body dissatisfaction (Ata et al., 2013; Bury et al.,
2016b, R2 change < .01; Bury et al., 2017, R2 change < .001; Tiggemann
et al., 2017, R2 change = .01). However, three studies did find that
trait appearance comparison tendency moderated the relation-
ship between disclaimer condition and body dissatisfaction (Bury
et al., 2016a; Fardouly & Holland, 2018; Tiggemann et al., 2013).
Specifically, Fardouly and Holland (2018) found that for women
who were low on trait appearance comparison, there were no
differences in body dissatisfaction between women exposed to a
thin-ideal image alone, a thin-ideal image + disclaimer, or travel
control images. However, it was found that women high on trait
appearance comparison reported more body dissatisfaction after
exposure to an image + disclaimer or image only, relative to the con-
trol condition, yet there were no significant differences between the
image + disclaimer and image-only conditions. This suggests that
mere exposure to a thin-ideal image causes increased body dis-
satisfaction for women high on trait appearance comparison and
that the presence of the disclaimer neither mitigates nor causes
any greater body dissatisfaction than exposure to the thin-ideal
image alone. Exposure to thin-ideal images had no greater effect
on body dissatisfaction than control travel images for women low
on trait appearance comparison. However, Tiggemann et al. (2013)
found that for women high on appearance comparison, the great-
est amount of body dissatisfaction was experienced when they
were exposed to a specific disclaimer (B = 1.90) relative to women
exposed to a generic disclaimer or no disclaimer. If women were
low on appearance comparison, then no significant differences
were found between the conditions on body dissatisfaction. Sim-
ilarly, Bury et al. (2016a) found that women who were high on
trait appearance comparison and who were instructed to rate the
appeal of thin-ideal advertisements that had specific disclaimers
experienced increased body dissatisfaction (␤ = .20), while those
low on trait appearance comparison experienced reduced body
dissatisfaction in this condition. Therefore, it remains unclear if
disclaimers that specify how and which body parts were altered
put women high in trait appearance comparison at greater risk for
increased body dissatisfaction, since two studies (Bury et al., 2016a;
Tiggemann et al., 2013) have found support for this relationship,
and one has not (Bury et al., 2016b), despite the fact that all three
studies used similar populations and stimuli.
3.5.4. Trait self-esteem
Only one study examined trait self-esteem as a moderator
between disclaimer condition and body image. Veldhuis et al.
(2014) found that adolescent girls with low trait self-esteem who
were exposed to images of thin models with an information label
experienced less body dissatisfaction (␩2 p = .10) and less body con-
sciousness (␩2 p = .05) compared to girls who viewed the images
with a warning label or no disclaimer at all, and these repre-
sented small-medium effects. No differences in body dissatisfaction
or consciousness were found for girls exposed to normal weight
images as a function of self-esteem. Therefore, for girls with
low self-esteem, informational disclaimers were protective against
48 S.E. McComb, J.S. Mills / Body Image 32 (2020) 34–52
body dissatisfaction and body consciousness caused by exposure to
thin media images, while warning labels were not.
4. Discussion
The purpose of the current review was to systematically exam-
ine what effect media disclaimers have on women’s body image
and mood following exposure to thin-ideal images. This review was
undertaken to determine if there is a scientific basis for including
media disclaimers on thin-ideal images as a public policy strategy to
protect women’s body image and mood after exposure to thin-ideal
images. It was the goal of this review to amalgamate all existing
findings on media disclaimers and body image and mood so that
if disclaimers were found to be an effective strategy at preventing
negative body image and mood after exposure to thin-ideal images,
it could be better understood which types of disclaimers were the
most effective, under what contexts, and for whom.
4.1. Summary of results for each type of disclaimer
4.1.1. Generic disclaimers
Of the 11 studies that included generic disclaimers, eight stud-
ies found that generic disclaimers were ineffective at preventing
body dissatisfaction relative to viewing a thin-ideal image alone,
and generic disclaimers were not found to be more effective than
any other type of disclaimer (Bissell, 2006; Bury et al., 2016a, 2016b;
Frederick et al., 2016; Tiggemann & Brown, 2018; Tiggemann et al.,
2013, 2017). It was also found that making disclaimers larger and
more noticeable does not seem to make the disclaimer any more
effective than when it is smaller in size (Tiggemann et al., 2017). The
effect of generic disclaimers on body dissatisfaction was not mod-
erated by levels of thin-ideal internalization (Slater et al., 2012),
state and trait appearance comparison (Bury et al., 2016b, 2017;
Tiggemann et al., 2017) or sociocultural attitudes towards appear-
ance (Harrison & Hefner, 2014). In all but one study (Tiggemann
et al., 2013) generic disclaimers also did not reduce engagement in
state appearance comparison to the thin-ideal images – those who
saw thin-ideal images with generic disclaimers engaged in rela-
tively equal degrees of state appearance comparison as those who
saw thin-ideal images without the disclaimer (Bury et al., 2016a;
Frederick et al., 2016; Tiggemann & Brown, 2018; Tiggemann et al.,
2017). Finally, exposure to generic disclaimers neither reduced nor
increased negative affect post-exposure, or relative to exposure to
the image alone (Harmon & Rudd, 2016; Slater et al., 2012).
However, two studies did find that generic disclaimers were
effective at mitigating body dissatisfaction resulting from exposure
to thin-ideal images (Harmon & Rudd, 2016; Slater et al., 2012);
however, these studies differed methodologically from the other
studies reported. Harmon and Rudd (2016) recruited a very specific
sample of participants majoring in Fashion and Retail studies, who
arguably are exposed to fashion advertisements more often than
the general population, and who may serve to benefit the most from
a reminder that the images they see on a regular basis are digitally
altered and do not reflect realistic or attainable bodies. Also, unlike
most other studies that used magazine advertisements for stimuli,
Slater et al. (2012) used fashion shoots. As has been pointed out by
other researchers (e.g., Tiggemann et al., 2013) fashion shoots may
appear more natural and realistic than the highly perfected images
presented in magazines advertisements, which aim to present ide-
als of a happy, successful, or perfect life that are due to the use of
the advertised product (Tiggemann et al., 2013). Therefore, when
placed on a magazine advertisement the disclaimer not only has
to make the model’s body seem like an unrealistic target for com-
parison, but also has to make the successful life portrayed seem
unrealistic as well. Therefore, it may be simpler for disclaimers
in fashion shoots to make the model’s bodies seem like unreal-
istic targets for comparison, compared to the difficulty of making
both the model and the life portrayed in magazine advertisement
unrealistic.
Finally, one study found that exposure to thin-ideal images
accompanied by generic disclaimers actually increased the levels
of body dissatisfaction and lowered physical self-esteem, relative
to exposure to the unaltered or retouched image alone (Harrison
& Hefner, 2014). This was the only study to use non-models as
stimuli—instead the researchers used images of older students as
stimuli, and the disclaimer specifically identified the person in the
image as a student. By identifying the person in the image as a
student, the disclaimer may have actually communicated to the
participants that the person in the image was an appropriate tar-
get for comparison, whereas those in the image only condition may
have assumed the person was actually a model and therefore less
of a suitable target for comparison. If the person in the image was
perceived to be just a student and a suitable target for comparison,
then it is possible this may have increased state social comparison
and greater subsequent body dissatisfaction, relative to viewing the
image alone where the person in the image may have been viewed
as a model and therefore a less suitable target for comparison.
4.1.2. Specific disclaimers
Four studies included specific disclaimers as a part of their
experimental design, and three found that overall specific dis-
claimers were ineffective at preventing body dissatisfaction after
exposure to thin-ideal images, relative to being exposed to the
image alone (Bury et al., 2016a, 2016b; Tiggemann et al., 2013).
Also, no differences in body dissatisfaction were found between
those exposed to an image with a specific or generic disclaimer,
indicating that specifically outlining which body parts have been
altered in an image is not superior in mitigating body dissatisfac-
tion to simply stating that the image has been altered (Bury et al.,
2016a; Tiggemann et al., 2013).
Regarding the effect of trait appearance comparison on the
relationship between specific disclaimers and body dissatisfaction,
results were somewhat inconsistent. It was found that for women
low on trait appearance comparison, there was little difference in
body dissatisfaction between those exposed to a thin-ideal image
alone, the image with a generic disclaimer, or the image with a
specific disclaimer (Tiggemann et al., 2013). However, for women
high on trait appearance comparison tendency, exposure to the
thin-ideal image with a specific disclaimer resulted in greater felt
body dissatisfaction than their counterparts who saw the image
alone or the image with a generic disclaimer, indicating that for
these women specific disclaimers were actually harmful to body
image rather than protective. Similarly, women that were high
on trait appearance comparison tendency experienced increased
body dissatisfaction when they were asked to rate the appeal of
thin-ideal advertisements that were accompanied by specific dis-
claimers (Bury et al., 2016a). Conversely, women that were low
on trait appearance comparison tendency actually derived bene-
fit from the specific disclaimer, and experienced reduced levels of
body dissatisfaction. Therefore, in this particular study the benefit
of specific disclaimers was dependent upon women’s degree of trait
appearance comparison. On the other hand, contrary to the findings
of the two studies explained above, Bury et al. (2016b) found that
trait appearance comparison did not moderate the effect of specific
disclaimers on body dissatisfaction. A post hoc power analysis of the
parameters of that study by the current authors suggest that it had
adequate power to detect a medium effect size. Eye tracking studies
have revealed that specific disclaimers direct more visual attention
to target body parts mentioned in specific disclaimer compared to
other types of disclaimers (Bury et al., 2016b, 2014), and therefore
it may be that for women who are already likely to compare them-
 S.E. McComb, J.S. Mills / Body Image 32 (2020) 34–52
selves to others, the specific disclaimer actually directs a greater
amount of visual attention to the body parts mentioned in the dis-
claimer, which has been shown to increase the likelihood of state
appearance comparison and increase subsequent body dissatisfac-
tion (Tiggemann, Brown, & Thomas, 2019). However, if women are
already unlikely to compare themselves to others the specific dis-
claimer serves the intended purpose of making the model seem like
an unrealistic target of comparison by outlining all the changes that
have been made to the model’s body.
Slater et al. (2012) were the only researchers to find that specific
(and generic) disclaimers were effective at mitigating body dissat-
isfaction after exposure to thin-ideal images, relative to viewing the
image alone. As in previous studies, specific disclaimers were not
found to be any more effective than generic disclaimers in prevent-
ing body dissatisfaction for this sample. As mentioned in the section
above, the most obvious difference between Slater et al.’ (2012)
methodological design and the other studies is that Slater et al.
(2012) were one of the only studies to use fashion shoot images,
while most other studies used fashion advertisements; this differ-
ence in stimuli may account for why they found disclaimers to be
effective and other studies did not.
In regard to the effect of specific disclaimers on engagement in
state appearance comparison, there was also some inconsistency
in the results. Two studies found that there were no significant dif-
ferences in engagement in state appearance comparison between
those exposed to a thin-ideal image alone, those exposed to the
image with a generic disclaimer, or those exposed to the image
with a specific disclaimer, indicating that specific disclaimers were
ineffective at preventing comparison to the thin-ideal models (Bury
et al., 2016a; Tiggemann et al., 2013). However, in the second exper-
iment of this study, Tiggemann et al. (2013) found that women
who were exposed to the thin-ideal image with either a generic
or specific disclaimer, actually engaged in more appearance com-
parison than those in the image only condition, and results did not
significantly differ between generic or specific disclaimers. Once
again, these results indicate that specific disclaimers can actually
be harmful, instead of helpful, for young women’s body image. The
mixed findings in regard to engagement in state appearance com-
parison may be due to procedural differences between studies.
In both of the studies that found no differences between condi-
tions in state appearance comparison, participants had a set time
limit of 45 s to view each image (Bury et al., 2016a; Tiggemann
et al., 2013). However, in studies where differences in engagement
in state appearance comparison were found, there was no time
limit on how long participants could look at each image, and the
researchers found that time spent looking at the images was quite
variable (12–46 seconds; Tiggemann et al., 2013). Therefore, it is
possible that the experimental groups spent different amounts of
time looking at the images, and therefore had different amounts of
time to engage in social comparison. Bury et al. (2016b) did find
that those exposed to specific disclaimers spent more time looking
at the model’s body parts mentioned in the disclaimer than those
exposed to the image alone or to a generic disclaimer. Therefore, it
is possible that women exposed to a specific disclaimer spent more
time looking at the images than those in the other conditions, and
therefore spent more time engaging in social comparison.
4.1.3. Warning or consequence disclaimers
Four studies examined the impact of including warn-
ing/consequence labels (hereby referred to as warning labels) on
thin-ideal images and their impact on resulting body dissatisfac-
tion (Ata et al., 2013; Kwan et al., 2018; Tiggemann & Brown, 2018;
Veldhuis et al., 2014). All four studies found that body dissatisfac-
tion did not differ between those exposed to a thin-ideal image
alone or those exposed to the thin-ideal image with the warning
label, indicating that warning labels were ineffective at prevent-
49
ing body dissatisfaction. Warning disclaimers were not found to
be any more effective than generic disclaimers at preventing body
dissatisfaction, relative to viewing the image alone (Ata et al.,
2013; Tiggemann & Brown, 2018). However, results were mixed
regarding how warning labels compared to information labels in
their effectiveness to prevent body dissatisfaction after exposure
to thin-ideal images. Tiggemann and Brown (2018) found that both
warning and information labels were equally ineffective at pre-
venting increased body dissatisfaction in young women. However,
Veldhuis et al. (2014) found that exposure to information labels
reduced body dissatisfaction in adolescent girls, while exposure
to warning labels did not, indicating that information labels were
superior to warning labels at preventing body dissatisfaction result-
ing from exposure to thin-ideal images. At present, it is unknown
whether cross-cultural differences could explain those differences
(the Tiggemann study was conducted with an Australian sample
whereas the Veldhuis study was conducted with a Dutch sample).
The effect of a number of individual difference moderators on
the relationship between warning labels and body dissatisfaction
were also explored. Neither trait social appearance comparison
nor self-esteem moderated the relationship between exposure
to a warning disclaimer and body dissatisfaction (Ata et al.,
2013; Veldhuis et al., 2014). However, trait body dissatisfaction
and thin-ideal internalization were significant moderators of the
relationship between warning labels and post-exposure body dis-
satisfaction, such that those who had high levels of trait body
dissatisfaction or internalization and who were exposed to the
warning label experienced higher post-exposure body dissatisfac-
tion scores, relative to those who saw the image alone or saw the
image with a generic disclaimer (Ata et al., 2013). Body dissatisfac-
tion did not significantly differ between the image only, disclaimer,
and warning conditions for those who were low on trait body
dissatisfaction or internalization. Therefore, in this case, warning
labels were actually found to be harmful to young women’s body
image if they were already high in trait body dissatisfaction or inter-
nalization. It is possible that for women who are already dissatisfied
with their bodies, and who internalize thinness as the standard of
beauty, exposure to a warning that states trying to look like the
model may be dangerous to their health only increases their dissat-
isfaction with their body when they are explicitly told that this body
type is difficult and dangerous to achieve. Essentially, the warning
label may challenge women’s hopes of being able to achieve the thin
ideal, which heightens their body dissatisfaction when they realize
how unattainable it is to have a body that looks like a model’s body.
This is consistent with previous research showing that thinness
attainability beliefs moderate the effects of exposure to thin-ideal
images, such that perceiving thinness as more attainable (i.e., that
dieting works) results in less body dissatisfaction among dieters
(Mills et al., 2002).
Similarly, warning labels were also found to increase the levels
of engagement in state appearance comparison, relative to expo-
sure to an image alone, once again indicating the harmfulness of
warning labels (Tiggemann & Brown, 2018). Additionally, those
exposed to a warning label experienced longitudinal increases in
the importance and attention placed on appearance from baseline
to a 4-week follow up, which was not experienced by those exposed
to the thin-ideal image alone (Kwan et al., 2018), further indicat-
ing the harmful effects of warning labels. Additionally, those who
were high on restrictive eating habits were found to consume less
kilocalories after exposure to a warning label, relative to exposure
to the thin-ideal image alone, indicating that exposure to warn-
ing labels can actually trigger more restrictive eating among those
who are already likely to exhibit restrictive eating habits. It is pos-
sible that the counterintuitive effects that occurred after exposure
to warning disclaimers may have been because the warning dis-
50 S.E. McComb, J.S. Mills / Body Image 32 (2020) 34–52
claimers actually directed greater visual attention to the model’s
bodies than having no disclaimer at all (Bury et al., 2016a).
4.1.4. Information disclaimers
Two studies examined the impact of viewing thin-ideal images
with information disclaimers on body image and found differing
effects. It was found that body dissatisfaction levels did not dif-
fer between young women who saw a thin-ideal image alone, or
those who saw the image with an information, warning, generic,
or graphic disclaimer, indicating that disclaimers with information
about the weight of models were ineffective at preventing body
dissatisfaction in young women, relative to seeing the image alone
or seeing the image with any other type of disclaimer (Tiggemann
& Brown, 2018). A post hoc power analysis of the parameters of that
study by the current authors suggests that it had sufficient power
to detect a medium effect size. Similarly, when participants were
exposed to normal weight models with information disclaimers that
stated “these models are normal weight” the information disclaimer
was found to be ineffective at preventing body dissatisfaction in
adolescent girls, relative to viewing the images alone (Veldhuis
et al., 2014). In this case, information labels were also equally as
ineffective as warning labels in preventing body dissatisfaction.
These information disclaimers may have been unhelpful at pre-
venting body dissatisfaction because by telling participants that the
models were normal weight, it implies the models should be sim-
ilar to most readers’ bodies; if the participants felt like their body
was not similar to the model this may be threatening because the
model should be a reasonable target for comparison since she is of
a normal and achievable weight. If participants felt their body did
not approximate the body of the model it makes sense that viewing
the information disclaimer would not prevent body dissatisfaction
from increasing.
However, when adolescent girls were exposed to thin models
with an information disclaimer that explicitly stated the models
were underweight, they felt less body dissatisfaction and body con-
sciousness than those who saw the images alone or those who
saw the images with a warning disclaimer (Veldhuis et al., 2014).
These results indicate that information disclaimers are effective,
and superior to warning disclaimers, at mitigating body dissat-
isfaction when adolescent girls are exposed to thin models, but
have little to no effect on preventing body dissatisfaction caused
by exposure to normal weight models. Further, these results were
moderated by self-esteem levels. More specifically, girls who were
low in self-esteem and who saw thin models with information dis-
claimers felt less body dissatisfaction and body consciousness than
those who saw images of the thin models alone or those who saw
the images with a warning disclaimer. Levels of body dissatisfaction
and consciousness did not significantly differ between the condi-
tions for those who were high in self-esteem. Arguably, information
labels about weight may be needed by adolescent girls with low
self-esteem to remind them that the models are not reasonable tar-
gets for comparison, which girls with high self-esteem may already
know.
4.1.5. Subvertising disclaimers
Only two studies examined the impact of subvertising labels
and thin-ideal images on women’s body image and mood. Both
studies found that there were no differences in body dissatisfac-
tion between those who saw a thin-ideal image alone and those
who saw the image with a subvertising label (Fardouly & Holland,
2018; Frederick et al., 2016), indicating that subvertising labels
were ineffective at preventing body dissatisfaction relative to see-
ing the image alone. It was also found that subvertising labels were
no more effective than generic disclaimers at preventing body dis-
satisfaction (Frederick et al., 2016). Subvertising disclaimers were
also found to be ineffective at preventing negative affect, drive for
thinness, or state social comparison, relative to seeing the image
alone (Fardouly & Holland, 2018; Frederick et al., 2016). Internal-
ization of the thin ideal was not found to moderate the relationships
between subvertising condition and either body dissatisfaction or
mood (Fardouly & Holland, 2018). Therefore, preliminary results
suggest that subvertising labels are ineffective at preventing body
dissatisfaction and negative mood that result from exposure to
thin-ideal images.
4.1.6. Graphic disclaimers
Only one study examined the impact of thin-ideal images with a
graphic disclaimer on women’s body image (Tiggemann & Brown,
2018). It was found that body dissatisfaction and state appearance
comparison did not differ between those who saw the images alone
or those who saw the images with a graphic disclaimer. There were
also no differences in body dissatisfaction between the graphic,
generic, warning, or information disclaimer conditions. Therefore,
graphic disclaimers were ineffective at preventing body dissatis-
faction, and were not superior to any other type of disclaimer.
4.2. General summary of results
Of the 15 studies reviewed here, 11 found that disclaimers
did not mitigate body dissatisfaction after exposure to thin-ideal
images, three found that disclaimers did mitigate body dissat-
isfaction, and seven found that disclaimers actually heightened
body dissatisfaction in women who are already at a high risk for
body dissatisfaction, such as those high in trait body dissatisfac-
tion and thin-ideal internalization. Of all the types of disclaimers,
specific and warning disclaimers seemed to be the most harmful
and dangerous to use, as they actually increased body dissatisfac-
tion after exposure to thin-ideal images, among those high on trait
appearance comparison, trait body dissatisfaction, thin-ideal inter-
nalization, and those who already exhibit restrictive eating habits.
Also, both specific and warning disclaimers were found to increase
engagement in state appearance comparison, which is actually
counterintuitive to their designed purpose.
Additionally, there seem to be few commonalities and little con-
sensus among the studies that did find disclaimers to be effective
at preventing poor body image after exposure to thin-ideal images.
Harmon and Rudd (2016) found generic disclaimers to be effective
at preventing body dissatisfaction, while Slater et al. (2012) found
both generic and specific disclaimers to be effective, and Veldhuis
et al. (2014) found information disclaimers to be effective. Further-
more, when disclaimers have been found to be effective it seems
to be among very unique or specific samples. As mentioned above,
Harmon and Rudd (2016) only recruited participants majoring in
Fashion and Retail studies, who are arguably exposed to fashion
magazine advertisements much more frequently than the average
person, which severely limits the generalizability of their results.
Similarly, Veldhuis et al. (2014) were the only study to recruit ado-
lescent girls from the Netherlands, rather than young women from
Australia or the United States. There is research that suggests that
girls and women from Western Europe experience less body dis-
satisfaction than their North American counterparts (Swami et al.,
2010), and therefore it may have been easier for media disclaimers
to prevent body dissatisfaction among European girls, who already
have healthier body image. Also, Slater et al. (2012) used differ-
ent, and arguably less threatening, stimuli than most other studies
(Tiggemann et al., 2013), and therefore it may have been easier for
media disclaimers to prevent body dissatisfaction in this study.
Therefore, overall, results consistently revealed that media dis-
claimers had no protective effect on body dissatisfaction, drive for
thinness, negative mood, or eating behaviour, beyond the effects
of image exposure alone. The combined results suggest that media
disclaimers in general are not effective at mitigating the negative
 S.E. McComb, J.S. Mills / Body Image 32 (2020) 34–52
effects of exposure to thin-ideal media images on body image and
mood among young women, and they can actually be harmful for
women who are already at risk for poor body image.
4.3. Implications
The current review confirms that, without disclaimers, expo-
sure to thin-ideal images often causes more negative body image
among female viewers. As such, there is still a strong scientific basis
for media literacy programs that aim to reduce social comparison
to unrealistic images that idealize thinness and appearance per-
fection. However, given that the large majority of studies found
disclaimers to be ineffective at preventing negative body image, and
were actually harmful in some cases, it cannot be concluded that
proposals or laws that advocate to include disclaimers on altered
media images, such as French and Israeli laws regarding retouched
images, are justified by the existing research. Systematic evalu-
ation is needed to determine whether these proposals and laws
regarding the use of disclaimers are actually helpful in amelio-
rating the negative effects of thin-ideal images on women’s body
image. Based on current research, it seems unwise to include dis-
claimers on media images as they have been shown across different
samples and teams of researchers to have negative consequences
on body image for certain groups of women. This review suggests
that when disclaimers are harmful it is because they increase or
exacerbate women comparing their own appearance to that of
thin, idealized models. If disclaimers are to be used, they should
be generic in nature. Specific and warning labels have both been
shown to be harmful to women’s body image (Ata et al., 2013; Bury
et al., 2016a; Tiggemann et al., 2013). While the research has found
that generic disclaimers are generally not helpful in protecting
women’s body image, they have also not been found to be harmful
to women’s body image. Disclaimers have been touted as an inex-
pensive and easy way to prevent body dissatisfaction. However,
given the results of the current review, government officials and
policy makers would do better to identify other strategies to reduce
the negative effects of thin-ideal media on women’s body image.
Other examples of prevention policy in action include legislation
prohibiting the use of underweight fashion models or charters
encouraging positive body image through the use of diverse body
types (Gauvin & Steiger, 2012).
4.4. Limitations of the literature
Despite the fact that the quality assessment revealed that most
studies were of high quality, there are still several limitations to
the existing literature on media disclaimers and body image. The
largest set of limitations is in regard to the samples most commonly
used. Results of the studies reviewed only generalize to primarily
white, educated, women between the ages of 18–30 years who are
Australian or American. Results cannot be generalized to adoles-
cents, older women, women of other racial or ethnic backgrounds,
or to adult men. Additionally, results can only be generalized pri-
marily to magazine advertisements, as the existing research has
not studied internet advertisements, billboards, celebrity images,
or cover stories of magazines as stimuli with or without disclaimers,
and only one study examined social media images. Furthermore,
several studies did not include a manipulation check to ensure that
participants had actually seen or read the disclaimers, and there-
fore it is difficult to judge whether null effects are due to the fact
that disclaimers are ineffective, or because participants simply did
not notice them. Finally, it was a limitation that only published
peer-reviewed articles were included in the present systematic
review, and unpublished work was not considered. Therefore, it
is possible that the results of this review could be biased by overes-
timating the effects of disclaimers on body image, as past research
51
has found that published literature sometimes overestimates treat-
ment effects relative to unpublished work; however, this was found
in only a minority of cases (Schmucker et al., 2017).
4.5. Future research
Future research should investigate the effectiveness of media
disclaimers in diverse samples of adolescents, men, and women to
see if the current findings are generalizable or specific to white,
educated, and Westernized female samples. More longitudinal
research is needed to examine the prolonged effect of exposure to
disclaimers on women’s body image. In particular, research designs
utilizing ecological momentary assessment (EMA) methods, with
multiple follow-up points, would be informative to ascertain how
long lasting the effects of disclaimers are on women’s body image,
mood, and eating habits, in a more naturalistic and ecologically
valid setting. Other moderators could also continue to be explored
such as participant’s own photo-enhancing behaviours and physi-
cal appearance perfectionism. Social media may be becoming even
more important than traditional media in terms of triggering body
dissatisfaction, owing to social comparison among peers, which has
been shown to be a more powerful predictor of body image con-
cerns than comparison to celebrities or models (Carey, Donaghue,
& Broderick, 2014). Exposure to attractive peers on social media
has been shown to cause increased negative body image (Hogue &
Mills, 2019) in young women, and photo retouching of selfies is very
common on social media (Mills, Musto, Williams, & Tiggemann,
2018).
4.6. Conclusions
Overall, the results consistently reflect that media disclaimers
are ineffective at ameliorating the negative effects of thin-ideal
images on women’s body image or mood. In fact, disclaimers can
actually be harmful to the body image of women who are high
on trait body dissatisfaction, thin-ideal internalization, and social
and appearance comparison. In particular, specific disclaimers and
warning disclaimers seem to be more harmful than generic dis-
claimers. Therefore, the use of media disclaimers should be avoided,
or when used should be generic in nature.
Declaration of Competing Interest
None.
Acknowledgements
The authors would like to thank Dr. Joel Katz for his edits on early
drafts of this work, Keisha Gobin for her assistance in conducting
the quality assessment, and Lindsay Williams for her assistance in
proofreading.
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