Cultural Differences in Body Image: A Systematic Review

Abstract

Culture affects individuals’ perceptions and experiences of their bodies. In order to provide the most effective solutions to body image-related issues, it is necessary to understand cultures and their influences on body image in various populations. This paper focuses on the effects of culture on body image. Therefore, a systematic literature search following PRISMA guidelines was performed in the PubMed, Scopus, and Web of Science databases, yielding 2064 articles published between 1990 and 2023. After applying inclusion and exclusion criteria, 54 articles were selected. Our findings showed a strong influence of culture on body image, highlighting the impact of societal expectations on individuals’ mental well-being. Western cultures, with their preference for thinness, differ from non-Western ideals. The findings also showed the impact of regional variations within the same culture and society on body image. Furthermore, the study found that the young demographic, especially females, is the most vulnerable to body image issues; however, emerging research within our review also indicates a growing concern among males. This study underscores the necessity of culturally considering interventions to address body image issues, which are integral to improving mental health concerns like body dissatisfaction, eating disorders, depression, low self-esteem, and anxiety.

1. Introduction

Body image is an individual’s perceptions, thoughts, and feelings about their body and physical appearance (Cash and Pruzinsky 2002). It is a multi-dimensional concept that includes body satisfaction and dissatisfaction, body size estimation, and emotional attitudes towards one’s body. According to Cash’s definition, it has two main dimensions, namely evaluation and investment (Cash 1994). Evaluation refers to the extent to which an individual is satisfied/unsatisfied with the body; investment refers to the cognitive, behavioural, and emotional aspects crucial for the body image experiences (e.g., self-preservation) in everyday life (Cash 2012). Negative self-assessment of physical appearance, known as body dissatisfaction, has been correlated with a spectrum of mental health disorders, including low self-esteem, depression, and eating disorders (Cella et al. 2021; Paxton et al. 2006). This emphasizes the critical need to comprehend the underlying factors that form body image, given its substantial impact on mental health interventions.

Cultural norms and expectations significantly influence individual body image perceptions and their association with mental health outcomes (Johnson and Wardle 2005; Croghan et al. 2006). Culture is shared values, beliefs, practices, and social norms that characterize a group. It has a range of social constructs, including but not limited to ethnicity, nationality, language, and traditions, influencing an individual’s worldview and identity (Hofstede 2001). The complex interplay between cultural variances, body image, and mental health reaches beyond the individual, resonating on a societal level. Societal consequences may encompass emotional distress, unhealthy lifestyle decisions, and considerable economic burdens linked to attempts to modify physical appearance (Raevuori et al. 2014; Cash and Fleming 2002).

Furthermore, the body is not just a biological entity; it is influenced by societal norms and expectations, a socially constructed phenomenon regulated through social institutions, which aligns with your work’s focus on cultural determinants of body image (Turner 2014). Culturally attuned interventions have demonstrated efficacy in enhancing body positivity and mental well-being (Tylka and Wood-Barcalow 2015). It is important to understand the body through cultural lenses; highlighting variations in body image across cultures and the intersection of culture and somatics is essential for addressing body image issues and promoting mental well-being (Wang 2021). Knowledge gaps persist despite strides in unravelling the nexus between culture and body image. Much of the extant research has been narrowly focused on particular cultural groups or facets of body image, underscoring the need for a more holistic understanding of culture’s broad influence on body image (Frisén and Holmqvist 2010). This is paramount in today’s globalized milieu, characterized by frequent cross-cultural interactions and pervasive cultural diversity (Arnett 2002).

The present study endeavours to bridge this gap by offering an exhaustive review of cultural disparities in body image across diverse cultural cohorts. By scrutinizing beauty ideals, cultural anticipations, internalization, repercussions of body dissatisfaction, and the requisites for culturally sensitive interventions, this study aspires to provide nuanced insight into the effect and manifestation of cultural determinants, such as societal norms, traditional values, and beauty standards, that significantly shape perceptions of body image (Strahan et al. 2006). Societal norms dictate acceptable body types, influencing individuals’ self-perception and behaviour. Beauty standards establish benchmarks for physical appearance, affecting how people view their bodies and their worth. These determinants impact health and well-being by influencing mental health outcomes, such as body dissatisfaction, eating disorders, and low self-esteem (Webb et al. 2013; Miller and Pumariega 2001).

2. Materials and Methods

2.1. Study Protocol

A systematic search was applied throughout the PubMed, Scopus, and Web of Science scientific databases using a combination of keywords related to culture, body image, and related psychological constructs (see

Table 1. Database queries using relevant keywords.

Database	Query	Number of Results
PubMed	(“Culture” OR “Cultural Norms” OR “Cultural Expectations” OR “Cultural Influences” OR “Cultural Values” OR “Cultural Factors” OR “ethnic” OR “ethnicity”) AND (“Cultural Differences” OR “Cultural Variation” OR “Cultural Diversity” OR “Cross-Cultural Differences” OR “Intercultural Differences” OR “Cross-Cultural Studies” OR “Cross-Cultural Comparison” OR “Cross-Cultural Analysis” OR “Cross-Cultural Research”) AND (“Body” OR “Body Image” OR “Self-Image” OR “Body Perception” OR “Body Esteem” OR “Body Attitudes” OR “Body Dissatisfaction” OR “Body Concerns” OR “Body Image Disturbance” OR “Negative Body Image” OR “Body Image Issues” OR “Body Discontent” OR “Appearance” OR “Negative Body Attitudes” OR “Body Image Dissatisfaction” OR “Beauty Ideals” OR “Beauty Standards” OR “Idealized Beauty” OR “Physical Attractiveness Standards” OR “Sociocultural Beauty Ideals” OR “Cultural Expectations” OR “Cultural Standards” OR “Societal Expectations” OR “Social Norms” OR “Cultural Norms” OR “Internalization of Standards” OR “Internalization” OR “Beauty Ideal Internalization” OR “Thin-Ideal Internalization” OR “Internalization of Sociocultural Standards” OR “Internalization of Body Ideals”) Filters: English, from 1990–2023	1003
Scopus	TITLE-ABS-KEY (“Culture” OR “Cultural Norms” OR “Cultural Expectations” OR “Cultural Influences” OR “Cultural Values” OR “Cultural Factors” OR “ethnic” OR “ethnicity”) AND TITLE-ABS-KEY (“Cultural Differences” OR “Cultural Variation” OR “Cultural Diversity” OR “Cross-Cultural Differences” OR “Intercultural Differences” OR “Cross-Cultural Studies” OR “Cross-Cultural Comparison” OR “Cross-Cultural Analysis” OR “Cross-Cultural Research”) AND TITLE-ABS-KEY (“Body” OR “Body Image” OR “Self-Image” OR “Body Perception” OR “Body Esteem” OR “Body Attitudes” OR “Body Dissatisfaction” OR “Body Concerns” OR “Body Image Disturbance” OR “Negative Body Image” OR “Body Image Issues” OR “Body Discontent” OR “Appearance” OR “Negative Body Attitudes” OR “Body Image Dissatisfaction” OR “Beauty Ideals” OR “Beauty Standards” OR “Idealized Beauty” OR “Physical Attractiveness Standards” OR “Sociocultural Beauty Ideals” OR “Cultural Expectations” OR “Cultural Standards” OR “Societal Expectations” OR “Social Norms” OR “Cultural Norms” OR “Internalization of Standards” OR “Internalization” OR “Beauty Ideal Internalization” OR “Thin-Ideal Internalization” OR “Internalization of Sociocultural Standards” OR “Internalization of Body Ideals”) AND PUBYEAR > 1989 AND PUBYEAR < 2024 AND (LIMIT-TO (DOCTYPE, “ar”)) AND (LIMIT-TO (LANGUAGE, “English”)) AND (LIMIT-TO (SRCTYPE, “j”))	2382
Web of Science	TS = (“Culture” OR “Cultural Norms” OR “Cultural Expectations” OR “Cultural Influences” OR “Cultural Values” OR “Cultural Factors” OR “ethnic” OR “ethnicity”) AND TS = (“Cultural Differences” OR “Cultural Variation” OR “Cultural Diversity” OR “Cross-Cultural Differences” OR “Intercultural Differences” OR “Cross-Cultural Studies” OR “Cross-Cultural Comparison” OR “Cross-Cultural Analysis” OR “Cross-Cultural Research”) AND TS = (“Body” OR “Body Image” OR “Self-Image” OR “Body Perception” OR “Body Esteem” OR “Body Attitudes” OR “Body Dissatisfaction” OR “Body Concerns” OR “Body Image Disturbance” OR “Negative Body Image” OR “Body Image Issues” OR “Body Discontent” OR “Appearance” OR “Negative Body Attitudes” OR “Body Image Dissatisfaction” OR “Beauty Ideals” OR “Beauty Standards” OR “Idealized Beauty” OR “Physical Attractiveness Standards” OR “Sociocultural Beauty Ideals” OR “Cultural Expectations” OR “Cultural Standards” OR “Societal Expectations” OR “Social Norms” OR “Cultural Norms” OR “Internalization of Standards” OR “Internalization” OR “Beauty Ideal Internalization” OR “Thin-Ideal Internalization” OR “Internalization of Sociocultural Standards” OR “Internalization of Body Ideals”)	992

). This study protocol is registered in the PROSPERO database (CRD42024522373).

2.2. Eligibility Criteria and Study Selection

After gathering the scientific information based on the presented queries, inclusion and exclusion criteria were defined to narrow down the relevant studies.

• Inclusion criteria

• Original peer-reviewed research articles published in English;
• Including human subjects of any gender and ethnicity;
• Participants with age more than 4 years old;
• Empirical research articles, including cross-sectional, longitudinal, and experimental designs;
• Published between 1990 and 2023;
• Focus on body image, body dissatisfaction, or related constructs with a cultural or cross-cultural component.

• Exclusion criteria

• Conference papers, review papers, book chapters, etc.;
• Participants less than the age of 4 years old;
• Non-English research articles;
• Articles not focusing on body image or related constructs;
• Studies without a cultural or cross-cultural component.

Data from eligible studies were consolidated by two researchers into a standardized data collection form, with a supervising authority resolving any differences. The gathered information detailed the heterogeneity of the studies, focusing on population outcomes and measures. This process, adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (Page et al. 2021), involved a comprehensive narrative analysis encapsulating the connection between culture and body image, identifying trends and relationships in the data (see Figure 1).

Factors such as age, culture, ethnicity, and country were specifically considered to enhance our understanding of the interplay between body image and culture. The review focused on cultural and racial groups, acknowledging the intertwined nature of race and culture. To avoid redundancy, duplicate papers were eliminated using Zotero (v. 6.0.35) as a reference management tool (Stillman et al. 2024). Two researchers independently conducted the article selection process, with supervisors mediating conflicts. The initial stage of the review focused on titles and abstracts, filtering studies based on whether they addressed participants’ culture, nationality, or ethnicity. Those meeting these preliminary inclusion criteria were then subjected to a thorough examination. The review accommodated studies of various sample sizes without setting a specific minimum threshold for inclusion.

2.3. Assessment of Quality

The selected studies were appraised for methodological quality utilizing the Mixed Methods Appraisal Tool (MMAT) (Hong et al. 2018) (see

Table 2. Mixed Methods Appraisal Tool.

Authors	Screening Questions		Quantitative Descriptive
	Are There Clear Research Questions?	Do the Collected Data Allow the Research Questions to Be Addressed?	Is the Sampling Strategy Relevant to Address the Research Question?	Is the Sample Representative of the Target Population?	Are the Measurements Appropriate?	Is the Risk of Nonresponse Bias Low?	Is the Statistical Analysis Appropriate to Answer the Research Question?
Aimé et al. (2020)	Y	Y	Y	Y	Y	C	Y
Akan and Grilo (1995)	Y	Y	Y	Y	Y	Y	Y
Ambrosi-Randić and Tokuda (2004)	Y	Y	Y	Y	Y	C	Y
Bohne et al. (2002)	Y	Y	Y	Y	Y	Y	Y
Brockhoff et al. (2016)	Y	Y	Y	Y	Y	Y	Y
Button et al. (1998)	Y	Y	Y	Y	Y	C	Y
Caradas et al. (2001)	Y	Y	Y	Y	Y	C	Y
Ceballos and Czyzewska (2010)	Y	Y	Y	Y	Y	C	Y
Chen and Swalm (1998)	Y	Y	Y	Y	Y	C	Y
Dunkel et al. (2010)	Y	Y	Y	Y	Y	Y	Y
Edman and Yates (2005)	Y	Y	Y	Y	Y	Y	Y
Forbes et al. (2012)	Y	Y	Y	Y	Y	Y	Y
Fung and Yuen (2003)	Y	Y	Y	Y	Y	Y	Y
Gailey and Harjunen (2019)	Y	Y	Y	Y	Y	Y	Y
Ghotbi and Khalili (2017)	Y	Y	Y	Y	Y	Y	Y
Gleaves et al. (2000)	Y	Y	Y	Y	Y	Y	Y
Gordon et al. (2010)	Y	Y	Y	Y	Y	Y	Y
Guo et al. (2023)	Y	Y	Y	Y	Y	C	Y
Henriques et al. (1996)	Y	Y	Y	Y	Y	C	Y
Jackson and McGill (1996)	Y	Y	Y	Y	Y	Y	Y
Jung and Forbes (2007)	Y	Y	Y	Y	Y	Y	Y
Kernper et al. (1994)	Y	Y	Y	Y	Y	Y	Y
Kim et al. (2015)	Y	Y	Y	Y	Y	Y	Y
Klaczynski and Felmban (2018)	Y	Y	Y	Y	Y	C	Y
Kronenfeld et al. (2010)	Y	Y	Y	Y	Y	C	Y
Maezono et al. (2018)	Y	Y	Y	Y	Y	Y	Y
Mazur et al. (2020)	Y	Y	C	Y	Y	Y	Y
McCabe et al. (2015)	Y	Y	Y	Y	Y	C	Y
McCabe et al. (2013)	Y	Y	Y	Y	Y	C	Y
Mellor et al. (2014)	Y	Y	Y	Y	Y	Y	Y
Monocello (2022)	Y	Y	Y	Y	Y	C	Y
Musaiger (2015)	Y	Y	Y	Y	Y	Y	Y
O’Garo et al. (2019)	Y	Y	Y	Y	Y	C	Y
Parker et al. (1995)	Y	Y	Y	C	Y	C	Y
Puhl et al. (2015)	Y	Y	Y	Y	Y	C	Y
Ramberan et al. (2006)	Y	Y	Y	Y	Y	Y	Y
Razmus et al. (2019)	Y	Y	Y	Y	Y	C	Y
Razmus et al. (2020)	Y	Y	Y	Y	Y	C	Y
Rongmuang et al. (2010)	Y	Y	Y	Y	Y	Y	Y
Sanderson et al. (2013)	Y	Y	Y	Y	Y	Y	Y
Schaefer et al. (2018)	Y	Y	Y	Y	Y	C	Y
Šerifović et al. (2005)	Y	Y	Y	Y	Y	C	Y
Shagar et al. (2021)	Y	Y	Y	Y	Y	C	Y
Sheffield et al. (2005)	Y	Y	Y	Y	Y	Y	Y
Smith and Joiner (2008)	Y	Y	Y	Y	Y	Y	Y
Smith and Cogswell (1994)	Y	Y	Y	Y	Y	Y	Y
Sorokowski et al. (2012)	Y	Y	Y	Y	Y	C	Y
Swami et al. (2010)	Y	Y	Y	Y	Y	Y	Y
Szabo and Allwood (2006)	Y	Y	Y	Y	Y	Y	Y
Tahara et al. (2003)	Y	Y	Y	Y	Y	Y	Y
Wardle et al. (1993)	Y	Y	Y	Y	Y	Y	Y
Wells et al. (2008)	Y	Y	Y	Y	Y	C	Y
Wilson et al. (1994)	Y	Y	Y	Y	Y	Y	Y

Note: Y—yes; C—can’t tell.

). The list asks two preliminary queries (“qualifying criteria”) suitable for all research methodologies, with five quality interrogatives linked to the study’s format (for instance, “Is the sampling strategy relevant to address the research question?”; “Is the sample representative of the target population?”). The standard can be judged as “yes”, “no”, or “couldn’t say”, with the guidelines for discerning the study category to reference and the particulars of each element detailed in the instrument handbook.

Each study underwent evaluation by two separate reviewers to ascertain quality, with any differing opinions settled through discussion and consensus or by seeking a third reviewer’s opinion for conclusive judgment.

3. Results

3.1. Sample Characteristics

The studies in this review included a wide range of different groups of participants and various types of studies, as presented in

Table 3. The characteristics of reviewed studies.

Authors	Study Aim	Age Range	Sample	Instruments	Cultures/Ethnicities	Countries
Aimé et al. (2020)	To assess positive body image, body satisfaction, weight bias, and appearance comparison in emerging adults across eight different countries	18–30	6272	Body Appreciation Scale-2, Body Areas Satisfaction Scale, Physical Appearance Comparison Scale, and Weight Bias Internalization Scale	Australian, Belgian, Canadian, Chinese, Italian, Japanese, Spanish, and American	Australia, Belgium, Canada, China, Italy, Japan, Spain, and United States
Akan and Grilo (1995)	Eating attitudes/behaviours, body image, and psychological functioning in college women from different ethnic groups	18–21	98	Self-Consciousness Scale, Rosenberg Self-Esteem Scale, Eating Attitudes Test, Goldfarb Fear of Fat Scale, Eating Disorder Examination—Questionnaire Version, Physical Appearance Related Teasing Scale, Body Shape Questionnaire, Black Racial Identity Attitudes Scale, and Suinn–Lew Acculturation Scale	African American, Asian American, and Caucasian	United States
Ambrosi-Randić and Tokuda (2004)	Differences in current and ideal body size among preschool children	4–6	237	Modified 7-point Collins pictorial scale	Japanese and Croatian	Japan and Croatia
Bohne et al. (2002)	The commonness of body image concerns and body dysmorphic disorder among American and German students	17–27	234	Body Dysmorphic Disorder Questionnaire, Beck Depression Inventory, Beck Anxiety Inventory, Maudsley Obsessive-Compulsive Inventory, Self-Esteem Scale, and Skin-Picking Inventory	American and German	United States and Germany
Brewis and McGarvey (2000)	Relationship between modernity, acculturation to slim ideals, and body size among Samoans	30–43	301	Visual Scale for Body Image, Anthropometric Measurements		Samoa, American Samoa, and New Zealand
Brockhoff et al. (2016)	Cultural influences on body image among Japanese adolescents in comparison with peers from China, Malaysia, Australia, Tonga, and Fiji	12–18	2382	Body Dissatisfaction Measure, media subscale of the Perceived Sociocultural Influences on Body Image and Body Change Questionnaire	Japanese, Chinese, Malaysian, Australian, Tongan, and Fijian	Japan, China, Malaysia, Australia, Tonga, and Fiji
Button et al. (1998)	Eating attitudes/problems and associated psychological problems in different ethnic groups	18–27	235	Eating Attitudes Test (EAT-26), Rosenberg Self-Esteem Scale, and The Hospital Anxiety and Depression Scale	Caucasian, Asian (originating from the Indian subcontinent), Black (Afro-Caribbean), and Chinese	United Kingdom
Caradas et al. (2001)	Differences in eating attitudes and body shape concerns among South African schoolgirls from diverse ethnic backgrounds	15–18	228	Eating Attitudes Test, Body Shape Questionnaire, and Body Silhouette Chart	Black, mixed-race, and White	South Africa
Ceballos and Czyzewska (2010)	Body image perceptions and dissatisfaction among Hispanic/Latino and European American adolescents	12–15	319	Computerized survey, FRS, ChEAT-26, and Body Stereotypes Assessment	Hispanic/Latino and European American	United States
Chen and Swalm (1998)	Body shape perception and body affect among Chinese and American college students	21–23	605	Body-image Questionnaire, BMI-based Silhouette-Matching Test, Rosenberg Self-Esteem Scale, Depression Anxiety Stress Scales-21, UCLA Loneliness Scale, Satisfaction With Life Scale, and Eating Behaviors and Weight Control Questionnaire	Chinese and American	China and United States
Dunkel et al. (2010)	Body satisfaction and enforcement to be thin in young and old Muslim and non-Muslim women, investigating the effect of Western and non-Western dress preferences	18–74	201	Demographic Questionnaire, Figure Rating Scale, Eating Disorder Inventory 3, and Sociocultural Attitudes Toward Appearance Questionnaire-3	Muslim and non-Muslim women	United States
Edman and Yates (2005)	Symptoms of eating disorders among Filipino and Caucasian college students and variables associated with disordered eating	18–33	290	Self Loathing Subscales, Figure Drawings, Drive for Thinness Subscale, and Eating Disorder Inventory-2	Filipino and Caucasian	United States (Hawaii)
Forbes et al. (2012)	Levels of body dissatisfaction, attitudes associated with disordered eating, and the influence of cultural appearance standards among young women from Argentina, Brazil, and the U.S.	18–24	301	Body Mass Index, Figure Rating Scale, Body Esteem Scale for Adolescents and Adults, and Eating Disorders Inventor Perceived Sociocultural Pressure Scale, Sociocultural Attitudes Toward Appearance Questionnaire, and Objectified Body Consciousness Scale	Argentinian, Brazilian, and American	Argentina, Brazil, and the United States
Fung and Yuen (2003)	Body image and eating attitudes among adolescent girls in Hong Kong	15–21	358	Body Mass Index (BMI), Body Parts Satisfaction Scale-Revised, and Eating Attitudes Test-26.	Chinese	Hong Kong
Gailey and Harjunen (2019)	To examine the shared Western fat lived experience and its perpetuation of a stigmatized gendered landscape in the lives of fat women in North America and Finland	19–65	121	In-depth interviews, autobiographical writings, and thematic analysis	North American (Latina, Native American, African American, and Caucasian) and Finnish (white ethnic Finns) women	Finland, United States, and Canada
Ghotbi and Khalili (2017)	Cultural values influencing attitudes toward cosmetic surgery among Chinese, Japanese, and Korean students	18–21	206	A questionnaire study focused on invasive surgical cosmetic procedures and qualitative data collection (comments to support their attitudes towards cosmetic surgery)	Chinese, Japanese, and South Korean	China, Japan, and South Korea
Gleaves et al. (2000)	Cross-cultural differences in various aspects of body image, including body size ratings of self, ideal and ideal opposite sex, and predictions about the opposite sex’s preferences	19–20	240	Body Image Assessment	Spanish and American	Spain and United States
Gordon et al. (2010)	Body image, eating disorder symptoms, and acculturation-relevant variables among White, Latina, and Black college women	17–49	276	Eating Disorder Inventory, Stunkard Body Figure Scale, Stephenson Multigroup Acculturation Scale, Societal, Attitudinal, Familial, and Environmental Acculturative Stress Scale, and Rosenberg Self-Esteem Scale	White, Latina, and Black	United States
Guo et al. (2023)	The influence of sociocultural attitudes toward the body on motivation for physical activity among Polish and Chinese youth	18–30	467	Sociocultural Attitudes Towards Appearance Questionnaire-3, and Inventory of Physical Activity Objectives	Polish and Chinese	Poland and China
(Henriques et al. 1996)	Ethnic differences in body satisfaction and the influence of social feedback	M = 21	117	Body Esteem Scale, Eating Disorders Inventory, Social Rating Scale, Manipulation Check, and Deception Check	White and Black American	United States
Jackson and McGill (1996)	Examine body type preferences and characteristics associated with attractiveness in African culture	~21	83	The Body Type Preferences Survey	African American and Anglo American	United States
Jung and Forbes (2007)	Body dissatisfaction and disordered eating among college women in China, South Korea, and the United States based on sociocultural and feminist theories.	18–25	348	Body Mass Index, Figure Rating Scale, Body Esteem Scale, Body Esteem Scale for Adolescents and Adults, Eating Disorder Inventory (EDI), and Sociocultural Attitudes Towards Appearance Questionnaire	Chinese, Korean, and American	China, South Korea, and United States
Kernper et al. (1994)	Ideal body size beliefs and perceptions among White and Black adolescent females	13–16	344	A 30-item questionnaire and a series of nine female and male body size drawings	White and Black	United States
Kim et al. (2015)	How cultural background and self-construal (interdependent vs. independent) influence women’s perception of their body weight and participation in health-related activities.	18–25	Phase One: 277 Phase Two: 182	Phase One: Body Mass Index, Subjective Evaluation of Obesity, and Measures of Engagement in Healthy Behavior Phase Two: Weight Overestimation Measurement, Health Activities Engagement, Exploratory Factor Analysis, Self-Criticism Measurement, Self-Construal Measure, and Self-Deprecation Measurement	Japanese, Korean, and American	Japan, South Korea, and United States
Klaczynski and Felmban (2018)	Age and cultural differences in obesity stereotypes among adolescents	13–16	335	Silhouette Matching Task, Obesity Attribution Questionnaire, and Sociocultural Attitudes Toward Appearance Questionnaire	Chinese and American	China and USA
Kronenfeld et al. (2010)	Ethnic and racial differences in body size perception and satisfaction	25–45	4023	General Eating and Dieting Questions and Figural Stimuli Questionnaire	Hispanic, non-Hispanic, White, Black or African American, Asian, Native Hawaiian, and American Indian	United States
Maezono et al. (2018)	To compare the prevalence of body image and eating distress among adolescents in Japan and Finland, examine associated factors	13–14	2975	Body Image and Eating Distress Scale and Strengths and Difficulties Questionnaire	Japanese and Finnish	Japan and Finland
Mazur et al. (2020)	Cross-cultural differences in body image ideals among Arab immigrants and Germans	12–34	180	Body Shape Perception Measures, Ideal Body Image Indication, and Self-Placement on Body Size Scale	Arab and German	Germany
McCabe et al. (2015)	Sociocultural pressures on body change behaviours	13–19	4904	Sociocultural effect on Body Image, Body Change Questionnaire, and surveys including questions about actual body change strategies	Australian, Chilean, Chinese, Indo-Fijian, Indigenous Fijian, Greek, Malaysian, Chinese Malaysian, and Tongan	Australia, Chile, China, Fiji, Greece, Malaysia, New Zealand, and Tonga
McCabe et al. (2013)	Cultural values connected to body image and eating practices in Western and non-Western societies	10–19	2223	Cultural Values Scale (assessing Pacific Islander values on body size and religious impacts on eating, including ideals and practices)	Fijian, Indo-Fijian, Tongan, and Australian	Fiji, Tonga, and Australia
Mellor et al. (2014)	Body features associated with male adolescents’ body dissatisfaction in different cultures	12–19	462	Extended version of the Body Image Dissatisfaction subscale from the Body Image and Body Change Inventory	Malaysian Malay, Malaysian Chinese, Chinese, and Australian	Malaysia, China, and Australia
Monocello (2022)	Intercultural variation in attention to male body features	18–30	59	Free listing, pile sorting, rating tasks, cultural consensus analysis	South Korean and American	South Korea and United States
Musaiger (2015)	Body weight concerns among female university students	17–32	1134	Modified questionnaire from previously validated questions translated into Arabic	Arab	Bahrain, Egypt, Jordan, Oman, and Syria
O’Garo et al. (2019)	Internalization of Western beauty ideals and depressive symptoms and the mediating role of self-esteem	16–23	222	The Sociocultural Attitudes Towards Appearance Questionnaire-3 and Beck Depression Inventory-II	African	Jamaica
Parker et al. (1995)	Body image ideals and dieting behaviours among African American and White adolescent females	14–18	296	Interviews, surveys, and focus groups	African American and White	United States
Puhl et al. (2015)	Exploring weight bias and its predictors in the United States, Canada, Iceland, and Australia	≥18	2866	Fat Phobia Scale, Universal Measure of Bias-FAT version, Beliefs about the Causes of Obesity, Experiences of Weight Bias, and Attributions of Weight-Related Blame and Willpower	American, Canadian, Icelandic, and Australian	Iceland, the United States, Canada, and Australia
Ramberan et al. (2006)	The correlates of adolescent body image perception, including ethnicity and weight-related behaviour	~16	251	Eating Attitudes Test, Body Shape Questionnaire, Rosenberg Self-Esteem Scale, Drive-for-Thinness subscale of the Eating Disorder Inventory–2, and Discriminant body silhouette chart	Indo-Trinidadian, Afro-Trinidadian, Indo-Afro mixed Trinidadian, and other ethnicities	Trinidad
Razmus et al. (2020)	Investigate the Body Appreciation Scale-2 (BAS-2) measurement invariance across adults from five countries	18–82	2944	Body Appreciation Scale-2	American, Polish, Serbian, and Iranian	Iran, Japan, Poland, Serbia, and the United States
Razmus et al. (2019)	Examine body-related emotions in Canada and Poland	19–30	561	Body and Appearance Self-Conscious Emotions Scale	Canadian and Polish	Canada and Poland
Rongmuang et al. (2010)	Differences in physical appearance identity among young women in four regions of Thailand	18–24	200	Q methodology (cards each labelled with a physical appearance characteristic)	Thai	Thailand
Sanderson et al. (2013)	Body image perceptions among African American college-age women from different university settings	18–25	651	“The Young Women’s Experiences with Body Weight and Shape” survey assessing weight dissatisfaction, body image, and other factors	African American	United States
Schaefer et al. (2018)	Cross-cultural differences in body image disturbance and eating pathology risk factors	18–30	2275	Sociocultural Attitudes Towards Appearance Questionnaire-4	Italian, English, Australian, American	United States, Italy, England, and Australia
Šerifović et al. (2005)	Cultural differences in body dissatisfaction, stress relationships, and body ideals	18–26	96	Body Shape Questionnaire, Impact of Event Scale, and Body Figure Rating Scale	Bosnian and American	Bosnia and United States
Shagar et al. (2021)	Body dissatisfaction, thin-ideal internalization, sociocultural influences, problematic weight-related behaviours, and health behaviours, examining how body dissatisfaction is linked with health behaviours like smoking, alcohol and drug use, and sexual activities across different cultures	18–25	830	Sociocultural Attitudes Towards Appearance Questionnaire 4, Body Image Concern (BIC) subscale of the Body Image and Body Change Questionnaire, Restrained Eating Subscale of the Dutch Eating Behaviour Questionnaire, Bulimia subscale of the Eating Attitudes Test, and Youth Risk Behavior Survey	Malaysian and Australian	Australi and Malaysia
Sheffield et al. (2005)	Body image dissatisfaction and eating disturbance among Australian and Hong Kong women, examining the validity of a biopsychosocial mediation model	17–28	148	EDI-2-BD (Eating Disorders Inventory-2—Body Dissatisfaction Scale), Rosenberg Self-Esteem Inventory (RSE), Multidimensional Media Influence Scale (MMIS), and Physical Appearance Related Teasing Scale (PARTS)	Australian Caucasian and Hong Kong Chinese	Australia and Hong Kong
Smith and Joiner (2008)	Body image discrepancies and perceived weight status in adult Japanese women, comparing Japanese and American body ideals	21–56	45	Stunkard Body Figure Scale, Perceived Weight Status Rating, and Eating Disorders Inventory	Japanese	Japan
Smith and Cogswell (1994)	Body perception among Jamaican adolescent girls	15–18	122	Questionnaire including demographic data, pregnancy status, and perception of weight	Jamaican	Jamaica
Sorokowski et al. (2012)	Examine leg-to-body ratio preferences in a traditional semi-nomadic group	15–18	81	Silhouette stimuli and attractiveness assessment (participants were asked to rate the attractiveness of each silhouette)	Himba	Namibia
Swami et al. (2010)	Global differences in ideal female body weight and body dissatisfaction	Various (General public and college students)	7434	Female Contour Drawing Figure Rating Scale and media exposure scale	Various	North America (Canada and USA), South America (Chile), Western Europe (Austria, Belgium, Germany, Portugal, Switzerland, and UK), Eastern Europe (Croatia, Estonia, and Poland), Scandinavia (Finland and Sweden), Oceania (Australia and New Zealand), Southeast Asia (Indonesia, Malaysia, Philippines, and Singapore), East Asia (China and South Korea), South and West Asia (India and Turkey), and Africa (South Africa)
Szabo and Allwood (2006)	Cross-cultural body figure preference in South African adolescents, examining the relationship between body dissatisfaction and eating disorders	13–18	1714	Body Figure Preference Test, Eating Attitudes Test, and body mass index	Black and White South African	South Africa
Tahara et al. (2003)	Differences in body size and composition between young adult Japanese Americans and nationals of Japan.	18–23	100	Underwater weighing for body composition measurement, anthropometric measurements, body mass index, body surface area, and ratios like the length of lower limbs to body height	Japanese Americans, and Japanese nationals	United States and Japan
Wardle et al. (1993)	Investigate cultural influences on body image by comparing body size ideals, body image, and dieting concerns in young White and Asian British women	14–15 19–22	274	General information, height/weight change, weight loss, weighing frequency, restraint (DEBQ), size judgments, body parts perception, Figure Rating Scale (Stunkard et al.), Body Shape Questionnaire (BSQ), and reading and viewing habits	Asian and Caucasian British	United Kingdom
Wells et al. (2008)	Body shape indices between white British and American adults and among different American ethnic groups	>17 years	12,244	Three-dimensional (3D) body-scanning instrumentation and general linear models	British, African American, Hispanic American, and American	United Kingdom and United States
(Wilson et al. 1994)	Perceptions of ideal body size among black and white adolescent females	14–17	173	Body Size Values instrument and demographic and weight control attitude questions	Black and White	United States

. The smallest study included 45 participants (Smith and Joiner 2008), while the largest involved 7434 participants (Swami et al. 2010). The ages of participants ranged from 4 to 6 years old (Ambrosi-Randić and Tokuda 2004) to older adults up to age 82 (Razmus et al. 2020). The studies included a diverse number of ethnic and cultural groups.

3.2. Body Image and Culture

In Western countries, such as the United States, Canada, England, and Australia, there is a notable emphasis on thinness as an ideal, often leading to higher levels of body dissatisfaction among women (Aimé et al. 2020; McCabe et al. 2015; Schaefer et al. 2018). This trend is contrasted in many Asian cultures, where, despite a general preference for slimness, cultural nuances lead to different body image ideals. For instance, Japanese culture, with its distinct emphasis on slimness, has led to significant body dissatisfaction among Japanese adolescents, particularly girls, as compared to their counterparts in countries like China and Malaysia (Brockhoff et al. 2016; Maezono et al. 2018; Sheffield et al. 2005; Smith and Joiner 2008). In South Korea, rigid beauty norms have resulted in high levels of body dissatisfaction and disordered eating behaviours (Jung and Forbes 2007). Moreover, a notable desire for slimness was observed among adolescent Chinese girls in Hong Kong, wanting to weigh less despite a low overweight prevalence. This reflects Chinese culture’s deep-seated influence of the ‘thin ideal’ (Fung and Yuen 2003). Also, in countries like Thailand, regional differences show varying valuations of physical attributes, such as an emphasis on facial appearance, indicating complex internal cultural landscapes (Rongmuang et al. 2010). However, in Asian and American culture, regarding facial features, male Americans prioritized particular features like defined jaws and muscularity, associating them with control and dominance. At the same time, South Korean men emphasized overall presentation and proportions, valuing traits such as a high nose and double eyelids, reflecting cultural preferences in physical attractiveness (Monocello 2022).

In African contexts, there is a more inclusive view of body types. For instance, studies have shown that urban South African adolescents prefer thinner bodies influenced by Westernized standards, contrasting with rural adolescents who are less affected by these standards and show less desire for thinness (Szabo and Allwood 2006; Caradas et al. 2001). In Middle Eastern countries, the influence of globalized beauty standards and local cultural norms creates a complex interplay in body image perceptions. For example, in Arab countries, despite a general trend toward preferring slimmer bodies, significant variations exist among countries (Musaiger 2015). In Europe, countries like Finland, Spain, and Italy show varying degrees of body dissatisfaction and eating attitudes influenced by their unique cultural values and societal norms (Gleaves et al. 2000; Maezono et al. 2018; Schaefer et al. 2018). Latin American countries, such as Argentina and Brazil, show cultural variances in the perception of ideal body types, with less pressure to be thin than Western standards. However, body dissatisfaction remains prevalent (Forbes et al. 2012). In Oceanic regions, including countries like Fiji and Tonga, cultural values favour a larger body, starkly contrasting the Australian preference for thinner bodies (McCabe et al. 2013). In a study comparing young Asian and Caucasian British women, Asian women showed less dissatisfaction with their body size and were less likely to want to lose weight despite appeasing slimmer body sizes than Caucasian women (Wardle et al. 1993). Samoan women in more modernized settings selected slimmer ideal body sizes and had larger bodies on average, indicating a shift towards Western body size ideals with increased modernization (Brewis and McGarvey 2000). Other regions, such as the Caribbean, exhibit ethnic and regional differences in body image perception, reflecting diverse cultural influences within these regions (Ramberan et al. 2006). Body image perceptions were found to be affected by the desirability of the individual to the other gender. For instance, African American males preferred larger female body types compared to Anglo American males. In contrast, females of both races preferred slightly thin male body types (Jackson and McGill 1996).

3.3. Vulnerable Groups

Across diverse cultural backgrounds, there is a universal trend among youth. Notably, the age range of 18 to 25 years is repeatedly identified as critical, with studies consistently showing heightened body image concerns in this demographic (Forbes et al. 2012; Maezono et al. 2018; Sanderson et al. 2013). Adolescents also show noteworthy vulnerability toward body image concerns compounded by the cultural and social landscapes they are exposed to (Brockhoff et al. 2016; Szabo and Allwood 2006). On the other hand, gender plays a significant role in vulnerability to body image issues. Females across various cultures and countries show a higher propensity for body dissatisfaction compared to their male counterparts. This gender disparity is particularly pronounced in studies focusing on adolescent girls (Brockhoff et al. 2016; Caradas et al. 2001; Jung and Forbes 2007). However, it is essential to note that body image concerns are not exclusive to females. Emerging research also indicates a growing concern among male adolescents (Mellor et al. 2014). Regarding geographic and cultural contexts, body image issues transcend national boundaries, affecting individuals in Western and non-Western societies. For instance, studies conducted in countries like Japan, Finland, Argentina, Brazil, the United States, Thailand, and various African and Arab nations reveal that cultural norms and societal expectations significantly impact body image perceptions across these diverse settings (Forbes et al. 2012; Maezono et al. 2018; Musaiger 2015; Parker et al. 1995; Rongmuang et al. 2010). Furthermore, minority and ethnic groups face unique challenges in body image perception. Studies show that adolescents from specific ethnic backgrounds, such as Indo-Trinidadian and Afro-Trinidadian, display varying degrees of body image concerns (Ramberan et al. 2006).

3.4. Mental Health

In the United States and European countries, there is a heightened prevalence of anorexia nervosa and bulimia nervosa, often linked to the internalization of thin ideals. This was particularly evident in studies focusing on American, British, and Australian populations (Puhl et al. 2015; Schaefer et al. 2018; Smith and Joiner 2008). American adolescents had more negative obesity stereotypes than Chinese adolescents, mediated by weight attributions and thin idealization (Klaczynski and Felmban 2018). In Asian cultures, including Japan and China, there is a rising concern about eating disorders that are not necessarily aligned with Western diagnostic criteria, often due to different cultural standards of beauty and body image (Chen and Swalm 1998; Kim et al. 2015). For instance, in Japan, eating disorder not otherwise specified is more commonly reported. Depression and anxiety, often accompanying body dissatisfaction, showed prevalence across various cultures. Studies involving both Western and Eastern populations highlighted a strong link between body image concerns and depressive symptoms (Chen and Swalm 1998; O’Garo et al. 2019; Tahara et al. 2003). In the United States, ethnic and racial variations in body size perception and satisfaction among women are quite diverse. Asian women perceived themselves as smaller, whereas African American women exhibited lower body dissatisfaction than White women, even after adjusting for BMI, highlighting racial differences (Kronenfeld et al. 2010). White and Latina college women preferred slimmer body ideals than Black women, with these ideals correlating with higher levels of eating disorder symptoms (Gordon et al. 2010). Filipino males showed higher body dissatisfaction and disordered eating compared to Caucasian males (Edman and Yates 2005). Low self-esteem and high public self-consciousness were linked to problematic eating behaviours across all ethnic groups studied (Akan and Grilo 1995). Body dysmorphic disorder (BDD) is another mental health issue linked to body image concerns. Studies from diverse cultural backgrounds reported significant BDD, including the United States and Germany (Bohne et al. 2002; Gleaves et al. 2000). The impact of body image on self-esteem was evident across different age groups and cultures. Muslim women wearing traditional clothing exhibited lower drive for thinness scores compared to those in Western dress (Dunkel et al. 2010). Adolescents showed heightened exposure to low self-esteem due to body dissatisfaction, as seen in studies from various cultural contexts (Kernper et al. 1994; Ramberan et al. 2006; Wilson et al. 1994).

4. Discussion

The results of this review paper align with studies demonstrating that culture and society impact body image and mental health (Stewardson et al. 2020; Anderson-Fye 2017). The findings from this review suggest that different cultures have diverse impacts on body image. The relationship between culture and body image varies widely among different groups. In Japan, heightened body dissatisfaction is evident among adolescents, particularly girls (Brockhoff et al. 2016; Maezono et al. 2018), while Chinese and Korean students show varying attitudes towards cosmetic surgery (Ghotbi and Khalili 2017). This reflects a cultural interplay distinct from Western standards, such as those in the United States, where a strong emphasis on thinness leads to higher body dissatisfaction levels (Schaefer et al. 2018).

Further, a consistent global finding across cultures is the heightened vulnerability of young individuals and adolescents to body image concerns. This vulnerability could be due to the pressures of social media and the quest for identity during these developmental years. The role of social media in shaping people’s perceptions of their bodies is a significant point, and its impact on globalizing beauty standards suggests that adolescents worldwide are increasingly influenced by these uniform beauty ideals, regardless of their cultural backgrounds (Rounsefell et al. 2020; Jill Thompson et al. 2020).

In addition to weight and shape concerns, physical characteristics like height can be a cause of dissatisfaction, especially in populations with generally shorter stature (Brockhoff et al. 2016; Ghotbi and Khalili 2017; Jung and Forbes 2007; Kim et al. 2015; Maezono et al. 2018). This adds to our knowledge of the fact that body dissatisfaction can be affected by height as well (Mellor et al. 2014; Perkins et al. 2021).

The impact of these dissatisfactions, however, varies across different cultures. Studies on African American and South African populations, for instance, indicate diverse levels of body satisfaction influenced by cultural and racial contexts, underscoring the role of regional factors. In rural South Africa, where Western ideals have less influence, there is a lesser inclination towards thinness (Caradas et al. 2001; Sanderson et al. 2013; Szabo and Allwood 2006). This diversity is also evident in European countries, where Finnish, Spanish, and Italian individuals exhibit varying levels of body dissatisfaction (Gleaves et al. 2000; Maezono et al. 2018), and in South American contexts like Argentina and Brazil, where cultural nuances shape perceptions of ideal body types (Forbes et al. 2012). To enhance the clinical relevance of our findings, we propose the development of culturally sensitive interventions to address body image issues. Such interventions should incorporate culturally relevant values and norms into therapeutic practices. For instance, therapists can use culturally adapted cognitive–behavioural techniques to address body dissatisfaction and eating disorders among diverse populations, as previous research suggests that culturally adapted interventions are more effective in improving mental health outcomes (Hwang et al. 2008). Developing specific guidelines for practitioners is crucial to help them recognize and address cultural impacts on body image. This can include training on cultural competence and integrating cultural assessments into routine practice. Practitioners should be aware of the diverse cultural backgrounds of their clients and shape their interventions accordingly (Clauss-Ehlers et al. 2019).

Regarding the significant preferences worldwide for slim body shape, some ethnicities and groups prefer larger body sizes in Pacific Island cultures like Fiji and Tonga (McCabe et al. 2013). These examples underscore the complex interplay between traditional cultural values, highlighting the need for culturally sensitive approaches to address body image concerns globally. The intersection of cultural background and gender emerges as a critical factor in body image perception. Young females across various cultures, including in Japan, Finland, Argentina, Brazil, Thailand, and different African and Arab nations, exhibit heightened body image concerns influenced by gender and culture (Forbes et al. 2012; Kim et al. 2015; Maezono et al. 2018; Musaiger 2015; Parker et al. 1995; Rongmuang et al. 2010). Gender differences are particularly significant, with females generally showing greater susceptibility to dissatisfaction. This trend is consistent across cultural contexts but is increasingly relevant for males, as indicated by a study of a male population (Mellor et al. 2014). Social norms are different from culture; social norms are the unwritten behavioural expectations within a cultural group, guiding what is considered appropriate or inappropriate and adaptable over time (Tomaszewski 2018). As we observed in Jamaican undergraduate students, the influence of societal norms affected by Western beauty ideals leads to conflicting perspectives on one’s body image (O’Garo et al. 2019). This suggests a worldwide influence of certain body types. This cultural variousness of body image perceptions offers insightful directions for further investigations and highlights the need for culturally sensitive approaches in addressing body image concerns.

Moreover, the mental health consequences of body image perceptions are considerable across different ethnicities and cultures. While African American females may exhibit a more accepting attitude towards larger body sizes, potentially offering some protection against negative mental health impacts (Sanderson et al. 2013), Asian cultures, particularly Japanese and Chinese, show tendencies towards disorders not aligning with Western diagnostic criteria (Chen and Swalm 1998; Kim et al. 2015). In Western societies, the prevalence of anorexia nervosa and bulimia nervosa is often linked to the internalization of thin ideals (Puhl et al. 2015; Schaefer et al. 2018; Smith and Joiner 2008).

Additionally, the influence of external factors like social feedback on body satisfaction varies significantly by ethnicity, as found in a study where White women’s body satisfaction was more affected by social feedback compared to Black women (Henriques et al. 1996). We observed that across various cultures, a vital link between body image concerns and depressive symptoms is consistently highlighted. Research in the United Kingdom suggests that the prevalence of body dissatisfaction and eating attitudes may not vary as distinctly among ethnic groups as previously thought, indicating that the overall levels of body dissatisfaction and psychological problems related to eating attitudes are similar across ethnicities (Button et al. 1998). This variance in cultural beauty standards underscores the complex relationship between body image and mental well-being. The interaction between cultural norms, societal pressures, and individual perceptions of body image creates a complex landscape where mental health is linked to multiple factors, including culture. The necessity for culturally sensitive mental health support strategies, especially for body image-related issues, is imperative. The evidence from these studies points to the need for culturally sensitive approaches to addressing body image concerns.

5. Limitations and Future Directions

While this study covers many cultures, there is insufficient information from different parts of continents like Asia (eastern and central regions) and Africa (northern and central regions). Furthermore, the focus of most studies on specific age groups, mainly on young individuals and adolescents, limits the generalizability of the findings across all age ranges. The dependence on literature published in English prevented us from employing helpful information from articles published in other languages. Similarly, much of the included research focuses on female populations, leading to a potential under-representation of male perspectives on body image. It is necessary for future research to explore under-represented regions, particularly Asia and Africa, to provide a more balanced and comprehensive global perspective on body image. Also, future research should try to include scientific papers in other languages, and qualitative studies would provide a better understanding of cultural influences on body image. In addition, there is a critical need to conduct more research on male body image to balance the gender perspective in this field. Further studies should aim to include a more exhaustive age range, including older adults.

6. Conclusions

In conclusion, this review shows how culture shapes perceptions of body image and their associated mental health outcomes. Our study highlights the prevalence of body dissatisfaction, eating disorders, depression, low self-esteem, and anxiety worldwide, indicating its profound impact on mental well-being. However, we also highlight the need for a wider representation of cultures, especially from underexplored regions. As we observe, many societies are becoming increasingly international; this stresses that understanding the cultures of different groups of people and their impact on body image becomes even more important to provide the unique assistance each individual needs.