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Beauty and Society

David B. Sarwer, PhD,* Ted A. Grossbart, PhD,'F and Elizabeth R. Didie, MA~
Beauty is an abstract construct. We all have our appearance, is not simply a matter of taste or
own ideas about what is and is not beautifulma arbitrary preference. While the evolutionary
particular song or painting, a man or woman.
Accurately describing what exactly "it" is that
mission of reproduction may be universal, re-
makes the song, painting or person beautiful, how- search suggests substantial gender differences
ever, is a daunting task. In this article, we attempt in humans. For men, fertility and good health
to m a k e the case that beauty a n d physical attrac- are high on the list of determinants of what is
tiveness is a serious matter. We begin with a dis- considered attractive in a woman. For the Inter-
cussian of the role of beauty in evolutionary the-
on/. Next, we turn to theories of the physiology of
national Mate Selection Project, 50 scientists
beauty, which focus on physical characteristics studied 10,047 people in 37 cultures located on
such as pathogen resistance, averageness, phys- 6 continents and 5 islands. Without exception,
ical symmetry, body ratios, and youthfulness. We physical cues to youth and health were seen as
then describe changes in the societal standards of attractive. "In no known culture do people per-
beauty through a discussion of the relatively re-
cent history of mass media images of beauty. We
ceive wrinkled skin . . . . thin lips,., poor muscle
then use the psychological construct of body im- tone, and irregular facial features to be attrac-
a g e to begin to understand the nature of beauty tive. "2 This seems so obvious that we might
on an individual level. The article concludes with never ask why.
a discussion of the things that we do to m a k e The evolutionary argument posits that phys-
ourselves more beautiful.
9 2003 Elsevier Inc. All rights reserved. ical signs of youth and health--full lips, smooth
clear skin, clear eyes, lustrous hair, good muscle
tone, animated facial expression, high energy
BEAUTY A N D E V O L U T I O N A R Y THEORY
level ~-- are at the top of every culture's beauty
It is often said that "beauty is in the eye of the list because they are the most reliable physical
beholder." Consistent with that belief, beauty markers of fertility. These characteristics are
has been described as an individual's subjective considered beautiful because, and only because,
assessment of attractiveness that is influenced of their evolutionary advantage. While many
by current cultural standards. However, Charles other characteristics may make for a good mate,
Darwin arid his intellectual descendants from it is hard to imagine obvious physical markers
the field of evolutionary biology offer a different for fidelity, parenting ability, temperament, or
theory of the nature of beauty. In his seminal intelligence. These qualities certainly make a
The Descent of Man and Selection in Relation to potential mate more attractive, but they are not
Sex, Darwin puzzled over the physical charac- components of beauty.
teristics that seemed to act as open lures to
predators and therefore interfere with survival
From the *Departments of Psychiatry and Surgery, University
maintenance activities. For example, how could
of Pennsylvania School of Medicine, The Edwin and Fannie Gray
(and why did) the brilliant plumage of peacocks Hall Center for Human Appearance, Philadelphia, PA; and "i'De-
have evolved? Darwin's answer was sexual se- partment of Psychiatry, Harvard Medical School, Beth Israel Dea-
l e c t i o n - t h a t certain characteristics evolved be- coness Hospital Medical Center, Boston, MA; ~Department of
cause of reproductive advantage rather than Psychology, Drexel University, Philadelphia, PA.
survival advantage. Reprinted from Kaminer MS, DoverJS, Arndt KA (eds) : Atlas of
Cosmetic Surgery, Philadelphia, PA, Saunders, 2002, pp 48-59
Are h u m a n concepts of beauty (and perhaps with permission.
their interest in improving their appearance Address reprint requests to David B. Sarwer, PhD, Department
through means such as cosmetic surgery) also of Psychiatry and Surgery, University of Pennsylvania School of
tied to some higher purpose like reproduction? Medicine, The Edwin and Fannie Gray Hall Center for Human
If we are on an evolutionary mission to increase Appearance, 3535 Market St/3309, Philadelphia, PA 19104;
e-mail: dsarwe~ailmed.upenn.edu.
the chances of our genetic material moving to 9 2003 Elsevier Inc. All rights reserved.
the next generation, what we consider desirable 1085-5629/03/2202 -0002 $30.00/0
in the opposite sex, or how we sculpt our own doi: 10.1053/sder.2003.500I 4

Seminars in Cutaneous Medicine and Surgery, Vol 22, No 2 (June), 2003: pp 79-92 79
80 SARWER, GROSSBART,AND DIDIE

A woman's campaign to select the man to help play more with attractive strangers than with un-
propel her genetic material into the future re- attractive ones/Infants also play for a longer pe-
quires a very different strategy. What male char- riod of time with attractive dolls than they do with
acteristics are most evolutionarily useful and will unattractive dolls, r These findings challenge the
therefore define attractiveness? The ability to ob- belief that judgments of facial attractiveness are
tain and defend resources and the willingness to learned through exposure to cultural standards
commit them to a particular female and her off- and stereotypes. Thus, beauty may not only be in
spring define attractiveness. Applied to the phys- the eye of a singular beholder, but rather many
ical realm, this would seem to require men to be beholders with similar genetic wiring. Or, as sug-
well muscled and athletic. Yet, raw muscle power gested by Buss, "Beauty may be in the eyes of the
has been partially replaced by the financial and beholder, but those eyes and the minds behind the
political equivalent in humans. "Across 36 of 37 eyes have been shaped by millions of years of
cultures from Australia to Zambia women place human evolution. 'u
great(est) value on financial prospects. ''2 Henry What are the implications of the evolutionary
Kissinger's suggestion that, "Power is the ultimate theory of beauty for cosmetic surgery? We
aphrodisiac," reflects the same evolutionary ver- would expect that patients would report the
ity. If the man's resources are not available to the greatest unanimity around cosmetic surgical
woman and children, they are irrelevant. Thus, goals that have an evolutionary purpose. Thus,
the observation that men are more swayed by female surgical goals would nearly all seek to
beauty, and women by a mix of physical attrac- simulate youth and health. We would expect
tiveness and the man's abilities as a provider, may more varied agendas around physical features
be less a reflection of a more evolved cognitive with no implications for fertility. In contrast, we
perspective in women and more the result of fun- would expect male cosmetic surgery agendas to
damental biological differences. emphasize economics motives--aiding men in
More recent research also supports the idea that appearing strong and powerful. While these hy-
perceptions of beauty may be guided by univer- potheses may characterize many cosmetic sur-
sally-shared biological wirings. From this ap- gery patients, they clearly do not capture the
proach, standards of beauty result from fixed surgical motivations of every patient. Neverthe-
neuroanatomical arrangements, which have bi- less, surgeons who recognize the link between
ological relevance. 3 For example, facial features, surgical goals and these fundamental biological
such as symmetry, averageness, and youthfulness, imperatives may better understand their pa-
may not only be indicative of attractiveness, but tients' motivations for surgery.
more importantly may signal health and repro-
ductive capabilities of potential sexual partners. PHYSICAL CHARACTERISTICS OF BEAUTY
Similarly, nonfacial features, such as waist-to-hip Evolutionary theory suggests that an organ-
ratio, may function as indicators of health and ism's ability to successfully identify a potential
reproductive success. 4 Despite some unique cul- mate who will help propel his or her genetic ma-
tural variability in aesthetic judgments, evidence terial into the future is a biological imperative.
has shown that similar patterns emerge across di- Furthermore, the theory suggests that selection of
verse cultures. 2 an ideal, "beautiful" mate is influenced by physi-
A set of compelling studies confirm that our ological, rather than cognitive, factors. Contem-
perceptions of attractiveness predate cultural in- porary research in this area has attempted to iden-
fluences. 3 Studies of infants have suggested that tify the physical features that make an individual
the ability to discriminate attractive from unat- attractive. This research has identified several fac-
tractive faces may be an innate ability, or at least tors: pathogen-resistance, facial and body symme-
one acquired at an earlier age than previously be- try, averageness, body-size ratios, and youthful-
lieved. 5 Three- to 6-month-old infants appear to ness.
be more attentive to "attractive" versus "unattrac-
tive" female facesS; with such preferences occur- Pathogen-resistance
ring across sex and race. 6 Similarly, infants ex- The pathogen-resistance theory of beauty sug-
press a more positive tone, are less withdrawn and gests that physical beauty is a "marker" or "signal"
BEAUTYAND SOCIETY 81

that a potential mate is pathogen free. 8 This model judgments of facial attractiveness by cross-sex
of sexual selection indicates that only healthy, raters. ~6 In one study, for example, body sym-
pathogen-resistant animals can develop and main- metry and facial attractiveness of hundreds of
tain their secondary sex characteristics. Further- college-aged men and w o m e n was examined by
more, the heritability of parasite resistance in- using right-left disparities of 7 body measure-
creases the chance that mates can provide genetic ments. A positive relationship was found for
resistance to their offspring, s Therefore, attrac- symmetry and facial attractiveness for men. 15
tiveness may be a visible sign that a prospective Furthermore, ratings of attractiveness of faces
partner is pathogen-free. are increased when bilateral symmetry is en-
This theory may influence human assessment hanced through digital technology that blend
of potential mates. For example, men and women images of the normal face and its mirror im-
of cultures with high pathogen and disease prev- age. 17 This preference for symmetry was found
alence (such as Nigeria, Zambia, and India) rated for both sexes, although the preference for sym-
physical attractiveness as more important in the metrical faces was stronger for men than for
selection of their long-term mates than men and women, as would be expected from the beauty-
women from cultures in which the pathogen prev- fertility theory proposed by the evolutionary
alence was low (such as West Germany, Sweden, biologists. In addition, men with the most sym-
and Norway).9 While certainly open to other in- metrical features reported both more sexual ex-
terpretations, these findings are not surprising, periences and being sexually active at an earlier
given that selecting a healthy partner may be more age than men with more asymmetric features. ~s
challenging in countries where pathogens are Thus, it may be that symmetrical facial and body
more abundant. However, there is no empirical features are not only aesthetically pleasing, but
evidence showing that physically attractive hu- also convey a message of reproductive health.
mans have greater parasite resistance than unat- According to evolutionary theorists, facial sym-
tractive humans. metry is an attractive quality as it signals health
and fitness. Under ideal developmental condi-
Facial and Body Symmetry tions, paired body features (ie, eyes, ears, elbows),
Bilateral symmetry has been proposed as one develop in synchronicity, leading to more-sym-
phenotypic indicator of a pathogen-free organ- metrical, and therefore more attractive, persons.
ism.l~ Animal studies show that highly symmetri- External factors, such as pollutants, pathogens,
cal creatures are at an advantage in competition and physical trauma, are thought to adversely af-
for sexual partners as compared to their lopsided fect symmetrical development. For many of the
competitors. 11 For example, female peahens pre- same reasons, bilateral symmetry of secondary
fer males with long tails containing large numbers sexual traits is a difficult developmental accom-
of bilaterally symmetrical eye spots. 12 Female plishment. As a result, evolutionary theorists be-
barn swallows select male sexual partners with lieve that only the hardiest and healthiest of the
symmetrical tails over those with asymmetrical population possess the ability to develop facial
tails. 11 Female zebra finches also prefer symmet- and body symmetry in spite of harsh environmen-
rically leg-banded males.13 The attraction for sym- tal conditions. 1~
metrical features has also been found in scorpion
flies/4 It appears that bilateral symmetry may be Averageness of Appearance
an advertisement for quality potential mates who Somewhat surprisingly to many individuals, av-
may offer a greater probability for reproductive erageness can equal attractiveness. Averageness is
SUCCESS. traditionally associated with the ordinary or un-
Humans are also thought to respond to visual exceptional, and certainly does not connote
cues of symmetry to identify potentially desir- beauty. Studies of averageness in facial appear-
able mates. Both male and female humans with ance have used a mathematical mean of a compos-
more bilaterally symmetrical facial features are ite of facial dimensions to generate an "average"
judged to be more attractive, regardless of the appearance/9-2~ To do this, a face is digitally com-
gender of the judges.l~ Facial symmetry for puterized and rated on a scale of "1" to "10,"
men and w o m e n is positively correlated with indicating increasing levels of physical attractive-
82 SARWER, GROSSBART,AND DIDIE

ness. The rater then assesses a series of faces that and women. 4 The WHR reflects the distribution of
are subsequently "bred" with the preceding face. fat between the upper and lower body and the
For both men and women, composite faces of the relative amount of abdominal fat. Before puberty
opposite sex are judged more attractive than the both men and woman have comparable WHRs. 4
individual faces that made up the composite. 19 During puberty, increased levels of estrogen in
Moreover, the more faces that are used to make up women aid in the development of breasts and hips
the composite, the more attractive the final pic- by adding fat deposits to these areas of the body.
ture is rated? ~ In men, testosterone stimulates fat deposits in the
The notion that averageness is associated with abdominal region and inhibits fat deposits in the
attractiveness is consistent with evolutionary the- area of the hips and thighs. 4 Therefore, it may be
ory. Arguably, individuals who fall within the that specific body ratios signal that a prospective
mean of the population distribution should be less mate is sexually mature and has the biological
likely to carry potentially harmful genes or muta- capability to be reproductively active.
tions. 2~ The parasite theory of sexual selection Typically, women rated as attractive are normal
contends that heterozygosity is greatest amongst weight and have a low WHR. 4 Healthy, fertile
individuals who have the "average expression of women typically have WHR of .60 to .80, meaning
continuously distributed, heritable traits. T M waists are 60% to 80% the size of the hips. 24 Fe-
Given this theoretical relationship between het- male figures with a WHR of greater than .80, in-
erozygosity and pathogen resistance, averageness dependent of overall body weight, were judged as
may be indicative of an organism's parasite-resis- less attractive and less healthy than those figures
tant genetic composition, t~ with a WHR of .80 or smaller. 4 The perceptions of
However, while average faces are considered to attractiveness of men are also influenced by WHR
be attractive, the most beautiful of the digital faces as well as relative weight. Specifically, healthy
are certainly not average. 2>23 In fact, these beau- men have WHRs in the range of .85-.95. 25 In spite
tiful faces are not common among the general of WHR, underweight and overweight male fig-
population, rather they are atypical in terms of ures were not judged to be highly attractive or
both the specific facial features and overall facial healthy; only normal weight male figures with
structure. Studies that have used digital compos- typical WHRs were perceived as healthy and at-
ites of faces have found that the most highly rated tractive. 26
composite female faces produced an image that WHR is thought to convey information about
was rated considerably more attractive than the both current reproductive and health status of
typical face that went into creating the final com- women. 26 Typically, menopausal w o m e n have a
posite5 2 Overall, the ideal composite female face WHR that is comparable to the WHR of men. 27
had facial features that were rather petite. The Besides being an indicator of reproductive po-
ideal face had a mouth that was smaller than av- tential, a relatively low WHR also signals health
erage, but had considerably fuller lips. This face status. The risk factor profile for m a n y obesity-
also had a preadolescent's tiny jawline, delicate related diseases, such as type 2 diabetes, hyper-
lower face and pronounced eyes and cheek- tension, and coronary heart disease, varies with
bones. 22 In addition, the distance from the eyes t o the distribution of fat. 28 A WHR greater than 0.8
the nose and from the eyes to the mouth, as well as for w o m e n and 1.0 for men is considered an
from the mouth to the chin, were smaller than independent risk factor for m a n y weight related
these distances in the individual faces that were illnesses.
used to develop the composite. 22 These findings
are a consistent with the evolutionary theory, Youthfulness
which suggests that beauty is characterized by Youthfulness marks an extended period of re-
youthfulness, as discussed below. productive potential? 9 Given the theoretical
model of sexual selection proposed by the evolu-
Body-size Ratios tionary biologists, it is not surprising that ratings
Body ratios, specifically the waist-hip ratio of facial attractiveness and youthfulness are
(WHR), also are thought to play a role in deter- highly correlated. 3~ Ratings of physical attractive-
mining opposite-sex attractiveness for both men ness of men and women declined with age, but the
BEAUTY AND SOCIETY 83

effects were more pronounced for women's SOCIOCULTURAL IDEALS OF BEAUTY


[ a c e s . 31 Women were rated as less feminine as they Evolutionary theories of beauty are most com-
aged, whereas ratings of masculinity were unaf- pelling when used to explain preferences that are
fected. 3z These findings suggest that standards for stable across history and culture. Nevertheless,
attractiveness for men are less stringent and less these theories only provide part of the answer to
connected to youth than they are for women, a the question of who or what is considered beauti-
conclusion again consistent with evolutionary ful. Sociocuhural approaches to beauty are intu-
theories of reproduction. itively pleasing and are helpful in understanding
Looking young may be more important than aspects of beauty which change over time. These
actually being young. Male raters from 5 popula- changes in sociocuhural images of beauty are best
tions judged faces that appear to be younger than reflected in a variety of popular beauty icons--
the actual age of the face to be more attractive than from pinup girls, magazine models, and Holly-
faces that appeared age-appropriate or older than wood stars to Ms. America and the Playboy Cen-
the actual age. 33 Altering facial features in the di- terfold.
rection of youth results in higher ratings of attrac-
tiveness. 34 Such preferences for youthfulness exist Pinup Girls,Magazine Models, and
in the real world, where more female models, as Hollywood Stars
compared to female college students, have Culture imparts a great deal of variability to
younger looking faces. 34 While this quality has ratings of attractiveness. 2 For example, short-
been shown to be an asset for ratings of female lived subcultural variants that are maladaptive in
attractiveness, the same influences have not been an evolutionary sense, such as the "heroin chic"
found for men. It may be more adaptive for men to look of the mid-1990s, can become very popular.
prefer youthful female features because of a strong Western culture has touted a range of body types
association with fertility# 5 as "the ideal" depending on the decade. This is
It appears that specific physical features are perhaps no better exemplified than through the
deemed attractive because they serve an evolu- changes of the ideal Western female figure of the
tionary purpose. Throughout the cons, reliance last century.
on phenotypic expressions for mate selection has In the 19th century, 2 idealized figures of fe-
been necessary to result in successful reproduc- male beauty in the United States were the "steel
tion and survival of the species. While overall fa- engraving lady," idolized for her fragile and deli-
cial attractiveness may be interpreted as a sign that cate features, and the "voluptuous woman,"
an organism is healthy, reliance on this feature whose full, rounded figure epitomized female sex-
alone is inadequate to ensure selection of high uality. During the late 1890s, a new model
quality mates. Therefore, other facial and bodily emerged, the "Gibson Girl," who, in addition to a
slender, athletic frame, had larger breasts and
features may influence sexual selection. The pres-
hips. 3o After the Victorian era, the 1920s pro-
ence of symmetrical features may indicate that an
moted an image that was curveless and almost
organism has overcome or avoided developmental
boyish in shape. 36 While models of the following
stressors and may denote a durable and hardy
decade became more curvaceous, these beauties
creature. Averageness may act as an indicator that conspicuously lacked extraneous fat. The "Petty
the organism is safeguarded against potential Girl," as the icon of the 1930s was known, had a
pathogens. Proportionate body ratios may be the slim lower body and a flat abdomen. 36 This theme
most obvious advertisement that the organism has continued through the 1940s as depicted by one
reproductive potential. Finally, a youthful face of the most famed pinups, Betty Grable.
has long been associated with fertility. Taken to- Curves accentuating a woman's breasts and
gether, these physical attributes--facial and body hips made a dramatic return during the 1950s,
symmetry, averageness, body ratio and youthful- perhaps most visibly when Marilyn Monroe posed
ness--not only have aesthetic appeal but very well for the first Playboy magazine centerfold. The vo-
may guide decisions in successful sexual selec- luptuous hour-glass figures of Monroe, as well as
tion. those of Jane Russell and Jane Mansfield, were
84 SARWER, GROSSBART,AND DIDIE

glorified as the ideal shape during this decade. 3r sources. In a study investigating perceptions of
Soon after, the waist size of the ideal woman de- the appearance of popular television characters,
clined sharply, and by the 1960s the ideal torso 69% of female characters were rated as thin, while
required an unnatural curvature, with fat distrib- only 18% of male characters were rated as thin. In
uted away from the waist to the hips and breasts. 36 contrast, more male (26%) than female (5%) char-
Similar to the beauty icons of the late 19th cen- acters were rated as overweight21 Similar thin-
tury, Western culture during the 1950s also ad- ning trends have been observed in an analysis of
mired the elegant sophisticated lines of Audrey popular female movie stars from 1933 through
Hepburn and Grace Kelly. 1978. 41 In the last 5 years, several prominent fe-
By the late 1960s, thinner fashion icons such as male television and movie stars (ie, Jennifer Anis-
Twiggy replaced the curvaceous figures of the pre- ton, Calista Flockhart, and Lara Flynn Boyle) have
vious decade. This slender trend has endured and become dramatically thinner. Many women and
has been accentuated by the increasing height and men have been openly critical of this current trend
decreasing weights of fashion models and beauty in Hollywood, both out of concern for the message
icons since that time. 3r The stringent guidelines this sends to young women and also for the health
for weight and shape relaxed somewhat during of the actresses themselves. Nevertheless, there is
the 1970s. Beauty icons such as Farrah Fawcett little to suggest that this trend will change anytime
and Cheryl Tiegs were more curvaceous then soon.

models from the previous decade, but still re-


mained slender. By the 1980s, another physical Miss A m e r i c a a n d the Playboy
characteristic helped define beauty. Media stars Centerfold
such as Christy Brinkley and Bo Derek not only The Western ideal of physical beauty has
had the desired curves but also well-developed changed repeatedly over the past 100 years. How-
musculature. Moreover, during the 1990s "super- ever, it has not always been clear that impressions
models" such as Cindy Crawford, Elle McPher- of change have accurately reflected actual change
son, and Tyra Banks continued to advertise lean in these standards. To investigate this issue, sev-
and muscular figures that were feminine and eral researchers have examined changes in the
curvy as well. physical features of 2 of America's most enduring
Comparable trends have been evident in mod- images of physical beauty--Miss America and the
els depicted in popular women's magazines. Dur- Playboy Centerfold.
ing the period of 1967-1987, there was an increase In the 1920s, the mean bust-to-hip measure-
in height and waist measurements of female fash- ments of Miss America winners were 32-25-35.36
ion models, but no increase in hip measure- By the 1930s, waist and hip measurements re-
ments. 4~ The bust to waist ratio of models in La- mained constant but the average bust line grew by
dies HomeJournal and Vogue has fluctuated greatly 2 inches. This trend continued through the mid-
over the century, with the combined average of 1960s. 36 Over a 20-year period (1959-1978) the
the bust-to-waist ratios of the 2 magazines re- weights of Miss America contestants gradually de-
maining at a low through the early 1980s. 41 While clined, while height climbed steadily. 38 Bust and
this issue has been studied extensively in maga- hips were still symmetrical but the height of con-
zines marketed toward adult women, research on testants rose by an average of i inch, while weight
fashion models depicted in magazines geared to- fell by an average of 5 pounds per decade. 36 Miss
ward younger female audiences, who may be most America finalists in the 1960s, for example, aver-
susceptible to the influence of such images, has aged 66 inches in height and 120 lbs. In contrast,
been sparse. One of the few studies that examined finalists in 1983 and 1984 also weighed 120
teen magazines uncovered similar trends as found pounds, but were 2 inches taller on average. 36
in adult magazines. Guillen and Barr 42 reported Body weight for Miss America was 13% to 19%
that the overall mean hip-to-waist ratio of models below their expected weight, with 60% of contes-
in young women's magazines had significantly de- tants at weights 15% or more below the expected
clined over time, depicting a less curvaceous weight for their age and height, a characteristic
shape. found in women with Anorexia Nervosa. 39 In con-
Thin ideals are also found in other mass media trast to normal height and weight relationships
BEAUTYAND SOCIETY 85

which are highly correlated, while Miss America cent, 45 further suggesting the cross-culture
has gotten taller, she has lost weight. commonalities of certain aspects of beauty.
Similar trends have been found for another icon In looking at the variety of images of Western
of Western beauty, Playboy Centerfolds. Over a beauty from the last century, it appears that ideals
20-year period (1959-1978), the weight of Play- of beauty have principally "evolved" from the
boy Centerfolds decreased while height has risen round voluptuous figures of female models to the
steadily. 38 A more recent update of this study strikingly linear figures of fashion models and ac-
found that the weight of Playboy Centerfolds con- tresses today. Unfortunately, it also appears that
tinued to fall during the period 1978-1988 and has many of these images have evolved to the point of
stabilized at a very low level. 39 For example, dur- projecting a potentially physically unhealthy ideal
ing the time period 1979-1983 the mean weight of to society. Given the theoretical relationship be-
Playboy Centerfolds was 111.5 pounds, a weight tween mass media images of beauty and eating
significantly less than the 115.7 pound mean re- disorders and body image problems, the potential
ported by Garner et al 3s for the years 1959-1978. influence of these ideals on young women in par-
Similar to Miss America contestants, over the 10- ticular is of great concern to many mental health
year period (1979-1988) 69% of the Playboy cen- professionals.
terfolds weighed 15% or more below the expected Many people argue that the mass media (maga-
weight for their age and height. 39 Troublingly, the zines, movies, television, and Internet) is an influ-
current height-weight ratios for both Miss Amer- ential promoter of beauty ideals. Others contend
ica and the Playboy Centerfold has reached the that the media is simply reflecting a trend of pub-
point where the majority of these women now lic preferences. Even if this thin ideal did not orig-
reflect an underweight, and potentially unhealthy, inate in the media, many believe that the media
body type. exploits this ideal and promotes the message that
thinness is equated with success and popularity.
Cross-cultural Studies of Beauty
One feminist perspective offered by Naomi Wolf 43
Although many argue that Western society suggests that the muhi-billion dollar diet, cosmet-
establishes the current ideals of beauty, it is ics, and cosmetics surgery industries, in her view,
often assumed that there are distinct cultural seek to keep women in frantic pursuit of this
variabilities in aesthetic judgments. Most of the "beauty myth." As such, the mass media functions
cross-cultural literature on beauty has focused as a counter-feminist movement that seeks to
on preferences in facial attractiveness. Across maintain and extend economic, political and sex-
37 cultures, both males and females prioritized ual control over women. Regardless of how one
physical attractiveness over personality charac- understands the relationship between the mass
teristics like dependability, emotional stability media and these images, the images themselves
and maturity in their choice of mates, z Further- are inescapable. While some would argue that
more, standards of physical attractiveness are these images inspire us to visualize our appear-
not arbitrarily isolated to certain cultures. 33 ance in the idealized form, others would suggest
Ratings of facial attractiveness of Greek men by that they, as one patient put it, " . . . leave me
women in China, England, and India were con- feeling that I look like chopped liver?" Given that
sistent across the cultural g r o u p s . 44 In a similar the vast majority of women will never attain the
study, the attractiveness of female faces of inter- idyllic standards reflected by media, it is not sur-
national contestants from the Miss Universe prising that women who are dissatisfied with their
Pageant were rated by Caucasian males. Those appearance are motivated to use a variety of meth-
faces that were rated as highly attractive also ods, including cosmetic surgery, to improve what
correlated with young looking features, such as they perceive as bodily imperfections.
wide eyes, small chin, and small nose. 33 In ad-
dition, features such as prominent cheekbones WHAT DO WE THINK ABOUT BEAUTIFUL
and narrower cheeks were also associated with PEOPLE
high ratings of attractiveness. 33 These findings Thirty to forty years ago, mental health profes-
have been replicated across female faces of sionals did not give much thought to beauty. If
Asian, Hispanic, and African American de- beauty was considered, it was seen as a trivial
86 SARWER,GROSSBART,AND DIDIE

pursuit of vanity or a misplaced effort at en- umented the negative, indifferent, or demeaning
hancing self-esteem. W o m e n who were inter- behavior that unattractive individuals, such as
ested in changing their appearance through cos- those who are facially disfigured or who are obese,
metic surgery during this time were typically have received from their physicians. Mental
seen in a negative l i g h t - - t h e i r motivations for health professionals also fall victim to the same
changing their appearance viewed as a mis- stereotypes about the beautiful and the homely as
placed attempt to solve an internal emotional everyone else. In general, psychotherapists tend to
conflict. Since that time, a body of research from attribute greater psychopathology to their unat-
the field of social psychology has greatly in- tractive patients. For years, psychotherapists have
creased our understanding of the role of physi- acknowledged that they prefer working with
cal beauty in daily life. This research has sug- YAVIS (young, attractive, verbal, interesting, and
gested that, whether we like to admit it or not, successful) clients rather than old, unattractive,
our appearance really does seem to matter. and unsuccessful clients. 51 Not surprisingly, sev-
One of the first experiments in this area was eral studies have suggested that psychotherapy
designed to test the belief first offered by the patients also prefer to work with more attractive
Greek philosopher Sappho 46 that, "What is beau- therapists. ~2-~3
tiful is good." To test this idea, men and women Physical appearance also influences our inter-
were asked to look at pictures of good-looking, actions with the legal system. Reviewing the liter-
average-looking, or unattractive individuals (the ature on the relationship between physical ap-
pictures were categorized by another group of rat- pearance and criminal behavior, Hatfield and
ers) and rate them on a variety of personality char- Sprecher 54 concluded that more attractive indi-
acteristics. As compared to the average and unat- viduals are less likely to be caught committing a
tractive pictures, good-looking individuals were crime and are less likely to be severely punished
rated as more kind, interesting, sociable, and out- by judges and jurors. There is one exception to the
going. In addition, they were predicted to have benefits of beauty in legal proceedings--if one's
happier marriages, better jobs, and more fulfilling physical beauty is used to prey on others. Attrac-
lives. 47 Over the next 25 years, numerous studies tive female defendants, for example, will receive
found similar results, strengthening the belief that longer prison sentences than less attractive defen-
more beautiful individuals are viewed more posi- dants in cases of embezzlement. 55 The benefits of
tively than those who are less attractive. physical beauty apply to victims as well, as attrac-
Not only are beautiful individuals judged more tive victims appear to be more successful in win-
positively than their less attractive peers, attrac- ning their legal cases. 54
tive individuals appear to receive preferential
treatment from others. Throughout the lifespan, Appearance and Helping Behaviors
beautiful men and women appear to be treated Physical beauty also determines who we help
more favorably. For example, elementary school and who we ask for help. Across several studies,
teachers typically assume that cute boys and girls men have been shown to be more likely to help
were more intelligent and were more likely to an a t t r a c t i v e w o m a n t h a n an u n a t t r a c t i v e
achieve academic success than less attractive chil- w o m a n with tasks ranging from mailing letters
dren. *s-49 Such biases also occur when schooling to providing directions. 56-57 While good-look-
has been completed. As compared to less attrac- ing individuals appear to be more likely to re-
tive persons, attractive individuals are more likely ceive help, they are less likely to be asked for
to be hired for jobs and receive higher starting help. Whether it is out of fear of rejection or
salaries, so concern about looking helpless in front of a
beautiful person, we are more likely to ask less
Appearance and the Medical, Mental attractive friends and strangers for help in times
Health, and the Legal Systems of need. 54
Medical and mental health professionals (who
we would like to think are immune to such beauty Appearance in Romantic Relationships
biases) appear to treat attractive and unattractive Physical appearance obviously plays a central
patients differently. Numerous studies have doc- role in the selection of our romantic partners. It is
BEAUTY AND SOCIETY 87
i

frequently the first bit of information we gather there is often disagreement as to what exactly
about a potential romantic partner. If the "spark" "body image" is. In his landmark text, Exacting
of physical attraction does not exist, the romantic Beauty, Thompson et a158 suggested that no less
relationship will most likely not flourish. In a per- that 14 terms can be used to describe body im-
fect world, almost all men and women would pre- age. In some respects, body image is similar to
fer to be with the most physically attractive part- its closely related construct of self-esteem. That
ner available, even at the expense of exceptional is, we all have an idea of what self-esteem is;
intelligence or a sense of humor. When the possi- however, if we were asked to put that idea into
bility of rejection is added to the romantic equa- words, we would struggle to come up with a
tion, however, desire for the most attractive part- concise definition that accurately represents the
ner is balanced by the fear of rejection. The end complexity of the construct. Thompson et a158
result is that people will typically end up selecting suggested that "body image" has come to be
people who are similar to themselves in attractive- accepted as the internal representation of your
ness. For example, if a woman views herself as a own outer appearance. 58 Regardless of the exact
"7," she may desire to be with a "10," but the fear definition used, body image plays a significant
of possible rejection by a more attractive partner role in how people feel about both their appear-
will lead her to become interested in another "7." ance and themselves.
In these more realistic settings, the other person-
ality characteristics that attract people to one an- Dimensions of Body Image
other, such as intelligence, sense of humor, com- While there is little agreement to the exact
passion, and loyalty, play a more central role in definition of body image, there is little disagree-
romantic relationships. Nevertheless, similarity in ment that body image is a multidimensional
physical attractiveness remains important, as cou- construct. Relevant psychological influences of
ples who are matched on physical attractiveness, body image typically include perceptual, devel-
as well as on other desirable personality charac- opmental, and sociocuhural dimensions. 59-6~
teristics, are more content in their romantic rela- Perceptual influences account for an individu-
tionships. 54 al's ability to accurately determine the physical
Over the last several decades, a significant body features of a given body part. This accounts for
of research has demonstrated the benefits of phys- our ability to perceive ourselves in time and
ical beauty. Not only are physically attractive in- space, as well as our ability to accurately (or
dividuals judged more positively by other individ- inaccurately) make judgments about the size
uals, they have been shown to receive preferential and shape of our bodies and its features. Devel-
treatment in numerous interpersonal encounters opmental influences consider the contribution
across the lifespan. Even in situations where we of childhood and adolescent experiences to the
would like to think our appearance does not mat- adult body image. The strongest of these influ-
ter--when we trust that others will help u s - - ences may be the experience of appearance-
beauty strongly influences how we are treated. related teasing. Recent empirical studies, as well
Physical attractiveness plays a vital role in our as anecdotal clinical reports, highlight the often
interpersonal interactions, yet it is almost com- devastating effects that childhood and adoles-
pletely unrelated to how we truly feel about our cent teasing can have on the adult body image.
appearance. In fact, no discussion of beauty is Each of us, in our psychotherapeutic work, has
complete without an exploration of the inner view been struck by patients who, even as highly
of beauty-- one's body image. successful adults, can recall the pain of being
teased about their appearance decades earlier as
BODY IMAGE if it just occurred. These patients often ask cos-
At the beginning of the new century, body im- metic surgeons to correct the feature that elic-
age is clearly one of the hottest topics in the field ited the schoolyard teasing, often years after the
of psychology. In the 1990s, numerous profes- last episode of teasing. Finally, sociocuhural
sional textbooks and hundreds of journal articles influences (as discussed in detail above) ac-
were devoted to the study of body image. Unfor- count for the interaction of the mass media and
tunately, as with any rapidly developing area, cultural ideals of appearance (which frequently
88 SARWER, GROSSBART, AND DIDIE

portray unrealistic and exaggerated images of ADDRESSING BODY IMAGE


beauty which have been digitally-enhanced and DISSATISFACTION
airbrushed to perfection) with the tendency of As discussed above, it appears that many
individuals to compare themselves to others. women (and some men) desire to achieve increas-
These 3 factors are thought to play a significant ingly unrealistic body shapes portrayed by the
role in the adult body image. mass media. Not only are these body ideals unat-
Body Image Valence and Value tainable for most people, the comparisons be-
tween the self and the ideal are thought to contrib-
Sarwer et al 6~ have suggested that attitudes to- ute to the dramatic increase in discontent about
ward the body have at least 2 dimensions. The first their own appearances. 5s-61 This dissatisfaction is
consists of a valence, defined as the degree of im- thought to motivate many behaviors: dieting and
portance of body image to one's self-esteem. Per- exercise, cosmetics use, and cosmetic surgery.
sons with a high body image valence, in contrast
to those with a low valence, are thought to derive
m u c h of their self-esteem from their body im- Dieting and Exercise
age. In addition, body image has a value (ie, Perhaps the most common response to body
positive or negative), which can also be under- image dissatisfaction is dieting and exercise. It is
stood as the degree of satisfaction or dissatisfac- estimated that the weight-loss industry contrib-
tion with the body image. Large-scale surveys uted $32.6 billion to the nation's economy in
have indicated that, in general, Americans are 1994. 62 The sale of self-help books, videos, and
dissatisfied with their appearance. 61 Compari- audio cassettes focusing on dieting toppled over
sons of survey results conducted in 1972, 1985, $380 million in 1994, while commercial weight
and 1996 have suggested that dissatisfaction loss programs, such as Jenny Craig and Weight
with overall a p p e a r a n c e a m o n g w o m e n in- Watchers, reported earnings of $1.7 billion. 62
creased from 23% to 56%, and in men increased Americans also spend billions of dollars annually
from 15% to 43%, in just 25 years. The n u m b e r on health club memberships; fitness club revenue
one concern for both genders was dissatisfac- grew from $6.7 billion in 1991 to $8.4 billion in
tion with weight. For example, the percentage 1994. 62
of w o m e n dissatisfied with their weight in- Reports of dieting a m o n g w o m e n are ex-
creased from 48% to 66%, an increase that tremely c o m m o n - - s u c h a large percentage of
closely parallels the change in the prevalence of w o m e n diet that it can almost be considered
obesity and overweight in the United States. "normative eating" in Western cultures. In a
This dissatisfaction is no trivial matter. Weight sample of 60,860 adults, 38% of w o m e n and
was so associated with personal happiness that 24% of m e n were attempting to lose weight. 63 As
24% of w o m e n and 17% of men said they would m a n y as 81% of high school girls desire to lose
give up more than 3 years of their lives to be weight, and 63% have dieted in the past year. 64
thinner. 61 Rosen and Gross 65 found in a sample of 3,000
It is difficult, however, to determine the point at adolescents that 63% of the girls were trying to
which an individual's body image dissatisfaction lose weight. Even some preadolescents are at-
becomes extreme and problematic. It has been tempting to lose weight. According to the Na-
hypothesized that body image dissatisfaction falls tional Heart, Lung, and Blood Institute Growth
on a continuum. 59-6~ Such dissatisfaction may and Health Study, among 9 and 10 year olds,
range from a dislike of a specific appearance fea- 40% of the girls were dieting to lose weight. 66
ture to psychopathological dissatisfaction, in Given the increasing prevalence of obesity in
which thoughts about appearance distress and the United States, and the well-established rela-
preoccupy the individual, and behavior is nega- tionship between obesity and health conditions
tively influenced by these c o n c e r n s 9 -6~ While such as type 2 diabetes, hypertension, and cor-
extreme dissatisfaction may be a symptom of clin- onary heart disease, which increase the risk of
ically significant psychopathology, mild dissatis- mortality, one could easily assume that more
faction may motivate a whole range of behaviors people are dieting to improve their health sta-
to improve body image. tus. In reality, the primary motivation for diet-
BEAUTYAND SOCIETY 89

ing, even among the severely obese, is almost image valence (the relationship of the body image
exclusively appearance-related. Not surpris- to self-esteem) and body image value (the degree
ingly, w o m e n are more likely than men to indi- of body image dissatisfaction) that influences the
cate that their primary concern for trying to lose decision to seek cosmetic surgery. One consistent
weight is improving their appearance. 67 Those finding of the preoperative studies of cosmetic
who engage in frequent physical activity also surgery patients is that persons who seek cosmetic
report that looking good is their primary moti- surgery have reported increased dissatisfaction
vation for exercising. 68 Therefore, even given with body image, r~.r2 Persons with a high body
the benefits of diet and exercise on improving image valence, for whom body image is an impor-
one's health, improving one's body image ap- tant part of self-esteem, and who have a height-
pears to be the primary motivation for improv- ened degree of dissatisfaction with a specific fea-
ing one's diet and being more active. ture, are thought to comprise the majority of
cosmetic surgery patients. 6~ In contrast, persons
Cosmetics Use with a low body image valence and little body
From the pages of magazines to music videos image dissatisfaction are unlikely to seek cosmetic
and television commercials, women are exposed surgery.
to thousands of messages and images instructing
them how to be beautiful. Cosmetics have become THE DISFIGURED
a profitable means through which women can at- We have spent the majority of this article dis-
tain beauty in Western society. Given the early cussing b e a u t y - - how we determine what is beau-
history of the cosmetics industry, manufacturers tiful, what do we think about and how do we treat
have done a phenomenal job at fostering the mar- beautiful people, how do we think about our own
ketability of their products. Prior to the 1920s, beauty, and what do we do to make ourselves
women who "painted their faces" elicited an im- more beautiful. Nevertheless, our article would be
age of women's sexuality that Victorian society incomplete without a discussion of those who are
was not ready to acknowledge. 69 Such ideas about not beautiful. Whether as a result of a genetic
cosmetics clearly have not endured, as American deformity or traumatic insult, there are many
consumers spent almost $16 billion on cosmetics, members of our society with disfigured appear-
toiletries, and perfumes in 1994. 70 ances who think about beauty in a way that those
In her book on the history of the cosmetics of us who are not disfigured can probably never
industry, Piess 69 suggests that women use makeup understand. While many persons who seek aes-
to "announce their adult status, sexual allure, thetic surgery hope to improve their "normal" ap-
youthful spirit, political belief, and self-defini- pearance to make it "stand out from the crowd,"
tion." Cosmetics offer women an accessible and those who are disfigured often desire nothing
affordable means to improve their appearance. It more than to have an appearance which allows
not only provides them with an opportunity to them to blend into the crowd without being the
improve their outward appearance, it also can im- victims of unwanted stares, looks of disgust, or
prove their body image and self-esteem. While relentless ridicule.
strains of the feminist movement are often critical Compared to the vast literature on beauty avail-
of the cosmetic industry and the messages it pro- able to us for this chapter, relatively little is known
motes, women from all walks of life use cosmetics about those who are not beautiful. In some re-
as an acceptable way to enhance desirable facial spects, this is not particularly surprising, as both
features and to create the appearance of youth or the lay public and mass media appears to be much
sexuality. more interested in talking about beauty. Never-
theless, children and adolescents with disfigured
Cosmetic Surgery appearances are at risk for psychological prob-
Increasing numbers of women and men use lems. We also know that disfigured adults may
cosmetic surgery to address body image dissatis- struggle with low self-esteem and poor quality of
faction. In their theory of the relationship between life, and may experience discrimination both in
body image and cosmetic surgery, Sarwer et a159,60 employment and social settings. Unfortunately,
speculate that it is the interaction between body we do not currently know how we can best help
90 SARWER, GROSSBART, AND DIDIE

t h o s e w h o l o o k d i f f e r e n t to c o p e w i t h t h e i r disfig- b e a u t y r e p r e s e n t e d in m a s s m e d i a f i g u r e s a n d
u r e m e n t . B e t w e e n w h a t w e do a n d do n o t k n o w found that many of the current images of beauty
a b o u t d i s f i g u r e m e n t , o n e t h i n g is certain. In a are n o t o n l y u n r e a l i s t i c a n d u n a t t a i n a b l e , b u t
society which puts such a premium on physical a r e also p o t e n t i a l l y u n h e a l t h y . T h e s o c i a l p s y -
beauty, w h i l e m a n y p e o p l e h a v e p r o b a b l y chological research on physical attractiveness
d r e a m e d of b e i n g m o r e b e a u t i f u l , p r o b a b l y n o o n e suggests that not only do we think more posi-
d r e a m s of b e i n g disfigured. t i v e l y a b o u t b e a u t i f u l p e o p l e , w e also t r e a t t h e m
more favorably in interpersonal situations
CONCLUSION a c r o s s t h e l i f e s p a n . T h e t h e o r y of b o d y i m a g e
T h e r o l e of p h y s i c a l b e a u t y in e v o l u t i o n a r y c a n be u s e d to u n d e r s t a n d p h y s i c a l a p p e a r a n c e
t h e o r y s u g g e s t s t h a t b e a u t y is m o r e t h a n s k i n concerns and our relentless pursuit of an im-
d e e p . B e a u t y is m a r k e d n o t j u s t b y o b v i o u s p r o v e d b o d y i m a g e t h r o u g h diet, e x e r c i s e , c o s -
p h y s i c a l f e a t u r e s s u c h as h a i r c o l o r a n d s k i n metics use, and cosmetic surgery. Finally, our
t o n e ; r a t h e r , it is also m a r k e d b y m o r e s u b t l e d i s c u s s i o n o f b e a u t y a n d s o c i e t y r e v e a l e d that,
f e a t u r e s s u c h as facial a n d b o d y s y m m e t r y , a v - in a world that places such a premium on
e r a g e n e s s , a n d b o d y - s i z e r a t i o s , all o f w h i c h beauty, we know very little about living with a
s e r v e as s i g n a l s for r e p r o d u c t i v e p o t e n t i a l . T h e d i s f i g u r e d a p p e a r a n c e . W h i l e w e c o n t i n u e to
i n t u i t i v e l y p l e a s i n g s o c i o c u l t u r a l a p p r o a c h e s to l e a r n m o r e a b o u t t h e n a t u r e o f b e a u t y , it is i m -
b e a u t y also r e v e a l e d s o m e i n t e r e s t i n g t h i n g s . p o r t a n t for u s to c o n t i n u e to l e a r n a b o u t t h e
W e t r a c e d t h e c h a n g i n g t r e n d s in i d e a l s o f d i f f i c u l t i e s a n d c h a l l e n g e s of b e i n g d i s f i g u r e d .

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