40-nation survey finds that almost three out of four unhappy with breast size

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The majority of women worldwide may be dissatisfied with the size of their breasts, found a 40-nation study. The authors note that this has significant implications for the physical and psychological well-being of women.

The Breast Size Satisfaction Survey (BSSS), led by Professor Viren Swami of Anglia Ruskin University (ARU), brought together over 100 international experts to conduct surveys with 18,541 women in 40 countries, making it the largest cross-cultural study to examine body image ever undertaken.

The research discovered that 48% of women who participated wanted larger breasts than they currently have, 23% of women wanted smaller breasts, and only 29% of women were satisfied with the size of their breasts. The average (mean) age of the women taking part in the study was 34.

Women who were dissatisfied with their breast size admitted they were less likely to practice breast self-examination and were less confident about detecting changes with their breasts, which are important self-care practices for the early detection of breast cancer.

The study also found that breast size dissatisfaction is associated with poorer psychological well-being — including lower levels of self-esteem and happiness — and that women with breast size dissatisfaction were more likely to be dissatisfied with their weight and overall appearance.

Women in Brazil, Japan, China, Egypt, and the UK have the greatest breast size dissatisfaction – the difference between their current breast size and their ideal breast size. Women in India, Pakistan, Egypt, Lebanon, and the UK have the largest ideal breast size, while women in Japan, the Philippines, Germany, Austria, and Malaysia reported the smallest ideal breast size.

Swami, professor of social psychology at ARU, said: “Our findings are important because they indicate that the majority of women worldwide may be dissatisfied with the size of their breasts. This is a serious public health concern because it has significant implications for the physical and psychological well-being of women.

“Breast cancer is the leading cause of female cancer-related deaths worldwide and poor survival rates are associated with poorer breast awareness. Breast size dissatisfaction may result in avoidance behaviours that reduce breast awareness, particularly if a woman’s breasts trigger feelings of anxiety, shame, or embarrassment.

“Our study found a direct link between greater breast size dissatisfaction and poorer breast awareness, as seen through lower frequency of breast self-examination and lower confidence in detecting changes in the breasts, and this requires urgent public health intervention.

“We also found that despite historical differences across nations, breast size ideals are now similar across the 40 nations we surveyed. This suggests that the objectification of medium-to-large breasts is now a global phenomenon.

“Another key finding is that breast size dissatisfaction decreases with age. It is possible that older women experience less pressure to attain breast size ideals or that motherhood and breastfeeding encourages women to focus on the functional purposes of breasts rather than seeing them purely in aesthetic terms.”

The Breast Size Satisfaction Survey (BSSS) was established to assess women’s breast size dissatisfaction and breasted experiences from a cross-national perspective. A total of 18,541 women were recruited from 61 research sites across 40 nations and completed measures of current-ideal breast size discrepancy, as well as measures of theorised antecedents (personality, Western and local media exposure, and proxies of socioeconomic status) and outcomes (weight and appearance dissatisfaction, breast awareness, and psychological well-being). In the total dataset, 47.5 % of women wanted larger breasts than they currently had, 23.2 % wanted smaller breasts, and 29.3 % were satisfied with their current breast size. There were significant cross-national differences in mean ideal breast size and absolute breast size dissatisfaction, but effect sizes were small (η2 = .02–.03). The results of multilevel modelling showed that greater Neuroticism, lower Conscientiousness, lower Western media exposure, greater local media exposure, lower financial security, and younger age were associated with greater breast size dissatisfaction across nations. In addition, greater absolute breast size dissatisfaction was associated with greater weight and appearance dissatisfaction, poorer breast awareness, and poorer psychological well-being across nations. These results indicate that breast size dissatisfaction is a global public health concern linked to women’s psychological and physical well-being.

Viren Swami, Ulrich S Tran, David Barron, Reza Afhami, Annie Aimé, Carlos A Almenara, Nursel Alp Dal, Ana Carolina Soares Amaral, Sonny Andrianto, Gulnaz Anjum, Marios Argyrides, Mohammad Atari, Mudassar Aziz, Benjamin Banai, Joanna Borowiec, Alexandra Brewis, Yeliz Cakir Kocak, Juliana Alvares Duarte Bonini Campos, Carmen Carmona, Trawin Chaleeraktrakoon, Hong Chen, Phatthanakit Chobthamkit, Bovornpot Choompunuch, Togas Constantinos, Aine Crumlish, Julio Eduardo Cruz, Simon E Dalley, Devi Damayanti, Joanna Dare, Stacey M Donofrio, Anja Draksler, Michelle Escasa-Dorne, Elaine Frances Fernandez, Maria Elisa Caputo Ferreira, David A Frederick, Antonio Alías García, Shulamit Geller, Alexias George, Louai Ghazieh, Cosmin Goian, Colin Gorman, Caterina Grano, Jonathan Eliahu Handelzalts, Heather Horsburgh, Todd Jackson, Lady Grey Javela Javela Delgado, Marija Jović, Marko Jović, Adam Kantanista, Sevag K Kertechian, Loes Kessels, Magdalena Król-Zielińska, Garry Kuan, Yee Cheng Kueh, Sanjay Kumar, Ingela Lundin Kvalem, Caterina Lombardo, Ernesto Luis López Almada, Christophe Maïano, Mandar Manjary, Karlijn Massar, Camilla Matera, Juliana F Figueiras Mereiles, Norbert Meskó, Hikari Namatame, Amanda Nerini, Felix Neto, Joana Neto, Angela Nogueira Neves, Siu-Kuen Ng, Devi R Nithiya, Salma Samir Omar, Mika Omori, Maria Serena Panasiti, Irena Pavela Banai, Eva Pila, Alessandra Pokrajac-Bulian, Vita Postuvan, Ivanka Prichard, Magdalena Razmus, Catherine M Sabiston, Reza N Sahlan, Jacob Owusu Sarfo, Yoko Sawamiya, Stefan Stieger, Cindi SturtzSreetharan, Eugene Tee, Gill A ten Hoor, Kulvadee Thongpibul, Arun Tipandjan, Otilia Tudorel, Tracy Tylka, Zahir Vally, Juan Camilo Vargas-Nieto, Luis Diego Vega, Jose Vidal-Mollón, Mona Vintila, Deborah Williams, Amber Wutich, Yuko Yamamiya, Danilo Zambrano, Marcelo Callegari Zanetti, Ivanka Živčić-Bećirević, Martin Voracek

Anglia Ruskin University material

Body Image abstract

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