Psychology, Health & Medicine

ISSN: 1354-8506 (Print) 1465-3966 (Online) Journal homepage: https://www.tandfonline.com/loi/cphm20

Media influence on drive for thinness, body

satisfaction, and eating attitudes among young
women in Hong Kong and China

Tina L. Rochelle & W. Y. Hu

To cite this article: Tina L. Rochelle & W. Y. Hu (2017) Media influence on drive for thinness,
body satisfaction, and eating attitudes among young women in Hong Kong and China, Psychology,
Health & Medicine, 22:3, 310-318, DOI: 10.1080/13548506.2016.1226507

To link to this article: https://doi.org/10.1080/13548506.2016.1226507

Published online: 01 Sep 2016.

Submit your article to this journal

Article views: 907

View related articles

View Crossmark data

Citing articles: 6 View citing articles

Full Terms & Conditions of access and use can be found at

https://www.tandfonline.com/action/journalInformation?journalCode=cphm20
Psychology, Health & Medicine, 2017
VOL. 22, NO. 3, 310–318
http://dx.doi.org/10.1080/13548506.2016.1226507

Media influence on drive for thinness, body satisfaction, and

eating attitudes among young women in Hong Kong and
China
Tina L. Rochelle and W. Y. Hu
Department of Applied Social Sciences, City University of Hong Kong, Kowloon, Hong Kong

ABSTRACT ARTICLE HISTORY

The present study examined the impact of thin-ideal media exposure Received 2 March 2016
on Chinese women’s drive for thinness, attitudes towards body Accepted 15 August 2016
shape, and eating attitude. Women were assigned to one of two KEYWORDS
video conditions, which portrayed the thin-ideal (experimental) or Drive for thinness; thin ideal;
was neutral (control group), in terms of content. A total of 83 young body satisfaction; eating
women from Hong Kong (N = 38) and Shanghai (N = 45), aged attitude; Chinese
between 18 and 25 years (Mage = 22.7) participated in the study. A
significant interaction was observed between the experimental video
condition and location. Hong Kong women in the experimental group
experienced greater levels of body dissatisfaction than Shanghai
women exposed to the same condition. Exposure to thin-ideal media
produced an increase in drive for thinness, body dissatisfaction and
problematic eating attitudes regardless of location, with a greater
immediate impact shown in Hong Kong women.

Introduction
Women are now under greater social pressure to be considered ‘beautiful’ by being thin,
particularly in western contexts (Grogan, 2008). For women, the most prominent feature of
idealised feminine beauty and attractiveness is thinness (Harriger, Calogero, Witherington,
& Smith, 2010). The media in particular has been criticised for depicting unrealistic and
digitally-enhanced images of flawlessly slim women as appropriate ideals against which
women should compare themselves (Grogan, 2008). Drive for thinness affects women more
than men, is more prevalent across the developed world, and is strongly associated with
ever-increasing levels of body image distortion, disordered eating, and diagnosable eating
disorders (Hewig et al., 2008; Lake, Staiger, & Glowinski, 2000). Little is known about the
sociocultural influences on body dissatisfaction, eating attitudes and drive for thinness
outside of western societies. The present study examined the impact of thin-ideal media
exposure on Chinese women’s drive for thinness, body shape satisfaction, and eating atti-
tude. Using two samples of Chinese women in Hong Kong and Shanghai, the present study
sought to address whether women in Chinese cultures are affected by exposure to media
depictions of the thin-ideal in the same way.

CONTACT Tina L. Rochelle [email protected]

© 2016 Informa UK Limited, trading as Taylor & Francis Group
 Psychology, Health & Medicine  311

Body dissatisfaction consists of dysfunctional, negative beliefs and feelings about one’s
weight and body shape. Body image refers to two aspects that make up an individual’s
body image: the perceived size and shape of one’s body, and the emotional aspect of how
an individual feels about their body, including attitudes, beliefs and feelings (Hewig et al.,
2008). There is substantial evidence suggesting that body image and body dissatisfaction are
socioculturally determined (Dittmar, 2005). Sociocultural theory attributes high levels of
body image concerns among women in the West to the media’s projection and promotion
of unrealistically thin models (Grabe, Ward, & Hyde, 2008). The thin-ideal has become the
beauty standard to which many women compare themselves. Research consistently identi-
fies links between exposure to the thin-ideal and female body dissatisfaction. Experimental
studies conducted in the West provide evidence of the immediate psychological effects of
acute media exposure on body image, overwhelmingly showing greater body dissatisfaction
in women exposed to thin-ideal images as opposed to neutral images (Grabe et al., 2008;
Groesz, Levine, & Murnen, 2002; Hargreaves & Tiggemann, 2004).
Numerous studies have supported the assumption that body image disturbance and
eating disorders are Western culture-bound syndromes (Lee, Ng, Kwok, & Fung, 2010).
This view is also supported by research reporting that Asian women have higher body
satisfaction and lower engagement in weight loss behaviours than their Western counter-
parts (Lowry et al., 2000). However, along with rising globalisation, research has suggested
that body-image concerns are now spreading to non-Western cultures (Xu et al., 2010). It
has been argued that eating disorders are becoming more common in high income South
East Asian societies, such as Hong Kong (Lee et al., 2010; Xu et al., 2010). The adoption of
Western values is one explanation given for the increase in body dissatisfaction and eating
disorders in non-Western societies. First reports of eating disorders came to public atten-
tion during the mid-1990s, with rates increasing since that time (Levine & Smolak, 2010).
However, the scale of the issue is not thought to be as significant as many Western societies,
with one study pointing out that Chinese women do not report drive for thinness or fear
of fat in the same way as women in Western societies (Lee, 2001).
Hong Kong offers an interesting backdrop due to its combination of traditional Chinese
and Western culture, as a result of its time as a British colony, thus creating a mix of old
and new values. Hong Kong, a cosmopolitan hub and global financial centre is known as
‘Four Little Dragons’, together with other three countries Korea, Taiwan and Singapore.
Shanghai is the largest city in mainland China, and similar to Hong Kong, is becoming both
a cosmopolitan hub and global financial centre (Preslan, 2002). However, Shanghai is very
much a traditional Chinese city, especially when compared with Hong Kong, with its high
exposure to western values and western culture. This is much less the case for Shanghai.
Food is greatly promoted in Chinese culture, with an inextricable link between food,
dietary behaviour, and health. Dietary adjustment for health promotion and maintenance
are deeply ingrained in the Chinese concept of health and illness (Ho, 1985). With a greater
emphasis on the promotion of food culture in Chinese societies, physical appearance is tra-
ditionally regarded as less important, while health is regarded as of paramount importance,
particularly when compared with western societies. However, with a westernised media
presence in China and particularly in Hong Kong, it will be interesting to explore whether
this has an influence on young Chinese women today. As Hong Kong is traditionally per-
ceived to be a more westernised society than Shanghai, due to its time as a British colony, for
312 T. L. Rochelle and W. Y. Hu

the purpose of the present study it is hypothesised that HK women will display a stronger
drive for thinness and have lower body satisfaction than their Shanghai counterparts.

Research aims
Given the paucity of empirical research examining media influence on body image and body
satisfaction outside of Western societies, the purpose of the present study is to examine
media influence on drive for thinness, body satisfaction and eating attitude among young
females in Hong Kong (HK) and Shanghai. The present study reports an experiment that
exposed women to a thin-ideal video or a neutral-stimulus video examining the impact
of the video on drive for thinness, body shape satisfaction, and eating attitudes. The study
explored any differences regarding drive for thinness, body satisfaction and eating attitude
by examining whether or not exposure to the thin-ideal experimental video condition has
the same effect on women from HK and Shanghai. Specifically it was hypothesised that:
H1: There will be an interaction between the experimental condition and location. Specifically,
we expect that HK women who view the thin-ideal video will experience a greater increase in
body dissatisfaction than Shanghai women who view the thin ideal video.

H2: Exposure to the video promoting the thin-ideal will produce greater drive for thinness,
body dissatisfaction, and eating attitudes.

Methodology
Sample
Participants consisted of young women recruited from universities of two countries, Hong
Kong and China. Among the 83 participants recruited to the study, 38 women were recruited
from Kowloon in HK and 45 women were recruited from Shanghai in China Participants
ranged in age from 18 to 25 years (Mage = 22.7,SD = 3.27). Women recruited from the two
locations differed in mean age: t(43.55) = 4.06, p < .001: HK (M = 24.26, SD = 4.14), Shanghai
(M = 21.42, SD = 1.34). The mean overall BMI was 19.48 (SD = 2.55, range = 16.00–28.23),
35 participants were classified as underweight, 45 as normal weight, and 3 as overweight
according to BMI guidelines (Zaninotto, Wardle, Stamatakis, Mindell, & Head, 2006). The
HK mean BMI was 18.58 (SD = 1.87, range = 16.36–27.24). The Shanghai mean BMI
was 20.24 (SD = 2.80, range = 16.00–27.23). Mean BMI across the two samples differed:
t(43.55) = 4.06, p < .001: HK (M = 18.56, SD = 1.88), Shanghai (M = 20.23, SD = 2.80).
Previous research has identified that BMI for Asian populations, including HK and
China, generally tends to be lower than Western populations (WHO Expert Consultation,
2004); this should be taken into consideration when noting participants classified as under-
weight. Sixty-seven participants were undertaking an undergraduate degree; the remaining
16 were undertaking postgraduate studies. All participants were recruited from the health
clinic in their respective universities whilst awaiting a medical appointment. Participants
were approached in the waiting room of their respective health clinic and invited to par-
ticipate in the study. The rejection rate was low: eight students approached declined to take
part in the study. The language of tuition at both institutions is English; all participants were
competent in English, as indexed by the entrance requirements at each of the universities,
 Psychology, Health & Medicine  313

as such all participants completed the questionnaire in English. No participants recruited

to the study had any history of eating disorders.

Questionnaire
Drive for thinness was assessed using the Drive for Thinness (DFT) subscale, adopted from
the Eating Disorder Inventory (Garner, Olmstead, & Polivy, 1983). The DFT evaluates eating
disorder symptomology, and measures the pursuit and maintenance of thinness alongside
concern with dieting and fear of gaining weight. The scale contains seven self-report items,
including ‘I am terrified of gaining weight’ and ‘I am preoccupied with the desire to be
thinner.’ Items are measured on a 6-point scale (0 = Never to 5 = Always). Cronbach’s α in
the current study was acceptable at α = .60.
Body dissatisfaction was assessed using the Body Shape Questionnaire (BSQ: Cooper,
Taylor, Cooper, & Fairbum, 1987), a 34-item self-report measure designed to assess negative
concerns regarding body shape and size. Items including: ‘Have you pinched areas of your
body to see how much fat there is?’ and ‘Have you thought that your thighs, hips or bottom
are too large for the rest of you?’ are measured on a 6-point scale (1 = Never to 6 = Always).
Scores are totalled with higher scores indicative of greater body dissatisfaction. Cronbach’s
α in the current study was highly satisfactory at α = .97.
Eating attitudes were assessed using the Eating Attitude Test (EAT-26: Garner, Olmsted,
Bohr, & Garfinkel, 1982). The EAT-26 contains two sections, the first part consists of 26 items
assessing dieting, oral control and preoccupation with food, for example: ‘Am terrified of
being overweight’ on a 6-point scale. Higher scores are indicative of a higher level of concern
about dieting, body weight or problematic eating behaviours. The EAT-26 demonstrated
good reliability in the present study at α = .88.
The final part of the questionnaire contained socio-demographic items such as age,
educational attainment, weight and height. BMI was calculated using measured weight (kg)
on digital scales and height (cm) measured using a stadiometer.

Videos
Two videos, each with duration of around two minutes were used. The experimental group
viewed a video which contained a brief interview with a popular model in the fashion
industry on the diet and beauty secrets of high fashion models. The control group viewed
a video containing an interview with a magazine editor, which served as the neutral stimu-
lus. All content from both the experimental video and the control video featured Western,
non-Chinese models.

Procedure
Participants were approached in the waiting room of their university’s health clinic. Those
who agreed to participate in the study were taken to a room within the clinic where height
and weight were first measured. Individuals were then assigned on an alternate basis to
either the experimental or the control group. Those assigned to the experimental group
watched the thin-ideal video, while those assigned to the control group watched the neu-
tral stimulus video. All participants completed the questionnaire, after which participants
314 T. L. Rochelle and W. Y. Hu

were debriefed. Prior to inclusion in the experiment, all participants provided informed
consent. No reward or compensation was provided for participation. The study received
ethical approval from a university ethics committee in Hong Kong. Statistical analyses were
performed using IBM SPSS Statistics 22.

Results
To test for any differences between participants based on location (HK vs Shanghai) and
video condition (experimental vs control) regarding drive for thinness, body dissatisfaction
and eating attitude, three 2-by-2 between-groups analysis of covariance (ANCOVA) were
conducted. The independent variables were location (HK vs Shanghai) and video condi-
tion (experimental vs control). BMI was used as a covariate to control for any individual
differences. The assumptions for ANCOVA were met. In particular, the homogeneity of
the regression effect was evident for the covariate, and the covariate was linearly related to
each of the dependent measures.
There was a significant condition x region interaction on body dissatisfaction (F(1,
78) = 6.07, p < .05, ŋp2 = 07), with HK participants displaying more body dissatisfaction in
the experimental condition than Shanghai participants. The main effects were also signifi-
cant for both region: F(1, 78) = 9.38, p < .01, ŋp2 = 11, and video condition: F(1, 78) = 38.72,
p < .01, ŋp2 = 33. These findings suggest that participants responded differently to the body
shape questionnaire following viewing of the control or the experimental video. Participants
in the experimental video condition demonstrated greater concern with body shape in
both Shanghai and HK. This supports H1, HK women exposed to the thin-ideal video
experienced greater body dissatisfaction than Shanghai women exposed to the same video.
A significant condition x region interaction was also observed on eating attitudes, with
HK participants displaying more concern with being overweight in the experimental con-
dition compared to their Shanghai counterparts (F(1, 78) = 4.82, p < .05, ŋp2 = 06). The
main effects were significant for video group: F(1, 78) = 25.00, p < .001, ŋp2 = 24, but not
for location: F(1, 78) = 2.39, p > .05, ŋp2 = 00. Findings indicate that participants responded
differently to the EAT-26 following the video. Participants in the experimental video group
reported more problematic eating attitudes compared to participants in the control group.
However, there was no evidence of a condition x region interaction on drive for thinness
(F(1, 78) = .001, p > .05, ŋp2 = 00). The main effects for both video condition (F(1, 78) = 1.45,
p > .05, ŋp2 = 02) and location (F(1, 78) = .20, p > .05, ŋp2 = 003) were also non-significant.
These findings indicate that there was no impact on drive for thinness for both Shanghai
and HK participants, regardless of which video condition participants were assigned to.
Means, standard deviations and range breakdowns were calculated for BMI, drive for
thinness, body dissatisfaction, and eating attitude scores by location (HK vs. Shanghai)
and video group (experimental vs. control; see Table 1). Participants in the experimental
video condition reported greater body dissatisfaction and problematic eating attitudes than
those women in the control video condition. Hong Kong women reported greater body
dissatisfaction and problematic eating attitudes than their Shanghai counterparts, regardless
of the video condition. Hong Kong women also displayed lower BMI than their Shanghai
counterparts, regardless of the video condition (see Table 1). These findings partially support
H2, in that exposure to the thin-ideal video produced greater levels of body dissatisfaction
and problematic eating attitudes, however no effect was observed in drive for thinness.
 Psychology, Health & Medicine  315

Table 1. Participant mean scores breakdown by location and experimental group.

HK control group (n = 16) Shanghai control group (n = 24)
Mean SD Range Mean SD Range
BMI 18.09 1.09 17–21 19.97 2.81 17–27
DFT 23.75 2.67 19–27 23.79 5.30 15–37
BSQ 76.31 15.18 52–101 73.58 34.07 38–170
EAT-26 2.94 2.64 0–8 5.96 5.90 2–26
HK experimental group (n = 22) Shanghai experimental group (n = 21)
BMI 18.91 2.26 16–27 20.63 2.83 16–28
DFT 24.5 7.68 15–47 25.52 3.53 16–32
BSQ 129.68 28.44 48–164 99.38 19.86 58–133
EAT-26 11.14 4.66 2–18 9.19 5.25 3–24

Discussion
The present study examined the impact of exposure to thin-ideal media on attitude towards
drive for thinness, body shape satisfaction, and eating attitude among young Chinese women
in Hong Kong and Shanghai. Findings revealed that HK women exposed to the thin-ideal
video experienced greater increases in body dissatisfaction than their Shanghai counter-
parts, supporting the first hypothesis. The second and final hypothesis, that exposure to the
thin-ideal video would produce an increase in drive for thinness, body dissatisfaction and
eating attitudes, was partially supported. All women exposed to the experimental thin-ideal
video, regardless of geographical location, reported higher scores on body dissatisfaction
and eating attitudes than those women exposed to the neutral stimulus video.
The present findings go some way to support the prediction that exposure to thin-ideal
media does not have the same effect on women. Significant condition × location interactions
observed for both body dissatisfaction and eating attitude; HK women were significantly
more likely to be affected by the thin-ideal in terms of body satisfaction and eating attitudes.
Greater levels of body dissatisfaction and problematic eating attitudes were observed for HK
women when compared with Shanghai participants. However, no interaction of significance
was observed regarding the impact of the thin-ideal on drive for thinness.
Cultural background played a critical role in satisfaction with body shape. Hong Kong
participants reported greater body dissatisfaction, more problematic eating attitude, and
lower BMI than their Shanghai counterparts, regardless of exposure to video condition.
One explanation for this is the sociocultural background of the two regions: HK society is
traditionally perceived to be more westernized than Shanghai as a result of being under the
jurisdiction of the British government for more than 100 years. Thus the projection of the
thin-ideal among women may be promoted more in such a westernised society and become
internalised as part of the self-concept. Shanghai is a more traditional Chinese society, with
an emphasis on more traditional Chinese values, where food culture and the appreciation
of food are very important values to uphold and are intricately linked to health. This may
overshadow the importance of physical appearance among mainland Chinese and may
explain such a difference in body dissatisfaction among HK and Shanghai women in the
present study.
One advantage of the current investigation is the uniqueness of the samples. As women
from HK are more acculturated to Western values while still preserving their Chinese
culture, this made for an interesting backdrop for the current study, particularly given the
comparison with a more traditional Shanghai cohort. Examining body satisfaction, drive
316 T. L. Rochelle and W. Y. Hu

for thinness and eating attitude among non-Western communities adds significant insight
to existing findings helping to understand the phenomenon on global terms. Previous
studies on the impact of thin-ideal imagery mostly used pictures as the stimuli (Ashikali
& Dittmar, 2012). The use of videos in the current study could have increased the intensity
of exposure; having ‘real’ women talking could have made the thin-ideal stimulus more
vivid and salient. Findings implied the significance of socio-cultural factors in the thin-
ideal phenomenon. In HK and China, where the average BMI of the female population is
generally lower compared to Caucasian women (WHO Expert Consultation, 2004), the fact
that participants were significantly influenced by the experimental thin-ideal video indicates
the vulnerabilities of women under the pressure of high beauty standards. Exposure to thin-
ideal imagery was associated with greater levels of body dissatisfaction and problematic
eating attitude in the present study.
Limitations of the present study must be acknowledged: one limitation is that the fig-
ures portrayed in the two video conditions were not of the same ethnicity as the partici-
pants, while participants were assigned to each group alternatively as opposed to randomly.
Findings are limited to acute reactions to instant exposure, instead of any fixed behaviour
pattern or attitude; it is also acknowledged that no specific traits were studied, and not all
women are affected in the same way by being exposed to thin-idealized media. It is argued
that some personality traits could be especially crucial in triggering the negative media
responses, including tendency to engage in social comparison (Ashikali & Dittmar, 2012;
Anschutz & Engels, 2010).
To conclude, the current study successfully confirmed the impact of instant media expo-
sure on women’s attitudes toward body shape and eating attitude in HK and Shanghai. One
direction for future studies is the examination of self-objectification. Self-objectification is
understood as internalization of a third person’s perception on one’s body image (Fredrickson
& Roberts, 1997). Although the objectification of women in the mass media plays an impor-
tant role in directing an individual’s perception towards their body, drive for thinness and
motivation to diet (Thompson & Stice, 2001), one must internalize social beauty standards
in order for media imagery to play a mediating role (Moradi, 2010). Further investigation
of the phenomenon is necessary, especially within non-Western societies.

Disclosure statement
No potential conflict of interest was reported by the authors.

References
Anschutz, D. J., & Engels, R. C. M. E. (2010). The effects of playing with thin dolls on body image and
food intake in young girls. Sex Roles, 63, 621–630. doi:10.1007/s11199-010-9871-6
Ashikali, E., & Dittmar, H. (2012). The effect of priming materialism on women’s responses
to thin-ideal media. British Journal of Social Psychology, 51, 514–533. doi:10.1111/j.2044-
8309.2011.02020.x
Cooper, P. J., Taylor, M. J., Cooper, Z., & Fairburn, C. G. (1987). The development and validation of the
body shape questionnaire. International Journal of Eating Disorders, 6, 485–494. doi:10.1002/1098-
108X(198707)6:4<485:AID-EAT2260060405>3.0.CO;2-O
Dittmar, H. (2005). Vulnerability factors and processes linking sociocultural pressures and body
dissatisfaction. Journal of Social & Clinical Psychology, 24, 1081–1087. doi:0.1521/jscp.2005.24.8.1081
 Psychology, Health & Medicine  317

Fredrickson, B. L., & Roberts, T. A. (1997). Objectification theory: Towards understanding

women’s lived experiences and mental health risks. Psychology of Women Quarterly, 21, 173–206.
doi:10.1111/j.1471-6402.1997.tb00108.x
Garner, D. M., Olmsted, M. P., Bohr, Y., & Garfinkel, P. E. (1982). The eating attitudes test:
Psychometric features and clinical correlates. Psychological Medicine, 12, 871–878. doi:10.1017/
S0033291700049163
Garner, D. M., Olmsted, M. P., & Polivy, J. (1983). Development and validation of a multidimensional
eating disorder inventory for anorexia nervosa and bulimia. International Journal of Eating
Disorders, 2, 15–34. doi:10.1002/1098-108X(198321)2:2<15:AID-EAT2260020203>3.0.CO;2-6
Grabe, S., Ward, L. M., & Hyde, J. S. (2008). The role of the media in body image concerns among
women: A meta-analysis of experimental and correlational studies. Psychological Bulletin, 134,
460–476. doi:10.1037/0033-2909134.3.460
Groesz, L. M., Levine, M. P., & Murnen, S. K. (2002). The effect of experimental presentation of
thin media images on body satisfaction: A meta-analytic review. International Journal of Eating
Disorders, 31, 1–16. doi:10.1002/eat.10005
Grogan, S. (2008). Body image: Understanding body dissatisfaction in men, women and children.
London: Routledge.
Hargreaves, D. A., & Tiggeman, M. (2004). Idealised media images and adolescent body image:
Comparing boys and girls. Body Image, 1, 351–361. doi:10.1016/j.bodyim.2004.10.002
Harriger, J. A., Calogero, R. M., Witherington, D. C., & Smith, J. E. (2010). Body size stereotyping
and internalisation of the thin ideal in preschool girls. Sex Roles, 63, 609–620. doi:10.1007/s11199-
010-9868-1
Hewig, J., Cooper, S., Trippe, R. H., Hecht, H., Straube, T., & Miltner, W. H. R. (2008). Drive for
thinness and attention toward specific body parts in a nonclinical sample. Psychosomatic Medicine,
70, 729–736. doi:10.1097/PSY.0b013e31817e41d3
Ho, S. S. (1985). Dietary beliefs in health and illness among a Hong Kong community. Social Science
& Medicine, 20, 223–230. doi:10.1016/0277-9536(85)90235-7
Lake, A. J., Staiger, P. K., & Glowinski, H. (2000). Effect of western culture on women’s attitudes
to eating and perceptions of body shape. International Journal of Eating Disorders, 27, 83–89.
doi:10.1002/(SICI)1098-108X(200001)27:1<83:AID-EAT9>3.0.CO;2-J
Lee, S. (2001). Fat phobia in anorexia nervosa: Whose obsession is it? In M. Nasser, M. A. Katzman,
& R. A. Gordon (Eds.), Eating disorders and cultures in transition (pp. 40–54). New York, NY:
Taylor & Francis.
Lee, S., Ng, K. L., Kwok, K., & Fung, C. (2010). The changing profile of eating disorders at a tertiary
psychiatric clinic in Hong Kong (1987–2007). International Journal of Eating Disorders, 43, 307–
314. doi:10.1002/eat.20686
Levine, M. P., & Smolak, L. (2010). Cultural influences on body image and the eating disorders.
In W. S. Agras (Ed.), The Oxford handbook of eating disorders (pp. 223–246). Oxford: Oxford
University Press.
Lowry, R., Galuska, D. A., Fulton, J. E., Weschler, H., Kann, L., & Collins, J. L. (2000). Physical activity,
food choice and weight management goals and practices among U.S. college students. American
Journal of Preventative Medicine, 181, 18–27. doi:10.1016/S0749-3797(99)00107-5
Moradi, B. (2010). Addressing gender and cultural diversity in body image: objectification theory as
a framework for integrating theories and grounding research. Sex Roles, 63, 138–148. doi:10.1007/
s11199-010-9824-0
Preslan, A. (2002). Hong Kong and Shanghai: A tale of two cities. Perspectives on Business & Economics,
20, 1–19.
Thompson, J. K., & Stice, E. (2001). Thin-ideal internalization: Mounting evidence for a new risk factor
for body-image disturbance and eating pathology. Current Directions in Psychological Science, 5,
181–183. doi:10.1111/146-8721.00144
WHO Expert Consultation. (2004). Appropriate body-mass index for Asian populations and its
implications for policy and intervention strategies. Lancet, 363, 157–163.
318 T. L. Rochelle and W. Y. Hu

Xu, X., Mellor, D., Kiehne, M., Ricciardelli, L. A., McCabe, M. P., & Xu, Y. (2010). Body dissatisfaction,
engagement in body change behaviours and sociocultural influences on body image among Chinese
adolescents. Body Image, 7, 156–164. doi:10.1016/j.bodyim.2009.11.003
Zaninotto, P., Wardle, H., Stamatakis, E., Mindell, J., & Head, J. (2006). Forecasting obesity to 2010.
London: National Centre for Social Research.