Objective
To evaluate the effects of a reality TV cosmetic surgery program on eating disordered attitudes, behaviors, mood, anxiety, and self-esteem.
Method
Participants (N = 147 women) completed baseline surveys and were subsequently randomly assigned to one of two conditions: one in which they watched a reality TV cosmetic surgery program (The Swan) and one in which they watched a reality TV home improvement program (Clean Sweep). Assessments were conducted immediately post-video and two weeks later.
Results
Women in the cosmetic surgery program group who reported higher internalization of the thin-ideal at baseline manifested lower self-esteem at posttesting. Among White women, those who watched the cosmetic surgery program reported greater perceptions of media pressures to be thin and stronger endorsement of their ability to control their body's appearance after watching the video. These differences persisted over a two-week follow-up period.
Discussion
Reality TV cosmetic surgery makeover programs may contribute to eating disordered attitudes and behaviors among young women, particularly those who have internalized the thin body-ideal. These findings seem to be especially applicable for White women; however, they should be further investigated with more diverse and international samples.
Sociocultural theories highlight the role of the media in the development of eating disordered behaviors (Levine and Harrison, 2004 and Stice and Shaw, 1994). In addition, empirical investigations have examined the influence of magazine and television exposure, and, although findings have differed somewhat across modalities, exposure to media images of the thin-ideal is generally associated with adverse consequences among college-age women (Irving, 1990, Stice and Shaw, 1994 and Tiggemann and Pickering, 1996).
A newer form of media exposure is the “reality TV” cosmetic surgery makeover program. These programs appear regularly on U.S. network and cable television and are very popular; for example, as noted by Sarwer and Crerand (2004), Extreme Makeover was the second highest rated program for adults under age 50 in 2003. The popularity of these programs coincides with the overall rise in cosmetic surgical procedures. In the U.S., the number of cosmetic medical treatments performed increased 1600% between 1992 and 2002 ( Sarwer & Crerand, 2004); an estimated 8.3 million individuals in the U.S. underwent cosmetic medical procedures in 2003 ( Sarwer et al., 2005). Cosmetic medical procedures are also becoming more widely accepted, particularly among college women ( Sarwer et al., 2005).
Despite the increased prevalence and acceptance of cosmetic surgery, as well as the popularity of cosmetic surgery makeover programs, there have been no investigations of the impact of these programs on viewers. One concern about these programs is that they actively promote the idea that a “perfect body” is attainable. On the typical reality makeover program, women undergo a full body critique, in which numerous surgeries are recommended to address multiple (perceived) flaws. Given the pervasiveness and popularity of this form of media, we decided to examine the impact of one of these programs, The Swan, on college women. The Swan presents the story of two women per episode who undergo an extensive transformation involving multiple plastic surgeries, an intense diet and exercise program, and counseling. The program's title refers to the Hans Christian Andersen fairy tale in which an “ugly duckling” is revealed to be a beautiful swan. The study design was informed by previous investigations of media exposure and eating disorders, which are briefly reviewed in the following sections.
