As the developmental process continues, the young person will acquire a much more complex definition of himself or herself as an individual, as a gendered being, as an offspring of parents and grandparents, as a sibling, as a student, as a friend, and as any other desired or required persona (Johnson &  Roberts, 1999). Similarly, the contemporary concept of self-esteem is complex and based on competencies across many domains. It also includes an overall global self-esteem component (Dubois &  Tevendale, 1999; Erkut, Marx, Fields, & Sing, 1999).  Each domain of competency may exhibit its own complex nature. For adolescents, the social domain is multifaceted and requires many nuanced skills, the acquisition of which begins within the family.  To further their understanding of the familial facet of the social domain, Ohannessian, Lerner, Lerner, and von Eye (1998) looked at the effect of parental support and acceptance on adolescent emotional adjustment.
 Adolescence is a time of transition and redefinition of the self physically, intellectually, emotionally, and socially (Bolognini, 1996). It is, in fact, a chaotic time of physical disquiet, emotional tumult, and social disorientation for the young girl or boy with limited experience. At such a time, a burgeoning sense of self, attempting to establish a multifaceted identity with competency in multiple areas, may easily experience setbacks. With so many disruptive changes taking place in their bodies, both girls and boys may tend to experience some diminished sense of self as they enter the early pre-adolescent years (Ohannessian, Lerner, Lerner, & von Eye,1998).  It may be that with increased cognitive abilities comes more introspection, along with more self-directed and other-directed criticism (Demo & Savin-Williams,1992, cited in Ohannessian et al., 1998). This critical bent may lead to a decreased sense of self-esteem and self-competence (Wigfield & Eccles, 1994, cited in Ohannessian et al., 1998).

Arriving at the pre-teen years, girls and boys will confront a period of culturally induced gender role intensification (Basow &  Rubin, 1999; Bolognini,1996; Lintunen, 1995). During these years, pre-teens are expected to more closely emulate socially defined concepts or stereotypes of feminine and masculine appearance and behavior. The bewildering adolescent years may destabilize a self, just when it is in most need of balance and rationality The most positive force in a young person’s life is a system of social support from family, teachers, classmates and close friends (Bolognini, 1996). The level of such support is in direct proportion to self-esteem and self-competence: the greater the support, the greater the sense of self-esteem and competence in the adolescent.

Ohannessian et al. (1998) has shown parental acceptance and firm but supportive parenting, to be important factors in adolescent adjustment, identity formation, autonomy, self-esteem, and competence. These factors were also seen to operate in the reverse direction: an adolescent’s high level of self-esteem and competence seemed to influence paternal and maternal behavior, fostering increased attention and acceptance. For girls, in particular, attention and acceptance which is openly expressed and communicated by parents is an important factor in adolescent adjustment (Holmbeck & Hill, 1986). Ohannessian et al. refer to the term developmental contextualism to suggest the importance of systematic, bidirectional, and reciprocal influences between the individual and the social context (Lerner, 1998, cited in Ohannessian et al., 1998).

                                  Appearance and Self-Esteem

Sibling rivalry often coalesces around issues of comparative appearance.  Many of the women I interviewed for my book, Appearances: In the Mirror and in the Mind’s Eye (Dowd, 2001), told me stories about comparing themselves negatively to their sisters and/or of being compared negatively to their sisters by peers, parents, relatives, and other adults. Their experiences have stayed with them for a lifetime, and while occasioning some humor in adulthood, these comparisons were devastating in childhood. Included in the following are a few of these stories (Dowd, 2001):
 Roberta’s older sister was a recognized beauty and their mother was dismissive of her older daughter as flighty and lacking Roberta’s intelligence and ambition. Thus, Roberta decided at an early age that she could not compete with her sister in the looks department. She instead concentrated her energies on academics and cultivated a responsible demeanor and a quick wit. Having set her expectations in a different direction than that of her soon-to-be-a-model sister, Roberta was nonetheless greatly distressed when one of the local boys taunted her, “Your sister is pretty; what happened to you?” (Dowd, 2001)

Colleen was always told she looked just like her father and although he was the light of her life, she wondered what it would mean to be a girl who looked like a man.  Her younger sister, Sue, not only looked like their mother but also garnered much more attention as the younger of the two siblings. Colleen remembers that whenever they were out together as a family, friends and acquaintances would stop to talk and invariably announce: “Oh, Susie is so cute, she looks just like her mother. And Colleen, she looks just like her father!” (Dowd, 2001)

Anita, too, was well informed that her older sister was the pretty one with green eyes, and long, straight, black, shiny hair. Although at the time Anita was convinced that her overly curly hair made her look like a female Bozo the Clown, she has since reconciled herself to her looks, especially because, as she says, her sister has not remained the titleholder. Anita is now the pretty one (Dowd, 2001).

Anne, like Colleen, was told as a young child that she resembled her father and as a result her appearance worries centered on how she, a girl, would deal with those masculine whiskers when and if they appeared on her face. She also suffered greatly in comparison to her sister and her mother, who were both considered legendary beauties. Their dramatic coloring and abundant heads of hair seemed far superior to her own pale complexion and listless locks. For the teenage Anne, who considered her appearance priorities to be cleanliness and neatness, the moment of truth came when she was informed by a friend’s father that she looked as if she had gotten dressed in the closet (Dowd, 2001). Stories such as these are not unusual among women, nor is their negative influence on self-esteem.

The importance of appearance in the development and maintenance of positive self-image has been empirically researched and recognized. The 1995 study by Lintunen, Leskinen, Oinonen, Salinto, and Rahkila cites Harter (1990) by way of saying there is considerable consensus that perceived physical appearance has the highest correlation to global self-esteem of all the variables of self-perception not only during the teen years, but across the life span.

When it comes to perceived appearance, gender is an important influence. As noted earlier, gender role assignment may begin as early as birth with parents describing daughters as quiet, delicate, and pretty (Rubin, Provenzano, & Luria, 1974, cited in Freedman, 1984). By the fifth grade, a child’s perception of his or her physical attractiveness begins to influence self-esteem (Krantz, Friedberg, & Andrews,1985, cited in Martin & Gentry,1997). Girls find themselves under increasing pressure to meet cultural ideals of beauty. An attractive appearance is considered basic to the female gender role and to perceived femininity. It can affect interpersonal relationships throughout life. Beauty is often seen by parents as the legal tender for a daughter’s future happiness and marriageability (Freedman, 1984).

Girls are socialized to be pretty. They are carefully taught to view their bodies as objects to be cared for, adorned, and protected (Rindskopf & Gratch, 1982, cited in Freedman, 1984), and to view their physical beauty as the measure of how they and others judge their overall value. Girls’ self-esteem tends to be globally oriented (Bolognini, 1996), with appearance an overarching factor of other closely related domains, such as friendship and social acceptance. Boys view their bodies more in terms of their various abilities and strengths. Their self-esteem is more differentiated by domain (Bolognini 1996) with the accumulation of individual competencies such as academics and athletics forming their self-evaluations (Franzoi, 1995, cited in Martin & Gentry, 1997). These attitudes are reflections of the cultural ideals for femininity and masculinity: the decorative versus the functional body. This cultural emphasis on attractiveness for girls, along with its global esteem influence, can easily make girls more susceptible to negative self-estimates (Franzoi, 1995, as cited by Martin & Gentry, 1997). Basow and Rubin (1999) have suggested that as young girls become more aware of the requirements of the stereotypical female role – being attractive to and serving the needs of men and others – and its devalued social status, they begin to experience lowered self-perceptions, self-doubt, and conflict over these role expectations. Pressure from peers and parents to conform to beauty and behavior ideals as well as to be popular with the male sex has also been noted as a possible cause of lowered self-esteem in adolescent females. Affiliation-achievement conflicts, ambivalence about success, and anxiety about potential and actual failure are also negatively related to self-esteem. Awareness of increased social comparisons may bring self-consciousness about appearance as well as academic and social abilities, which may be particularly injurious to self-esteem (Eccles, Barber, Jozefowicz, Malenchuk, & Vida, 1999).

In fact, girls have lower self-esteem and lower self-perceived attractiveness than boys. Boys, more often, judge themselves as more attractive than their peers; girls, more often, judge themselves as less attractive then their peers (Bolognini, 1996). For girls, too, negatively experienced physical development may diminish self-perceived appearance ratings, which can carry over into diminished global self-esteem (Bolognini, 1996).

Here again in the area of appearance, parental acceptance has a strong influence on adolescents’ self-estimates. In turn, the adolescent’s positive appearance and self-esteem reinforce parental acceptance. In their 1998 study, Ohannessian, Lerner, Lerner, and von Eye found that for sixth and seventh grade girls, both paternal and maternal acceptance were consistently associated with high levels of perceived physical appearance. Although the study showed no significant gender differences for perceived levels of parental acceptance, it noted that among girls higher levels of perceived parental acceptance were related to higher self-ratings of appearance and competence. There were, however, gender differences for perceived levels of physical appearance and self-worth. Both sixth and seventh grade girls rated themselves significantly lower in appearance and self-worth than did boys.

It is not difficult to understand why female appearance is so closely connected to self-esteem. Physical coordination, while a somewhat less obvious factor in self-esteem, also proves to exert a powerful force.

                                    Physical Coordination and Self-Esteem

One of the most poignant stories I heard was from a woman who, as a child, had experienced seemingly uncontrolled growth spurts which created havoc with her physical coordination and sense of appearance (Dowd 2001). Joani and her older sister were both genetically destined to be tall, but while her sister grew slowly and consistently well into late adolescence, Joani’s experience of her body was completely disconcerting from her earliest years. She grew rapidly and early; every summer between the ages of 5 and 12 brought major growth spurts. By the time Joani had celebrated her twelfth birthday, she was 5' 10", her ultimate adult height. Her friends and classmates, whom she desperately wanted to resemble, were generally six to ten inches shorter than she was. With each passing year, Joani was constantly surprised, constantly annoyed, and constantly trying to compensate. When she took to slouching, particularly around the boys, her mother initiated posture lessons and eight years of very disciplined ballet lessons.

During her grade school years, Joani was taller than the principal, all the teachers, and the entire student body. It wasn’t until junior high school that a few of the boys and some of the male teachers were taller than she was. In all her class photos, Joani is the first person in the back row, a position she did not relish.

Shopping for clothes and shoes was not only extremely difficult, it was also humiliating, embarrassing, and unfruitful. The most difficult issue for Joani, however, was the day-to-day reality of her uncoordinated, tall, and gawky body. She was, she says, always either falling down or walking into something. Constantly bruised or bleeding from an injury, she was continuously in the school nurse’s office. Just as the effects of each new growth phase became somewhat tolerable and even familiar, a new phase would begin, bringing with it new physical and emotional discomforts. With all of this, Joani came to see her body as the enemy, an entity that could never be expected to cooperate with her. Awkward and growing literally by inches, she felt, too, that she was ugly because everything about her was wrong. She had gotten glasses at a young age and her hair was, for her, unmanageable. At age seventeen, she started gaining weight rapidly and, even with her new contact lenses, she knew she would never look like everyone else. What saved her at that point was a revised and more lenient dress code at her high school, allowing the students to wear blue jeans. At last, Joani was able to buy boys’ clothes that fit her and that looked just like the other girls’ clothes. She could look like everyone else and feel that she fit in. As she began to grow out of her coordination problems, she also began to forget about her appearance and concentrate on her grades (Dowd, 2001).

For Joani, both her appearance and her coordination had a negative effect on her self-esteem. With or without the obvious appearance issues and the growth spurts, poor coordination afflicts many children and diminishes their sense of self. Research has shown that in learning to deal with the environment and to effect change in it, a child with good physical coordination and motor skills will be more likely to have a positive experience of competency than will a child with poor coordination. Two studies by Rose, Larkin, and Berger (1997;1998) indicate that children with good coordination and competency exhibit high self-perception ratings and positive emotions. These high self-perception ratings relate to such competency domains as athletics, academics, behavior, social acceptance, and physical appearance, along with an independent global self-esteem factor. Although the children in these two studies by Rose, Larkin, and Berger (1997;1998) were aged 8 to 12, the authors refer to a 1994 study by Cantrell, Smyth, and Ahonen which documented similar results with adolescents.
 According to these two studies by Rose, Larkin, and Berger (1997;1998), the possession of poor coordination and motor skills can have far-reaching effects in the psycho-social realms of a child. Poor printing and writing negatively affects academic competency. Awkward movement negatively affects athletic and social activities. The uncoordinated are less likely to be asked to join in games and groups. Clumsiness with eating utensils may cause social embarrassment. Difficulty dressing, including tying shoes, buttoning buttons, combing hair, and being neat, may result in an untidy appearance. The ongoing experience of poor coordination may elicit negative emotions such as self-consciousness, feelings of inferiority, fearfulness, and anxiety. These feelings may further result in reticence or unwillingness to engage in physical and social activities while reducing the opportunities to improve coordination and initiating a downward spiral of social rejection, isolation, inactivity, and stalled development. Other difficulties for the uncoordinated child, say Rose et al. (1997, 1998) may include introversion, social immaturity, problems setting and accomplishing goals, a poor sense of personal control, and lowered self-perceptions. Several studies by other researchers have also recorded higher levels of anxiety and lower ratings of competence, self-worth, and social support by both children and adolescents with poor motor coordination (Schoemaker & Kalverboer, 1994; Skinner & Piek, 2001).

Both of these studies by Rose et al. (1997, 1998) have found that coordinated children experience themselves and rate themselves positively in the social, academic, athletic, appearance, and behavior realms. The coordinated girls, in particular, experienced themselves very positively in terms of appearance and global self-esteem, giving them a seeming advantage over other girls. In contrast, the uncoordinated girls registered the lowest ratings of global self-esteem. Being uncoordinated and female would appear to be a double disadvantage, say the authors.

A ten year longitudinal study by Losse, Henderson, Elliman, and Hall (1991) reported that most of the uncoordinated children who had grown into adolescents still had difficulties with motor coordination, had poor self-esteem, and were having problematic experiences in school. Some of the older subjects, however, exhibited individualistic coping strategies relative to their continuing difficulties. Two of the subjects in this study were notable for the similarity of their difficulties at age 6 and the marked differences in their coping methods at age 16. While poor coordination may cause many problems, there are indications that some children, at least, may grow out of it or learn to compensate for it. Race is another factor which often influences self-esteem in unexpected ways.

                             Sports Participation, Appearance, and Self-Esteem

One morning in November of 2001, I ran into my neighbor Cathy in the produce department of our local grocery store. Inquiring about her recovery following knee surgery, I requested a recap of the causes of her long-standing knee problems. Her answer involved a summer job as a trick water skier, falling to her knees on a ski jump ramp, and being dragged down the ramp by the ski boat. These were impressive credentials and their retelling catapulted us into a discussion of girlhood exposure to and experiences of athletics. Had she had brothers, I asked, and if so, had they been responsible for nurturing her fearlessness? She laughed out loud! It seems her only brother had been singularly un-athletic, while Cathy and her sister had been true jocks. Well, I inquired, how did she get involved in sports? As a result of a family move, during her early grade school years, she had found herself in a neighborhood full of boys. She was one of only three girls in her age group. The boys, in desperate need of enough players to form softball teams, had not only included the few neighborhood girls, but had initiated them into the mysteries of successful performance on the ballfield: choke up on the bat and bunt. From these early experiences of inclusiveness and lessons in competence, Cathy went on to become an avid skier on water and snow, a tennis player, and a golfer. When I commented on what terrific experiences of athletics and risk-taking she had had, she thought for a moment before replying. “You know, I have never stopped to consider how those early experiences in sports with the neighborhood boys have shaped my life, but I guess they have!” This, from a young woman journalist who had spent several weeks this spring in Kosovo covering the hostilities. I assured her that her involvement in sports had most probably had a profound effect on her (Personal communication, 2001).

The sports in which Cathy participated – softball, skiing, tennis, and golf – are included in the list of athletic activities which research has shown to elicit a positive sense of self in girls. In 2001, Parsons and Betz published their research on young women’s participation in sports and physical activity as related to body objectification, instrumentality, and locus of control. This was one of the first research projects to consider the nature of the relationship between body objectification and participation in both specific sports and general physical activity.

With cultural norms for female gender roles and femininity emphasizing the cultivation of relationships, sensitivity to the needs of others, and physical beauty, young girls often learn that to be pretty and feminine also means to be passive, to wait for life to act upon them, and to see themselves as reflected in the eyes of others.  These attitudes, along with those that define the female body as a decorative and sexual object to be protected and enhanced, are now suspect in the process of self-objectification. Parsons and Betz (2001) have referred to Frederickson and Roberts (1997) in theorizing that young women internalize such objectification in a way that may increase body image problems, eating disorders, and depression. Poor body image and body shame have also been linked to negative body esteem.

Positive body esteem is linked to such qualities as self-acceptance, autonomy, and mastery of personal environment (McKinley, 1999, cited in Parsons & Betz, 2001).  Women’s participation in sports has been related to positive body image and greater feelings of competence and empowerment (Richman & Schaffer, 2000, cited in Parsons & Betz, 2001), along with a more proactive attitude (Blinde, Taub, & Han, 1993, cited in Parsons & Betz, 2001). Recent research has suggested that women’s participation in sports and other physical activities would promote the experience of an active body and an active self, engaged in athletic risk-taking (Frederickson & Roberts, 1997, cited in Parsons & Betz, 2001).

These qualities are also related to instrumentality, which refers to several characteristics associated with the traditional masculine gender role: assertiveness, decisiveness, self-reliance, self-confidence, independence, and physical activity (Spence & Buckner, 2000, cited in Parsons & Betz, 2001). Instrumentality, then, contrasts with the more expressive characteristics associated with the traditional feminine gender role, such as empathy for and nurturance of others.

Ongoing research into the relationship between instrumentality, expressiveness, and mental health (Betz, 1995; Cook, 1987; Dimitrovsky, Singer, & Yinon, 1989; Gilbert 1981; Roos & Cohen, 1987; Spence et al., 1975; Whitley, 1983, cited in Parsons & Betz, 2001) has shown that instrumental traits are closely connected to higher self-esteem and healthier psychological adjustment. Instrumentality has been shown to function as a type of shield against stress, anxiety, and depression which have, in turn, been linked to expressiveness (Roos & Cohen, 1987, cited in Parsons & Betz, 2001).  Parsons and Betz propose that for young women, who are more often socialized to emphasize expressiveness and who more often experience anxiety and depression (Frederickson, Roberts, Noll, Quin, & Twenge, 1998, cited in Parsons & Betz, 2001), the development of instrumental traits and the experience of instrumental behaviors may be beneficial to mental health.

The third characteristic Parsons and Betz (2001) examine in relationship to sports participation for young women is called locus of control, which may be described as internal or external. While an internal locus of control focuses on results as directly due to personal effort or attitude, an external locus of control focuses on results as random and not due to personal effort or attitude (Lefcourt, 1991, cited in Parsons & Betz, 2001). An internal locus of control is connected to instrumentality. An individual with a higher degree of instrumentality, actively engaged with the environment and the solving of problems, is more likely to have a more internalized locus of control.

Parsons and Betz (2001) theorized that various sports would provide different levels of emphasis on feminine appearance and different effects on the participants’ potential for body objectification. The study then ranked seventeen different sports, judged most likely to be played by high school girls, according to their perceived focus on the body and femininity. Participation in the more feminine sports (cheerleading, gymnastics, dance team and synchronized swimming) was expected to relate to higher levels of body objectification. The project then surveyed 437 female first-year college students, aged 18 to 20, including African American, Caucasian, Hispanic, Asian American, and Native American athletes and non-athletes.

Both the athletes and the non-athletes studied by Parsons and Betz (2001) scored similarly on self-perceptions of masculinity and femininity. As predicted, the athletes reported much higher levels of personal efficacy and interpersonal control. Contrary to the researchers’ expectations, however, the athletes scored similarly to the non-athletes on instrumentality and significantly higher than the non-athletes on body shame. These higher body shame scores were, as theorized, reported by the athletes participating in the more body-objectified and feminine sports.

Participation in non-sport physical activity was also considered by Parsons and Betz (2001) in terms of its potential relationship to body objectification. Here again, higher measures of personal efficacy, instrumentality, interpersonal locus of control, perceived masculinity, and body shame were reported by those women with the higher participation in general physical activity. Importantly, general physical activity showed an even stronger relationship with the empowerment traits than did sports activity. The empowerment traits including efficacy, instrumentality, and locus of control have a positive relationship with high self-esteem, a healthy psychological outlook, and the absence of anxiety and/or depression (Cook, 1987; Whitley, 1983, cited in Parsons & Betz, 2001).

The authors’ predictions of significant differences in objectification and instrumentality between those who participated in more feminine versus more masculine sports were not upheld in this sample of high school girls. One possible reason for this is that most female high school athletes participate at a non-elite level where sports do not exert high expectations for female appearance, and where a reduced risk of eating disorders has been documented.  It is more often at the college and professional levels that athletes are categorized as elite, and where participation in the feminine sports, which especially emphasize thinness, puts them most at risk for eating disorders (Smolak, Murnen, & Ruble, 2000, cited in Parsons & Betz, 2001).

In the Parsons and Betz (2001) study, higher levels of body shame – concern over nonconformity to beauty standards – were related to increased participation in sports and physical activity. The authors suggest that perhaps girls who experience body shame participate in sports and physical activity as a way of increasing levels of fitness and/or thinness. They also indicate that other researchers such as Bartky (1988) and McKinley and Hyde (1996) have theorized that participation in sports may be seen by young women as a way to achieve culturally defined body standards, to enhance female identity, and to achieve a sense of personal empowerment. The authors further suggest it is likely that girls with high levels of instrumentality and locus of control also gravitate to sports and physical activity.

In conclusion, Parsons and Betz (2001) note that although body objectification theoretically derives from cultural expectations and standards for female appearance and gender role, the extent of its internalization by any one woman does not seem to be related to her perceived femininity. In this study, however, instrumentality and internal locus of control in women have been positively related to perceived masculinity. With a view that until recently the term “female athlete” was an oxymoron and that sports participation was considered a nontraditional role for women, the authors suggest the possibility of substantial differences in the personality profiles of women engaging in the traditional (non-sports) role and of those engaging in the non-traditional (sports) role (Lemkau, 1983, cited in Parsons & Betz, 2001).

For women like my neighbor Cathy participation in sports like softball, tennis, golf, and skiing can contribute to feelings of empowerment and competence which, in turn, can enhance self-esteem and mental health.
 

As a young girl, Tucker was bigger and taller than her classmates. She felt she was overweight and looked older than the others. It was impossible for her to find size eleven shoes and age appropriate clothes, much less the right clothes as designated by her peers.  In her high school, without the right clothes she didn’t fit in, and she heard all the little comments from everyone. Newly ensconced in a large step family, her weight became an item of daily harassment by her stepbrothers and stepsisters. Looking back on the experience, she is not sure if she saw herself as overweight or if other people did. She is also not sure if she really was overweight or just bigger and taller than the others. She was 5' 7 ½" tall by the time she was 13 and all the scrutiny was emotionally debilitating.  Following a falling out with a somewhat older cousin-friend, Tucker began being subjected to the epithet, “Blubber,” by her older sister and the cousin-friend. Not just some of the time, the torment was constant. The experience has stuck with Tucker to the extent that for many years she was unable to accept compliments on her appearance without attributing them to an ulterior motive. She says it was also problematic in that it has taken her a long time to develop a measuring stick with which to evaluate her appearance (Dowd, 2001).

Both Janet and Tucker provide anecdotal evidence of the ways that teasing can negatively influence self-esteem. The phrase my mother taught me, “Sticks and stones will break my bones, but names will never hurt me!” seriously underestimates the effects of teasing. Researchers are discovering more about its insidious nature.

Sandi was one of the top gymnasts at her high school. At age 12, she left her midwestern home and went to California to further her training. Ironically, she describes much of the education she and her classmates received as very negative. Their teachers and coaches ripped them apart, destroying what confidence they might have had in their physical abilities and their intelligence. Their appearance also became a subject of negativity when their bodies started to develop. The first person who told Sandi to lose weight was her gym coach. She was thirteen. With hindsight, Sandi realized that she did not need to lose weight; but at the time, she looked up to the coach and trusted his judgement. She looked in the mirror and rejected what she saw.  Although the emphasis on thinness was widespread in Sandi’s performing arts high school where she had shifted from gymnastics to dance, there was no counseling or nutritional program to guide the girls. They were on their own for solutions and many turned to smoking, crash dieting, extreme food restriction, and/or purging. At one point, Sandi’s own self-inflicted diet and smoking regimen landed her in bed feeling so weak she was unable to dance. She credits her parents with instilling in her the strength of will to finally rebel against a situation which, she realized, was defeating the whole purpose of her life. Turning to nutritional counseling she was able to finally stabilize her weight and go on to become a professional dancer. She sadly recounts how some of her classmates from those early years have suffered major and irreversible weight gains. Another fellow dance student has suffered tragic brain damage as a result of her long-term bulimic behavior (Dowd, 2001).

Both boys and girls with lower self-esteem showed a likelihood of higher levels of dietary restraint. Gender differences in self-esteem profiles emphasized girls’ greater reliance on multiple appearance factors such as weight, height, health, fitness, dissatisfaction with face and hair, and clothing concerns for their sense of self-worth. For girls, academic and social competencies were moderately related to self-esteem, while athletics were even less so. For girls, then, it was appearance, especially fatness, which showed a higher impact on self-esteem. Because higher levels of dietary restraint were most closely, consistently and strongly linked to perceived fatness in both boys and girls, the authors indicate that perceived fatness may be an important intermediate factor in dietary restriction. Fox et al. (1994) note that for boys and girls, higher dietary restraint is associated with lower self-perceptions, specifically in the areas of appearance, health, and fitness.
 Fox et al. found that lower levels of dietary restraint were related to general positive feelings of self-esteem and specific positive feelings of fitness, athleticism, appearance, and appropriate weight. For girls, low restraint/normal eating meant lower levels of preoccupation with looks and higher perceptions of scholastic achievement.

In summary, although both boys’ and girls’ self-esteem is influenced by appearance factors, the girls’ self-perceptions were more dependent on, and more vulnerable to, more aspects of appearance than were the boys. The girls were more likely to resort to dietary restraint to change their appearance if they perceived it to be less than acceptable. The boys were more likely to discount the importance of appearance if they felt their appearance was lacking.

Significantly, Fox et al. (1994) point to the fact that perceptions of fatness do not always coexist with actual fatness. Many more girls than boys in the study perceived themselves as somewhat fat or very fat with girls also representing a higher percentage of the high restraint group. More than twice as many girls than boys in the high restraint group, who were not fat according to the research standard, reported that they perceived themselves as fat. Two of these girls, in fact, had low levels of fat.  On the other hand, almost twice as many of the fat boys, compared to the fat girls, in the sample reported medium and low restraint, compared to the fat girls who so reported. Fox et al. suggest that girls seem to be more susceptible than boys to dietary restraint when they experience appearance pressures regarding actual or perceived fatness. At particular risk, are early maturing girls who were larger but not fatter than average for their age. Although, in general, lower restraint was associated with higher self-perceptions, the data revealed a range of self-esteem ratings even among the high restraint group; and for the girls, self-esteem scores did not appear to correlate with reports of low or high restraint. This suggests to the authors that the influencing factors in eating behaviors are various and complex and require a much greater understanding.
 
Physical fitness is now becoming an additional factor in attractiveness, at least within the confines of the contemporary achievement-oriented female sex role model.  At the same time, the media-generated variety of fitness is becoming yet another impossible-to-attain beauty marker for adolescent girls with already unstable self-image. When so many girls with poor body image are so desirous of changing their appearance, the benefits of self-imposed exercise and fitness may become confused with obsession and compulsiveness. The intense marketing of fitness, fitness gear, and exercise wear lends several negative aspects to this purportedly healthful endeavor: the cost of outfitting oneself for fitness, the potential for increased body image anxiety and self-destructive activities such as restrictive dieting, can be very counterproductive facets of the exercise trap (Freedman, 1984).