As the old adage goes: if everyone else had body dysmorphia wouldn’t you? Social physique anxiety is unfortunately a global phenomenon, exacerbated by social media and an increasingly appearance-based society. So, what is social physique anxiety and is there really something wrong with you for caring what other people think of your body?

What is Social Physique Anxiety?

The term social physique anxiety was first coined by Hart et al. in 1989. They define social physique anxiety (SPA) as:

“anxiety that people experience in response to others’ evaluations of their physique”^[1].

Immaculate. Not only do I have my own anxiety to deal with, I have to deal with anxiety about what others think of my body. Body image and body satisfaction are components of social physique anxiety (shortening it to SPA just doesn’t sit right with me), but these are largely within our control. Body image and satisfaction are related to our thoughts about our bodies (a twisted version of My Body, My Destructive Thoughts) – but what about what other people think of our bodies? If that doesn’t send you down an anxious hellhole, I don’t know what will. Enter social physique anxiety.

Social physique anxiety draws heavily on the human drive for social acceptance. The need to belong is an evolutionary trait we inherited so that we stayed alive and didn’t go down with the dinosaurs. Individuals that were accepted into a tribe were given protection and friendship. Those who were rejected had a much harder time running from dinosaurs and generally staying alive. As a consequence of this innate drive for survival we have, we tend to feel happier when we are socially accepted, and bitter when we perceive we are being rejected^[2]. So, we are wired to seek acceptance. Social physique anxiety ensues when we realise that others are potentially evaluating our body unfavourably^[1].

The Impact of Social Physique Anxiety

Exercise

Anyone can suffer from social physique anxiety. However, it manifests a little differently than other body image disturbances. Individuals with high levels of social physique anxiety are less likely to engage in activities where their physique will be scrutinised, which encompasses most exercise modalities. Activities that require the individual to display their physique induces this anxiety^[1]. Consequently, activities such as the gym can become frightening. Women suffering from physique anxiety are more likely to dress in baggier clothes and less likely to don tight fitting gym gear^[3], which can create a barrier to exercise. We get lower levels of engagement in exercise in individuals suffering from social physique anxiety^[4], which can have huge implications for the metabolic and overall health of these individuals.

Eating Behaviours

You knew I would bring up eating behaviours at some stage, it just took me more than my usual opening sentence to fully immerse myself in. Interestingly, most of the research around social physique anxiety tends to lump it in with other disordered eating behaviours, possibly because it encompasses many facets of self-esteem (body image and satisfaction). Regardless, its potential influence on our eating is vast.

When we feel rejected socially (e.g. we perceive others to have a negative view of our bodies), our self-regulation and impulse control is impaired. This is evidenced in a 2005 study which showed that socially rejected people ate more than double the amount of cookies (the only obvious metric for sadness) than those who weren’t^[5]. Social physique anxiety is also linked with a high engagement in disordered eating behaviours, such as a drive for thinness, binge-eating and purging behaviours^[6]. Of course, these habits are hugely life-limiting and greatly impact on the well-being of an individual.

Lifestyle

It’s not just diet and exercise that these individuals don’t engage fully in – it’s so much more of life. Sufferers report more anxiety when dating^[7], lower engagement in general social activities^[1] and overall lower self-esteem^[8]. Therefore, it is super important that we can identify those at high risk, and do what we can to minimise its impact.

Who is Most Likely to Suffer From SPA?

Anyone can suffer from social physique anxiety, however it tends to be the “outliers” on the scale. Women are more likely to suffer from social physique anxiety than men^[1], but again the OG Social Physique Anxiety Scale doesn’t really take into account male presentations of physique anxiety – such as the drive for muscularity^[9]. And of course, most of the research around social physique anxiety involves college students (they are easy to recruit!), who are more concerned with social standings at baseline. Given that physique and body image concerns appear to become less pertinent to self-esteem as we age^[10], I think that we need to be careful hanging our hat on any of these major findings of research.

We also need to discuss the absolute tomfoolery that was actually dignified in print from the OG social physique anxiety article that legitimately said these words:

“The objective physique measures suggest that the concerns of the high social physique anxiety women might have been partly justified.”

Now, it is immediately apparent that this statement could only have been made in the 80s. What they meant to say was that women who tend to deviate further from the societal norms – taller women, women with higher body fat percentages and elevated BMI tend to suffer more from social physique anxiety. What they actually said was: objectively, you’re a freak, so fair enough you’re worried what people think of you.

Rampant misogyny aside, it tends to be those who stray a little further from what we deem socially acceptable that suffer a little more from anxiety about their physique. Anecdotally, can confirm that being a tall girlo does give you some physique anxiety. I am most certainly not a delicate little ladyflower, and growing up it was the source of many a body hang-up for me. Now that I am older, I care far less about what those under six foot think of me, but it is important to appreciate that it is not the same for everyone. In addition, not all “outliers” are created the same. I will not experience the same stigma for being tall as I will for being overweight or obese^[11].

Conclusions

Social physique anxiety is a really interesting concept that has many promising explanations for why some individuals engage in unhealthy diet and exercise behaviours. It is a little all-encompassing in my opinion to exist as a stand alone influence on anything. However, the research raises some interesting points and considerations.

Let me know what you think about social-physique anxiety in the comments!

References

1. Hart EA, Leary MR, Rejeski WJ (1989) The Measurement of Social Physique Anxiety. J Sport Ex Psych 11(1), 94-104.
2. DeWall CN, Bushman BJ (2011) Social Acceptance and Rejection: The Sweet and the Bitter. Curr Dir Psychol Sci 20(4), 256-260.
3. Tiggemann M, Andrew R (2012) Clothing choices, weight, and trait self-objectification. Body Image 9(3), 409-412.
4. Auster-Gussman LA, Crim J, Mann TL (2021) The soulless cycle: Social physique anxiety as a mediator of the relation between body mass index and exercise frequency. Stigma Health 6(2), 192-199.
5. Baumesiter RF, DeWall CN, Ciaracco NJ et al. (2005) Social exclusion impairs self-regulation. J Pers Soc Psychol 88, 589-604.
6. Diehl NS, Johnson CE, Rogers RL et al. (1998) Social physique anxiety and disordered eating: what’s the connection? Add Behav 23(1), 1-6.
7. Swami V, Robinson C, Furnham A (2021) Associations between body image, social physique anxiety and dating anxiety in heterosexual emerging adults. Body Image 39, 305-312.
8. Hagger MS, Stevenson A (2010) Social physique anxiety and physical self-esteem: Gender and age effects. Psychol Health 25(1), 89-110.
9. Grieve R, Helmick A (2008) The Influence of Men’s Self-Objectification on the Drive for Muscularity: Self-Esteem, Body Satisfaction and Muscle Dysmorphia. Int J Men Health 7(3), 288-298.
10.  Paxton SJ, Phythian K (1999) Body image, self-esteem, and health status in middle and later adulthood. Aus Psychol 34(2), 116-121.
11.  Alimoradi Z, Golboni F, Griffiths MD et al. (2020) Weight-related stigma and psychological distress: A systematic review and meta-analysis. Clin Nutr 39(7), 2001-2013.