Publications from the Centre for Appearance Research (CAR)

Strength training offers substantial physical and psychological health benefits for women, yet gym environments often remain exclusionary, gendered spaces that reinforce harmful appearance ideals and undermine body image. This study explored women's experiences of gym-based exercise using photo-elicitation methodology. Seventeen women (aged ≥18 years) were recruited from a prior survey study, with 47% aged 30–39 and 65% residing in the UK. Over a period of 1–2 weeks, participants captured or selected images representing their gym experiences, which were then used to guide semi-structured interviews conducted online. Data were analysed using reflexive thematic analysis, generating four themes: (1) ‘It's Bigger Than Me’: Strength Training for Lifelong Health; (2) ‘Be Afraid and Do It Anyway’: Empowerment from Strength Training; (3) ‘I Am Proud of My Body but … Will It Ever Be Good Enough?’: The Inescapability of Diet Culture; and (4) ‘I Think I Look Good’: Positive Body Image Dichotomy. Although participants engaged in strength training for health, longevity, and empowerment, many continued to experience negative body image thoughts and practices, including comparison with others and discomfort in gym attire. Participants further described a continual negotiation between rejecting appearance ideals and navigating the sociocultural pressures embedded within and beyond gym spaces. Findings highlight the need for more inclusive and supportive gym cultures and challenging fitness industry norms that perpetuate body dissatisfaction. By using photo-elicitation to examine women's everyday gym experiences, this study conceptualises body image as a dynamic and negotiated process and offers applied insights for creating more inclusive and psychologically supportive gym environments.

This chapter explores the impacts that sociocultural beauty ideals in media have on body image and societal attitudes towards appearance. The chapter begins by outlining how appearance is portrayed in traditional and social media, specifically focusing on the over-representation of narrow beauty ideals and the under-representation of minoritized groups, including individuals with appearance-altering conditions. The chapter then presents research on the negative impacts that exposure to beauty ideals in media can have on body image and related components of psychological well-being. Additionally, this chapter examines the potential for social media to as a tool to foster positive body image and to increase acceptance of appearance-altering conditions and appearance diversity more broadly. The chapter ends with suggestions for further research and practical recommendations for using media in ways that support positive body image and psychological well-being.

Approximately 1 in 5 people in the UK are currently living with a visible difference, for example, scarring. Evidence suggests that an increasing number of adults are using decorative tattooing to camouflage and/or decorate scarring. However, literature on the motivations and potential benefits of this is limited and more research into the impact of tattooing on psychosocial wellbeing is needed. This PhD explored the use of decorative tattooing as a form of scar camouflage and/or decoration, to understand the psychosocial motivations from the perspectives of adults with tattoos and scarring, drawing also on the perspectives of tattoo artists and the general UK population. Through an interdisciplinary mixed method sequential design, the PhD utilised semi-structured interviews, incorporating photo-elicitation, and survey data to investigate the breadth of the topic through an interpretivist lens, adding new knowledge to both the visible difference and tattooing literature. The direction of this thesis was developed by drawing on key lines of enquiry within each respective study to inform the next, enabling the thesis to map key findings across all studies. Study one investigated the lived experiences of 15 individuals who had used decorative tattooing to camouflage and/or decorate scarring. Study two built upon these findings through interviewing 14 tattoo artists with experience of tattooing scarring and study three examined broader population perceptions of scars and tattoos through an online survey, assessing 180 responses. Overall, the research indicated that decorative scar tattoos can be a tool for re-defining relationships with scarring and identity, potentially as an alternative to more conventional methods. Decorative tattoo artists play a significant role in shaping individual experience, however, training allowing them to provide additional support may be beneficial. General perceptions vary between experiences of tattoos and/or scarring and the broader societal perceptions of both scars and tattoos remain complex. While tattoos appear to have more sociocultural acceptability than visible scarring, the navigation of tattooed identity is highly influenced by cultural contexts, and scars often remain stigmatised. Each study identified how findings supported and contradicted existing literature, making recommendations for future research, including the potential for decorative tattooing to aid existing visible difference support and highlighting routes for best practice for decorative tattoo artists. Ultimately, calling for a broader recognition of the transformative potential of decorative tattooing, with the view to inspire more inclusive discourses and practices within academic and cultural domains.

Introduction: This study aimed to explore UK healthcare professionals’ perspectives on support for male breast cancer patients and their informal carers, and to identify avenues for improvement. Methods: UK-based HCPs involved in the care of breast cancer patients (men and/or women) were invited to complete an online survey about their experiences of explaining diagnoses and treatment, perceptions of current support and areas for improvement. Data were analysed using descriptive statistics and qualitative content analysis. Results: Respondents (N = 62) reported providing a variety of resources and sources of practical and emotional support, but 81% found existing resources inappropriate and insufficient. Recommendations included increased availability of male-specific breast cancer information and support, and training for healthcare professionals working in this field. Conclusion: Increased psychosocial support and enhanced, gender-appropriate resources are crucial for supporting male breast cancer patients and their informal carers and reducing isolation. Healthcare professionals need access to training on this topic.

Objective Influencers have been used to deliver messaging in public health campaigns and have begun collaborating with researchers to deliver evidence-based content. Building on this approach, this study explored adolescent girls’ perspectives on influencers and utilising influencers to deliver body image and mental health interventions. Methods A mixed-methods study was conducted with 375 UK-based girls (Mage  =  15.39, SD = 1.63) to understand their experiences with influencers and their opinions about influencer-delivered body image and mental health interventions. Data were analysed quantitatively via descriptive statistics and qualitatively using inductive content analysis. Results Most participants expressed likeability, credibility, authenticity, and relatability were key influencer qualities when choosing to trust an influencer, whilst their ethnicity, gender, and body size were not important. In considering intervention development, the most salient factor in trusting an influencer about body image was that the influencer shared their own experiences. Participants preferred offline body image support (47%) versus online (38%); however, just over 60% agreed that influencer-delivered body image interventions were a good idea. The content analysis generated three main categories: ‘Influencer-delivered interventions would be helpful’ (53.5%), encompassing the offer of support and online environment as ideal; ‘influencer-delivered interventions would be unhelpful’ (28.1%), including influencers are not qualified and the toxicity of the internet; and ‘influencer qualities’ (18.3%), such as relatability. Conclusion Overall, adolescent girls thought an influencer-driven approach could be helpful in improving their body image and mental health. Caveats included that the influencer must be trustworthy, relatable, and authentic, which could encompass self-disclosure related to their mental health.