School of Health, Care and Social Welfare

SOCIAL MEDIA USAGE AND BODY

APPRECIATION
A quantitative cross-sectional study among Swedish adults

GRETA KARLSSON

Main Area: Public Health Sciences Supervisor: Susanna Lehtinen-Jacks

Level: Second Cycle Examiner: Katarina Bälter
Credits: 15 Higher Education Credits
Programme: Master’s Programme in Public Seminar date: 2020-06-04
Health within Health and Social Welfare Grade date: 2020-06-25
Course Name: Thesis in Public Health
Sciences
Course Code: FHA024
ABSTRACT

Among Swedish adults, 50% are active on social media daily. Regarding body image, 50% of
Swedish adolescents are happy with their weight, although no statistics are available among
Swedish adults. Time spent on social media is related to body dissatisfaction and viewing of
body positive content increases body appreciation. Applying a salutogenic approach, a
theoretical framework of sense of coherence was used in this study. The aim was to examine:
if there is a relationship between social media usage and body appreciation in Swedish
adults; if there are gender differences; whether this potential relationship is evident after
controlling for age, gender, physical activity, sedentary lifestyle, and viewing of body positive
content. A quantitative method was used. Data from 153 participants was collected using
questionnaires, and analysed using correlation analyses and multiple regression analyses.
The results revealed that there was no relationship between general social media usage and
body appreciation – however, the less time spent on social media, the better body
appreciation participants had. This relationship was only evident among women. The
relationship was still observed after controlling for confounding. These findings were in line
with some previous findings. Women’s body appreciation could possibly favour from
decreased time spent on social media.

Keywords: body appreciation, quantitative study, sense of coherence, social media usage.
CONTENTS

1 INTRODUCTION ............................................................................................................... 1

2 BACKGROUND ................................................................................................................ 2

2.1 Social media ............................................................................................................... 3

2.2 Body appreciation ...................................................................................................... 4

2.3 Social media and body appreciation ........................................................................ 5

2.4 Problem formulation .................................................................................................. 7

3 AIM .................................................................................................................................... 8

3.1 Research questions ................................................................................................... 8

3.2 Study hypothesis ....................................................................................................... 8

4 METHODS AND MATERIAL ............................................................................................ 8

4.1 Methodological approach and study design ........................................................... 8

4.2 Sample ........................................................................................................................ 9

4.3 Data collection ............................................................................................................ 9

4.4 Measures ................................................................................................................... 10

4.4.1 Physical activity ................................................................................................ 10
4.4.2 Sedentary lifestyle ............................................................................................ 10
4.4.3 Body positive content ....................................................................................... 10
4.4.4 Social media usage .......................................................................................... 11
4.4.5 Body appreciation ............................................................................................. 11

4.5 Processing of data ................................................................................................... 11

4.6 Analysis .................................................................................................................... 13

4.7 Ethical considerations ............................................................................................. 16

5 RESULTS ........................................................................................................................ 17

5.1 Relationship between social media usage and body appreciation ..................... 19
5.1.1 Gender specific relationships ........................................................................... 19

5.2 Relationship between social media usage – time spent on social media – and
body appreciation controlled for confounding ..................................................... 20
 5.2.1 Relationship controlled for confounding among women ................................... 22

6 DISCUSSION .................................................................................................................. 23

6.1 Methodological discussion ..................................................................................... 24

6.1.1 Sample and data collection .............................................................................. 24
6.1.2 Measures, processing of data, and analysis .................................................... 25
6.1.3 Quality and ethical considerations .................................................................... 26

6.2 Result discussion .................................................................................................... 27

6.2.1 Future research and practical implications ....................................................... 30

7 CONCLUSIONS .............................................................................................................. 30

LIST OF REFERENCES ........................................................................................................ 31

APPENDIX A; COVER LETTER

APPENDIX B; QUESTIONNAIRE

APPENDIX C; COVER LETTER IN SWEDISH

APPENDIX D; QUESTIONNAIRE IN SWEDISH

1 INTRODUCTION
In Sweden, the public health is considered good. However, the mental health is a public
health issue, as approximately one in five Swedish adults experience impaired mental well-
being (Folkhälsodata, 2018). Body image is a part of mental health, and research suggest that
body image concerns are common (Conner, Johnson & Grogan, 2004). While body image
concerns are a risk factor for aspects of mental ill-health such as anxiety and depression,
body appreciation is related to various aspects of well-being: life satisfaction, self-esteem,
and happiness (Halliway, 2015). To increase the well-being of Swedish adults, addressing
body appreciation promoting factors could be considered important. While previous research
mostly has focused on negative body image, this study will highlight positive body image by
examining the relationship between social media usage and body appreciation.

Previous research has discovered relationships between body image and social media usage
(Cohen, Fardouly, Newton-John & Slater, 2019; Sherlock & Wagstaff, 2019). However,
research on Swedish adults is lacking on this topic. Regardless, social media usage is related
to both positive and negative aspects of body image, depending on how social medias are
used (Choukas-Bradley, Nesi, Widman & Higgins, 2019). For example, viewing body positive
content on social media platforms can lead to increased body appreciation (Cohen et al.,
2019). Additionally, it is primarily young women who are affected by the relationship
between social media usage and negative body image (Conner et al., 2004). Thus,
interventions specifically targeting this group could contribute to closing the gap in health.

Similarly to other study populations, the majority of Swedish adults have accounts on social
media and uses social media in their everyday life (Statistics Sweden, 2019). Thus,
relationships on social media and body appreciation may be similar among Swedish adults,
as compared to populations previously studied. However, since social media is constantly
evolving, previous research might not be accurate today. Thus, the relationship between
social media usage and body appreciation needs to be studied further. As body appreciation
can influence the well-being, it could be considered an important matter for the public
health. The author of this study had a limited preunderstanding of the topic. However, the
interest arouse from related topics discussed during the course of the author’s education.
Because the topic has not received much attention in Sweden, the author’s interest increased.

In March 2020, during the on-going degree project work, Sweden was affected by extensive
societal changes due to the risk of the contagion COVID-19 virus. A recommendation was
given to organize all university-level teaching to be conducted online. As major parts of the
society were affected, the Government gave regulations to avoid physical contact with other
people to avoid spreading the infection. As a consequence, there were difficulties to collect
data for the degree projects. Therefore, in this specific thesis, questionnaires were shared via
Facebook, and instead of targeting a specific group (e.g. a specific gender or age group), a
larger source population was targeted.

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2 BACKGROUND
In an international perspective, the public health in Sweden is considered to be good
(Folkhälsomyndigheten, 2020a). In February 2020, the Swedish adult population (18 years
and older) consisted of about 8 250 000 people (Statistics Sweden, 2020). During the last
decade, there have been improvements in the population’s overall health, and the majority
rates their overall health as good or very good. However, as some aspects of health increases,
some decreases – for instance, mental health (Folkhälsodata, 2018). In the Swedish adult
population, 17% have an impaired mental well-being – an increase of five percentage points
during the last decade (Folkhälsodata, 2018).

The goals in the United Nation’s (UN) agenda 2030 are essential for the work conducted
within the public health sector in Sweden (Folkhälsomyndigheten, 2019). One of the goals
included in agenda 2030 refers to ensuring good health and well-being; in order to ensure
this, health risks should be targeted (UN, 2015). As the well-being of the Swedish adult
population decreases (Folkhälsodata, 2018), targeting and working with indicators of well-
being could possibly be a way to reverse this trend, and is in line with the UN’s advice in
agenda 2030: to target health risks (UN, 2015).

Another goal included in agenda 2030 refers to gender equality (UN, 2015). Inequities in
health occur in several layers in society. For example, societal norms and values generates
gender inequities, putting women in an unfavourable position (CSDH, 2008). For instance,
while 14% of the adult Swedish males have impaired mental well-being, 20% of the women
have impaired mental well-being (Folkhälsodata, 2018).

There are several determinants of health, existing at different levels in society. The social
environment is one of these determinants and involves social interaction and social
connectedness. Social relationships can both have positive and negative effects on health;
while social connectedness have positive effects on health, social strain, in form of for
instance criticism and excessive demands, can have negative consequences on health (Green,
Tones, Cross & Woodall, 2015). Social interaction occurs for instance on social media
platforms (Bekalu, McCloud & Viswanath, 2019).

Sense of coherence (SOC) is a theory developed by Aaron Antonovsky in the 1970’s

(Antonovsky, 1979). SOC refers to the extent people have pervasive, yet dynamic, feelings of
confidence. For people with high SOC, stimuli (i.e. something perceived by the senses) are
structured and predictable, and the available resources are enough to counter perceived
demands. Further, the demands are perceived as welcomed challenges. SOC origins from the
salutogenic perspective of health – the focus lies on health and how to promote health. On
the contrary, a pathologic perspective of health rather studies aspects of disease and how to
prevent disease. By applying a salutogenic approach, studying health promoting factors
rather than risk factors is suitable. These two perspectives of health are however
complementary, and both contribute to gained knowledge. Moreover, SOC have been shown
to protect from ill-health (Antonovsky, 1987). For example, SOC is a protective factor against
mental health problems, such as anxiety and depression (Hochwälder, 2013). On the same

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note, there is also a relationship between mental well-being and SOC (Mato & Tsukasaki,
2017).

SOC is also related to physical activity. Among adolescents, high levels of physical activity is
related to high levels of SOC (Moksnes, Løhre & Espnes, 2012). Further, physical activity is a
protective factor against several health problems, including both physical and mental aspects
of health (WHO, 2010). Thus, physical activity could possibly be a protective factor for body
appreciation. Being physically active reduces risks of for example cardiovascular disease and
depression – whereas a sedentary lifestyle constitutes a risk. The global recommendations for
physical activity among adults aged 18 to 64 is at least 150 minutes of moderate physical
activity, or 75 minutes of intense physical activity – or a combination (WHO, 2010). The
same recommendations are adopted in Sweden (Folkhälsomyndigheten, 2016). Sedentary
lifestyles are common in Sweden, as many people work, commute, and spend their spare time
sitting down. Sedentary lifestyle is a risk factor for ill-health, even among people who reach
the recommendation for physical activity (Statens Folkhälsoinstitut, 2012).

2.1 Social media

Social media can be defined as websites and apps where users can upload and post original
content which can be viewed and commented on by other users (Choukas-Bradley et al.,
2019). In this study, social media and social network will be treated synonymously. Social
networking sites are websites where users can upload and post information about themselves
and message other people (Longman dictionary of contemporary English, 2009). In this
study, social networking sites will regard specific sites. The majority of the Swedish adult
population have an account on social media. In 2018, half of the Swedish population aged
between 16 and 84 were active in a social network on the internet every day. Further, in 2018,
three quarters of the same age group were active on a social networking site at least monthly.
The use of social media varies between age groups in Sweden, whereas younger people more
frequently engage in social media. The majority of Swedish people aged between 16 and 34
were active on social networking sites every day in 2018. In Swedish people aged 16 and
older, women are more active on social networking sites than men. Among women, 80% are
active on social networking sites monthly; daily, half of the Swedish women are active on
social networking sites. Among men, approximately 70% are active on social networking sites
monthly, while just below half of the men are active every day (Statistics Sweden, 2019).

Social media is used widely around the world, and is increasingly common (Shayka &
Christakis, 2017). Social media is a tool that, for example, can be used for social interactions,
for identity formation, to receive news, and for entertainment (Bekalu et al., 2019). Social
media has changed how people communicate with each other and has been shown to
influence mental health both positively and negatively. Further, life satisfaction is negatively
associated with social media usage – whereas having real life friends is a health promoting
factor (Shayka & Christakis, 2017). Similarly, research suggest that there is a slight
association between high SOC and lower usage of smartphones for social interaction
(Sharabi, Sade & Margalit, 2016).

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Recently, a new trend on social media platforms has developed – body positivity. Body
positivity aims to challenge social norms that idealizes thin bodies of women, and instead
shows a diversity of bodies with a variation of sizes, shapes, colours, functions, and features.
Body positive content involves photos representing a variety of bodies, highlighting people’s
differences (Cohen et al., 2019). From June 2018, to April 2020, the hashtag #bodypositivity
had increased the number of posts from around 1.8 million posts to around 4.4 million posts.
The hashtag #BoPo had, in the same time period increased the quantity of posts on
Instagram from around 670 000 posts to over a million posts (Cohen et al., 2019; Instagram,
2020).

2.2 Body appreciation

Body image is a complex concept with several definitions and many dimensions. Body image
involves the feelings, perceptions, thoughts, and acts of individuals’ own bodies (Conner et
al., 2004; Rutledge, Gilmore & Gillen, 2013). Body satisfaction is defined as “individual’s
contentedness with their overall body or with specific body parts” (Wang et al., 2020). Body
appreciation is defined as “accepting the features, functionality, and health of the body”
(Tylka & Wood-Barcalow, 2015a, p. 122). Further, it is not merely focusing on appearance
(Tylka & Wood-Barcalow, 2015a). Both body appreciation and body dissatisfaction are
indicators of the wider concept body image. However, there are some differences between
them. Body dissatisfaction is an indicator for negative body image; body appreciation is an
indicator for positive body image (Tylka & Wood-Barcalow, 2015a). Further, while body
dissatisfaction is related to depression, there is no such correlation between body
appreciation and depression, after taking attachment (i.e. how people have learned to
interact in relationships) and perfectionism into account (Halliway, 2015).

Around half of the 15-year-old adolescents in Sweden are happy with their weight – 47% of
the girls, and 57% of the boys. However, 40% of the girls in Sweden think that they are too
fat, and 19% of the boys think they are too fat. On the contrary, 13% of the girls think that
they are too thin, while 24% of the boys think that they are too thin (Folkhälsomyndigheten,
2018). However, there are no statistics on how Swedish adults view their bodies. Moreover,
there has not been any focus on body appreciation in Swedish adolescents; rather, focus have
been on perceived weight and dieting (Folkhälsomyndigheten, 2018). Notwithstanding, body
dissatisfaction is a risk factor for disordered eating and eating disorders (Myers & Crowther,
2009). On the contrary, body appreciation is related to for example happiness, self-esteem,
life satisfaction, and optimism (Halliway, 2015).

Body image has been researched extensively among young women (Choukas-Bradley et al.,
2019; Strubel, Pietrie & Pookulangara, 2018; Veldhuis, Alleva, Bij de Vaate, Keijer & Konijn,
2020; Wang et al., 2020). However, when examining how age affects body image, research
suggests that body appreciation increases with age (Halliway, 2015). Body dissatisfaction has
become an issue among increasingly younger people (Myers & Crowther, 2009). However,
women aged 40 to 65 has reported feeling less body acceptance from family, friends, and
society than women aged 18 to 39 (Halliway, 2015).

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In a sample of Swedish young adults, the development of a positive body image included
feelings of acceptance, belonging, empowerment, and control over actions and their
consequences (Gattanio & Frisén, 2019). Additionally, high levels of SOC are related to higher
body appreciation among adolescents (Latzer, Weinberger-Litman, Spivak-Lavi &
Tzischinsky, 2019). Further, SOC is developed during childhood and adolescence. Fully
development of SOC, however, occurs approximately at the age of 30 (Antonovsky, 1987).

As previously stated, research on body image has predominantly addressed young women
(Choukas-Bradley et al., 2019; Strubel et al., 2018; Veldhuis et al., 2020; Wang et al., 2020),
undermining the effect of body image concerns in men. However, research conducted among
both men and women indicate that women and girls, to a greater extent, struggle with body
dissatisfaction than men and boys do (Conner et al., 2004; Gonzaga, Claumann, Scarabelot,
Silva & Pelegrini, 2019), and that women and girls are more appearance oriented than men
and boys (Rutledge et al., 2013).

Body image concerns are especially occurring in western countries. Research suggests that
women tend to strive for a slim body, while men tend to strive for a muscular body (Conner et
al., 2004; SturtzSreetharan et al., 2020). Men’s tendency to strive for a muscular body is
linked to low self-esteem, anxiety, depression and upper body dissatisfaction
(SturtzSreetharan et al., 2020). Body image disturbance among women is related to
depressive symptoms, anxiety and low self-esteem (Sherlock & Wagstaff, 2019).

Body satisfaction in both male and female adolescents is related to physical activity; a low
degree of body satisfaction predicts lower levels of physical activity (Neumark-Sztainer,
Paxton, Hannan, Haines & Story, 2006). Additionally, high levels of SOC in adolescents are
related to high levels of physical activity (Moksnes et al., 2012). Further, high SOC is
associated with weight satisfaction in both men and women (Swan, Bouwman, Hiddink,
Aarts & Koelen, 2016).

2.3 Social media and body appreciation

In line with the complexity of body image, and given that social media constantly changes
and evolves, the associations between social media and body appreciation has been shown to
be ambiguous. Previous research has shown that the more time spent on Instagram, the more
body image disturbance women experience (Sherlock & Wagstaff, 2019). However, research
has also suggested that the way people use social media might be more predictive of body
image than the time spent on social media (Choukas-Bradley et al., 2019; Stein, Krause &
Ohler, 2019). For instance, exposure to body positive content on Instagram have been shown
to improve women’s body satisfaction, body appreciation, happiness, and confidence (Cohen
et al., 2019). On the contrary – viewing images of beauty and fitness increases body image
disturbance (Sherlock & Wagstaff, 2019). Exposure to body neutral content does neither
increase, nor decrease body satisfaction or body appreciation (Cohen et al., 2019). This
finding could perhaps explain similar non-relationships – research on the matter has also
suggested that there is no relationship between weight satisfaction and the browsing of
strangers’ profiles and photos on Instagram (Stein et al., 2019).

5
Recent research has shown that there is no relationship between Facebook usage and
women’s body image (Strubel et al., 2018). However, other research on Facebook and body
image have shown that there, in fact, is an existing relationship. Women, people who spend
more time on Facebook, and people who are more emotionally attached to Facebook are
more oriented towards appearance. People who have more friends on Facebook also view
their bodies in a more positive way (Rutledge et al., 2013).

Appearance-related social media consciousness, that is, thoughts and feelings regarding how
attractive one is to a social media audience, is related to body image disturbance (Choukas-
Bradley et al., 2019). However, deliberate selection and posting of selfies are associated with
body appreciation in young women (Veldhuis et al., 2020).

The theory SOC consists of three parts; comprehensibility, manageability, and

meaningfulness (Antonovsky, 1987). Comprehensibility refers to the extent stimuli is
perceived as information that is ordered, structured, consistent, and clear. People with high
sense of comprehensibility are likely to be able to cope with experiences in life. These people
are also likely to expect future experiences to be predictable to some extent and are able to
perceive unpredicted happenings as understandable and comprehensible. On the contrary,
people with low sense of comprehensibility are likely to perceive negative experiences as
occurring often and believes that these things will continue to occur often in the future
(Antonovsky, 1987). In a context of social media and body appreciation, this kind of stimuli
could arise from social media, with messages about for example norms and ideals regarding
bodies. Manageability refers to the extent resources are perceived to be enough to meet the
demands that are set by the stimuli in the external, or internal, environment. People with a
high sense of manageability are likely to be able to feel control over things that happens and
are likely to be able to cope with such experiences. People with a low sense of manageability,
on the other hand, might feel victimized and unfairly treated (Antonovsky, 1987). In this
context, meeting demands could refer to living up to the norms and body ideals viewed in
social media. Meaningfulness, which is the third component of the theory, refers to the
extent life emotionally makes sense, and how much emotional investment and energy is
worth spending on problems and demands. People with a high sense of meaningfulness are
likely to welcome challenges and seek meaning in them, rather than seeing the challenges as
burdens not worth investing energy in (Antonovsky, 1987). In a social media context,
research has shown that using Facebook is perceived as a less meaningful activity than
browsing the internet and refraining from using social networking sites, which in turn leads
to lowered positive mood (Yuen et al., 2019).

Research conducted on social media usage and body image has seldomly been conducted
with a public health perspective, with several reports highlighting this knowledge gap, by
emphasizing the need for development of interventions aimed for larger groups of people
(Cohen et al., 2019; Essayli et al., 2017; Halliway, 2015; Neumark-Sztainer et al., 2006;
Veldhuis et al., 2020). For example, health workers should instead of focusing on pathologic
aspects of body image and social media, rather focus on factors that contribute to health
(Veldhuis et al., 2020). As previously mentioned, there is an association between high SOC
and lower usage of smartphones for social interaction (Sharabi et al., 2016). Additionally,
high levels of SOC are related to body appreciation among adolescents, and with weight

6
satisfaction in adults (Latzer et al., 2019; Swan et al., 2016). Thus, studying social media
usage and body appreciation through SOC could contribute to reducing this knowledge gap.

Because the topic mostly have been studied in the field of psychology (Tylka & Wood-
Barcalow, 2015a), much of the literature focus on pathology and the negative aspects of body
image (Choukas-Bradley et al., 2019; Conner et al., 2004; Gonzaga et al., 2019; Sherlock &
Wagstaff, 2019; Stein et al., 2019). In order to not simply prevent disease and negative body
image – promoting positive body image could be an important strategy for the public health
sector. Promoting body acceptance could, for instance, result in higher participation in
health-related behaviours, and thus – healthier lifestyles. Furthermore, taking advantage of
social media platforms could be a time- and cost-effective way to reach a large population
(Cohen et al., 2019). In sum, there is a need for a public health perspective when examining
social media usage and body appreciation – and a need for health promoting interventions
for the adult population as well as for adolescents.

2.4 Problem formulation

The public health agency in Sweden has examined body image of adolescents during the last
three decades (Danielson & Marklund, 2000). However, there are no statistics regarding
adult’s body image – even though research points out that body image can be a concern even
in adulthood. Body satisfaction positively influences mental health and well-being, while
body dissatisfaction constitutes a risk factor for mental ill-health (Halliway, 2015; Stice,
2002). Mental well-being is an important topic for the public health (Folkhälsomyndigheten,
2020a). Further, the UN (2015) highlights that targeting indicators of health can contribute
to ensuring health and well-being.

There seems to be inequalities in body appreciation, as previous research has found

differences across gender and age (Halliway, 2015; Conner et al., 2004; Gonzaga et al., 2019).
Furthermore, social media influences health in various ways – both negatively and positively
(Shayka & Christakis, 2017). Studies have seldomly solely focused on positive aspects of body
image. Therefore, examining social media and body appreciation through a framework using
SOC could potentially highlight the positive aspects, and thus, shed new light on the subject.

From a public health perspective, it could be considered important addressing how

promoting body appreciation could be achieved. The majority of the Swedish adult
population uses social media (Statistics Sweden, 2019). However, it appears that there is a
knowledge gap when it comes to social media usage and body appreciation in the adult
Swedish population. Thus, identifying whether there is such an association on this population
could be a starting point in order to promote health within this topic. This could further
enable identification of health promoting factors for body appreciation and within social
media usage, which could be beneficial for the public health. Hence, this study intends to
investigate potential associations between social media usage and body appreciation.

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3 AIM
The aim was to examine if there is a relationship between social media usage and body
appreciation among Swedish adults, and to investigate if there are any differences across
gender on this relationship. Further, the aim was to examine whether this potential
relationship is evident after controlling for age, gender, physical activity, sedentary lifestyle,
and viewing of body positive content.

3.1 Research questions

• Is there a relationship between social media usage and body appreciation?
• Is there a difference across gender on the potential relationship between social media
usage and body appreciation?
• Is there a relationship between social media usage and body appreciation after
controlling for age, gender, physical activity, sedentary lifestyle, and viewing of body
positive content?

3.2 Study hypothesis

The hypothesis proposed was that there is a negative relationship between social media usage
and body appreciation, and that this relationship remains after controlling for age, gender,
physical activity, sedentary lifestyle, and viewing of body positive content. Further, it was
hypothesised that this relationship is stronger among women.

4 METHODS AND MATERIAL

In this chapter, methodological choices, materials used, and procedures are explained.

4.1 Methodological approach and study design

To answer the aim and research questions, a quantitative method was applied. When using a
quantitative method, an objective approach is strived for. Testing of theories are conducted
by collecting and analysing numerical data (Bryman, 2012). Often, questionnaires are used to
collect this type of data (Bruce, Pope & Stanistreet, 2018). This study was based on a
positivistic approach, which implies that science and knowledge are based on reasoning and
on rational thought. Positivism assumes an objective approach. Thus, the phenomena of
interest is observed from a distance. The result are solely based on actual observations (Bruce

8
et al., 2018). A deductive approach was applied in this study. In deduction, knowledge is
expanded by testing of hypotheses with empirical data. This means that, on a theoretical
basis, a hypothesis is formulated, and observations are made. These observations can either
deny or confirm the hypothesis (Bruce et al., 2o18). A cross-sectional study design was
applied. Distinctive for a cross-sectional design is that all variables are measured at the same
time, at a given time-point. The cross-sectional design can be used in order to detect
associations between variables in a population (Creswell & Creswell, 2018; Merrill, 2013).

4.2 Sample
The target population consisted of Swedish adults who have Facebook accounts. The
inclusion criteria were that participants were Swedish speaking and were at least 18 years old.
Targeting a large source population was deemed suitable in this case, as the COVID-19 virus
affected the possibilities to reach out to potential participants. Using a large source
population presumably increased the chances of receiving an appropriate sample size. The
sample was a snowball sample. A snowball sample is distinguished by finding people from
the population, who in turn can use their networks to find more people from the same
population (Bruce et al., 2018). This was evident in this study, since the questionnaire was
shared on the author’s Facebook account, and was then shared by ten additional Facebook
users, on their own timelines. In this way, the questionnaire reached more people from the
population. A snowball sample is not a random sample, and thus, likely not representative for
the population. However, it may help identify people from the population (Bruce et al., 2018).
Because there was no way to randomly select a sample from the target population, this
sample technique was deemed appropriate.

4.3 Data collection

The cover letter and the questionnaire were in Swedish and created in Google Forms
(appendix A-D). After receiving approval from the supervisor, the questionnaire was tested
by two peers, who gave input and shared their experiences and spontaneous reactions of
answering the questionnaire. The questionnaire – including the cover letter – was shared on
the author’s Facebook page on the 21st of April 2020. A post was published, where it was
stated that the author of this study was working on a degree project regarding social media
and body appreciation. The post also included the link to the questionnaire. Further, the
Facebook post was shared by ten people. The data collection proceeded for seven days, and
ended on the 28th of April 2020. The response rate – which is how many percent of those in
the available sample, from whom data was collected (Bruce et al., 2018) – is unknown, as it
cannot be established how many of those who received the questionnaire actually answered
it. Further, it was not possible to determine how many started filling in the questionnaire
without completing it. Due to the COVID-19 virus, questionnaires could not be handed out in
person, thus, using Facebook to reach participants was deemed an appropriate strategy.

9
4.4 Measures
Age was measured by simply asking how old the respondents were, as an open question; that
is, participants were free to write how old they were and did not get any specified response
alternatives (Bruce et al., 2018). Gender was measured by asking the respondents which
gender they identify with, with the options man, woman, or I do not identify as either man
or woman (appendix B; appendix D). No other genders were included, in order to decrease
the risk of receiving identifiable responses. Measures of physical activity, sedentary lifestyle,
body positive content, social media usage, and body appreciation are described in the
following chapters.

4.4.1 Physical activity

Physical activity was measured using two questions from the national public health survey in
Sweden (Folkhälsomyndigheten, 2020b). The first question regarded physical exercise, and
participants were asked to estimate how much time in a regular week they exercised, with
response alternatives ranging from 0 minutes/no time to more than 2 hours. The second
question regarded everyday activities, and participants were asked how much time, in a
regular week, they performed everyday activities. Response alternatives ranged from 0
minutes/no time to more than five hours.

4.4.2 Sedentary lifestyle

Sedentary lifestyle was measured by asking participants to estimate how much they sit in
average in a day, with response alternatives ranging from more than 15 hours to never
(appendix B; appendix D). This question was adopted from the national public health survey
in Sweden (Folkhälsomyndigheten, 2020b).

4.4.3 Body positive content

To measure viewing of body positivity content, a question from previous research was used
(Cohen et al., 2019). The question read: “How often do you currently view body positive
content on social media in your everyday life?”, with the response alternatives never, seldom,
sometimes, often and always. Because the question was written in English, it had to be
translated into Swedish. The back-translation technique was used, which includes
translating the original content to the intended language, and then translating the content
back to the original language (Lemoine et al., 2018). The author of this study translated the
question to Swedish, and then consulted two persons highly fluent in both English and
Swedish, who were unaware of the wording of the original question. The consultants then
translated the Swedish question back to English, resulting in a very similar question as in the
original form. After discussing the difference, one word in the Swedish version was changed
in order to completely attain to the same meaning as the English question (appendix B;
appendix D).

10
4.4.4 Social media usage
In order to measure time spent on social media, a question was inspired by Sherlock and
Wagstaff (2019). The question read: “During a regular week, how much time do you spend on
social medias?” with response alternatives ranging from less than ten minutes to more than
three hours (appendix B; appendix D).

General social media usage was measured with the general social media usage subscale,
which is a subscale from the media and technology usage and attitudes scale (Rosen,
Whaling, Carrier, Cheever & Rokkum, 2013). The scale consists of nine items, with ten
response alternatives ranging from never to all the time. Unfortunately, one of the
alternatives were unintentionally excluded from the questionnaire, and thus, only nine
response alternatives were represented. The alternative not included in the questionnaire was
several times a day. Because the subscale originally was written in English, it had to be
translated into Swedish, and was translated using the back-translation technique, as
described above. In this case, the author of this study translated the subscale into Swedish,
and then consulted the two persons highly fluent in both English and Swedish, who were
unaware of the wording of the original version. Next, the consultants translated the Swedish
version of the subscale back to English, resulting in almost identical wordings as in the
original form. After discussion, two words in the Swedish version was changed in order to
fully capture the context of the English version (appendix B; appendix D).

4.4.5 Body appreciation

Body appreciation was measured with the body appreciation scale-2 in Swedish (BAS-2 in
Swedish). The scale was originally in English and developed to highlight positive body image
– body appreciation, rather than body dissatisfaction. Additionally, BAS-2 was developed to
enable measuring both women and men. The English version of BAS-2 shows good validity
and reliability among American college and community women and men (Tylka & Wood-
Barcalow, 2015b). The Swedish version of BAS-2 have shown good validity and reliability in
adolescent girls and boys – and in young women and men (Lemoine et al., 2018; Gattario &
Frisén, 2019). BAS-2 in Swedish has ten items, and response alternatives on a five-point
Likert scale, ranging from never to always. The scale measures participants’ acceptance of,
favourable opinions of, and respect for their bodies. However, two items of BAS-2 in Swedish
was modified, to further highlight the positive approach, and to ensure that ethical aspects
were considered. The original question “I feel that my body has at least some good qualities”
was modified into “I feel that my body has good qualities”, and the original question “I feel
like I am beautiful even if I am different from media images of attractive people (e.g., models,
actresses/actors)” was modified into “I feel like I am beautiful” (appendix B; appendix D).

4.5 Processing of data

All registered answers in Google Forms was exported to Google Spreadsheets. From there,
the spreadsheet was further exported to Microsoft Excel. The spreadsheet in the excel format

11
was then imported to IBM SPSS Statistics version 24. When all data had been imported, the
questions of the questionnaire constituted the variables. The response alternatives were
referred to as categories, and the categories were coded with numerical values. In addition,
any missing values was reported for each variable in the result. Missing values occurs when
participants chooses not to answer, or misses to answer, specific questions (Bryman, 2012).

General social media usage and time spent on social media, respectively, were the
independent variables. An independent variable is a variable that is presumed to be causing
something, independently of other factors (Field, 2018). Body appreciation was the
dependent variable; a dependent variable is the presumed effect, and is dependent of the
independent variable (Field, 2018). Age, gender, physical activity, sedentary lifestyle and
viewing of body positive content was confounding factors. A confounding factor is a variable
that is related to both the independent and dependent variable but is not on the causal
pathway between the independent and dependent variable (Bruce et al., 2018).

General social media usage was measured using a scale, including nine questions with nine
response alternatives each (appendix B; appendix D). These nine questions were summed up
by creating an index. In order to make sure that an index was appropriate, the reliability was
assessed. The reliability of a measure refers to how consistent and stable a measurement is
(Merrill, 2013). Internal consistency assesses to what extent items in an index measure the
same concept. There are several ways to assess internal consistency, one of which being
Cronbach’s Alpha – α (Bannigan & Watson, 2009). In this study, Cronbach’s α was assessed,
which indicates how well each item in the scale measures the phenomenon it is supposed to
measure. The a value can range from zero to one; zero implying that the items are not related
at all, while one indicates a perfect relation. A common interpretation is that an α value above
0.8 is acceptable (Field, 2018). After assessing the reliability, it was concluded that the
reliability was good (α=0.862). Since the reliability of the scale was good, an index could be
created. The index consisted of the nine questions from the general social media usage
subscale, with scores ranging from zero to 72. A low score indicated low usage of social
media, while a high score indicated high usage of social media (Rosen et al., 2013).

Body appreciation was measured using a scale consisting of ten questions with five response
alternatives (appendix B; appendix D). Before creating an index, the reliability was assessed.
The reliability was considered good (α=0.951). The ten questions were summed up into an
index, and scores ranged from zero to 40. A low score indicated low body appreciation and a
high score indicated high body appreciation (Tylka & Wood-Barcalow, 2015b).

The variable physical activity was created by making an index out of the variables physical
exercise and everyday activities. In order to do so, the variables had to be recoded (table 1).
The category of each variable was recoded so that the middle value of each category
represented the new code. For example, less than 30 minutes was recoded into 15, 30-59 was
recoded into 45 and so on. The two questions were made into an index, using the algorithm:
physical exercise x2 + everyday activities = activity minutes (Folkhälsomyndigheten, 2016).
According to Folkhälsomyndigheten (2016), physical exercise should be counted twice as it is
a more intense form of activity than everyday activities. The index was made in order to
enable measuring physical activity and everyday activities together, and thus, estimating the

12
total number of activity minutes per week. The estimation of activity minutes is used to
assess whether the Swedish recommendation for physical activity is achieved – that is 150
activity minutes per week (Folkhälsomyndigheten, 2016).

Table 1: Recoding of physical exercise and everyday activities.

Physical activity Original value Recoded valuea

Physical exercise 0 min à 0 min

<30 min à 15 min
30-59 min à 45 min
60-89 min à 75 min
90-119 min à 105 min
>120 min à 120 min

Everyday activities 0 min à 0 min

<30 min à 15 min
30-59 min à 45 min
60-89 min à 75 min
90-149 min à 120 min
150-299 min à 225 min
>300 min à 300 min

a Recoding based on the original value’s middle value.

Sedentary lifestyle was, in accordance with Folkhälsomyndigheten (2016), presented in three

groups; in an average day, sitting down: 75% or more of the time, 50% of the time, and 25%
or less of the time. In order to do so, the original codes were recoded. The first group, 75% or
more, consisted of the three categories that indicated sitting more than ten hours; the second
group, 50%, consisted of the category seven to nine hours; the third group, 25% or less,
consisted of the three categories that indicated sitting six hours or less. However, in the
inferential analyses, the original codes were used, in order to obtain as accurate results as
possible.

4.6 Analysis
Descriptive statistics were used to describe the total sample, and to separately describe
genders. This was done using frequencies, percentages, ranges, medians, means and standard
deviations. Any missing data was reported. Furthermore, inferential statistics were used in
order to analyse the data and to answer the research questions. When performing inferential
analyses, the level of significance adapted in this study was <0.05. The level of significance is
the acceptable statistical risk of arriving at the wrong conclusion, by believing that there is an
effect in the population, when in fact there is not. When adapting the <0.05 level of
significance, the right conclusion will be determined in 95 of 100 cases (Field, 2018).

13
In order to answer the first research question, “Is there a relationship between social media
usage and body appreciation?”, Pearson’s correlation coefficient was used, which may be
used when examining a relationship between two variables. These variables should be
continuous, that is, have an equal distance between each value. The variables general social
media usage, time spent on social media, and body appreciation were used. Additionally,
the assumption of additivity and linearity should be met, and involves that scores on the
dependent variable is linearly related to scores on the independent variable, which can be
assessed by creating a scatterplot. Furthermore, the assumption of normality should be met.
This refers to residuals (i.e. the difference between predicted and observed values) of a model
being normally distributed (Field, 2018). Normality was assessed by examining skewness and
kurtosis of each variable. Values of skewness and kurtosis between –2 and 2 indicates that
residuals are normally distributed (George & Mallery, 2019). Pearson’s correlation
coefficient, r, can identify the strength and direction of a relationship. A relationship can
have an effect size between –1 and 1. An r value of –1 implies a perfect negative relationship,
while an r value of one implies a perfect positive relationship. Furthermore, an r value of zero
implies that there is no relationship between the two variables. Moreover, a negative
relationship indicates that high values of the one variable is related to low values of the other
variable; a positive relationship indicates that high values of the one variable is related to
high values of the other variable. The strength of the association can vary and have small
(r=0.1-0.29), medium (r=0.3-0.49), and large (r≥0.5) effect sizes; these cut-offs are the same
for negative associations (Field, 2018).

The second research question, “Is there a difference across gender on the potential
relationship between social media usage and body appreciation?” was answered by
conducting stratified correlation analyses. This was done by splitting the variable gender and
then separately conducting Pearson’s correlation coefficient analyses and using the variables
general social media usage, time spent on social media, and body appreciation.

Further, the third research question, “Is there a relationship between social media usage and
body appreciation after controlling for age, gender, physical activity, sedentary lifestyle, and
viewing of body positive content?” was answered by conducting hierarchical multiple linear
regression analyses. This analysis is conducted in order to assess the role of potential
confounding, by first assessing how much variance – that is change – in the dependent
variable the independent variable accounts for, and then assessing how much more variance
is accounted for when including potential confounding factors – or predictors (Field, 2018).
When conducting a regression analysis there should be an appropriate sample size, and the
formula N ≥ 104+k might be used. N represents the number of respondents needed, and k
represents the number of predictors used in the analysis (Green, 1991). In this case, time
spent on social media, age, gender, physical activity, sedentary lifestyle and viewing of
body positive content was used as predictors, and thus, a sample size of at least 11o would be
required. Since the sample size in this study was 153, a regression analysis could be
conducted. Based on the stratified correlations, a regression analysis was also conducted
solely among women. Conducting a regression analysis solely for women was possible, as 118
women answered the questionnaire. However, a separate analysis could not be performed
among men, since only 35 men answered the questionnaire. This second regression analysis
was conducted in order to produce as accurate results as possible.

14
Before conducting the analyses, it was assessed whether assumptions were met. These
assumption includes: additivity and linearity, independence of errors, homoscedasticity,
normality, and multicollinearity (Field, 2018).

The assumption of additivity and linearity is crucial for linear regression, as the regression is
based on the assumption that scores on the dependent variable is linearly related to scores on
the independent variable. When several predictors are used to describe the dependent
variable, the effects are best explained by adding the effects together. Additivity and linearity
can be assessed by creating a scatterplot of predicted values of a model and the errors in the
model (Field, 2018). The assumption of independence of errors is important in order for
significance tests, standard errors, and confidence intervals to be accurate. To assess whether
errors are independent, the Durbin-Watson test can be used. This test compute values
ranging from zero to four; a value of two indicates that errors are independent. A value
greater than two indicates a negative correlation, whereas a value below two indicate a
positive correlation. The assumption can be considered met for values between one and three
are acceptable (Field, 2018). Homoscedasticity is another assumption that should be
considered. Violating this assumption can lead to inaccurate results. The variance in the
dependent variable should not differ across the values of the predictor variable.
Homoscedasticity is assessed using the same scatterplot as for assessing additivity and
linearity (Field, 2018). Moreover, normality refers to that residuals in the model should be
normally distributed. As previously mentioned, skewness and kurtosis values between –2 and
2 are acceptable values for normal distribution (George & Mallery, 2019). Lastly,
multicollinearity also needs to be assessed. Multicollinearity refers to strong correlations
between predictors; multicollinearity makes it difficult to assess the importance of a
predictor that is highly correlated to another predictor. In order to assess multicollinearity,
the two concepts variance inflation factor (VIF) and tolerance are examined. A VIF value
considerably below ten and a tolerance value greater than 0.2 indicates that substantial
multicollinearity does not occur. Further, if the average VIF value is very close to one, this
suggest that there are no problems with multicollinearity (Field, 2018). After these
assessments had been done, it was concluded that a regression analysis could not be
performed using the independent variable general social media usage. Thus, only the
independent variable time spent on social media was used in the regression analyses.

When conducting a multiple linear regression, using a hierarchical method, predictors of the
independent variable are entered in blocks (Field, 2018). When answering the third research
question, the independent variable time spent on social media was entered in the first block.
In the second block, the potential confounding factors were entered, that is, age, gender,
viewing of body positive content, physical activity, and sedentary lifestyle. By doing this, it
could be assessed whether including the potential confounding factors improved the ability to
predict body appreciation, and thus, if the relationship between time spent on social media
and body appreciation still was evident.

The multiple linear regression includes some test statistics needed in order to interpret the
analysis. The adjusted R2 explains how much of the variance in the dependent variable can be
accounted for by the predictors. The adjusted R2 adjusts for the number of predictors in the
model and can be expressed as a percentage. The size of the unstandardized regression

15
coefficient, B, indicates the strength of an association between a predictor and the dependent
variable, using a unit change in the predictor (e.g. a year for the variable age) to explain this
association (Field, 2018). The 95% confidence interval (95% CI) for B is the range, calculated
around the sample value of B, that includes the true population value for B (Bruce et al.,
2018; Field, 2018). The standard error for B (SE B) indicates how much the B values vary
across samples. The size of the standardized regression coefficient, b, indicates the strength
of an association between a predictor and the dependent variable, using standard deviations
to indicate this association. Lastly, the F value determines whether the regression model
improves the ability to predict the dependent variable – the larger the F value, the better the
model. An F value of zero implies that the model did not improve the prediction of the
dependent variable (Field, 2018). All analyses were performed in IBM SPSS Statistics.

4.7 Ethical considerations

When conducting research, four principles are to be considered. These principles involve
requirements of: information, consent, confidentiality, and utilization (Vetenskapsrådet,
2002). These ethical principles have been developed in order to protect participants from
taking harm from any research conducted (Swedish research council, 2017).

The first requirement involves giving potential respondents information regarding the aim of
the study. Further, information regarding the voluntariness to participate, the possibility to
discontinue, and the presumed possible positive and negative effects that participating in the
study could entail (Ventenskapsrådet, 2002). This was ensured by firstly addressing in the
Facebook post that the degree project regarded social media usage and body appreciation.
Secondly, a cover letter to the questionnaire was provided, where information about the
study’s aim was provided. Information was also provided specifying that it was voluntary to
participate and that it was possible to discontinue at any time. Potential advantages and
disadvantages related to participating was highlighted in the cover letter. The potential
disadvantage of participating was that some questions could be considered sensitive. To
ensure that participants felt calm, it was highlighted that the answers would be kept
confidential and that participants would be anonymous. The presumed potential benefits of
participating that were mentioned was that participants would contribute to increased
knowledge regarding the topic, and that they would have the opportunity to reflect on their
social media usage and body appreciation. Further, it was stated were the participants would
be able to read the completed thesis (appendix B; appendix D).

The second requirement regards that participants have the right to decide over whether or
not taking part in the study. This is ensured by obtaining consent from the participants
(Vetenskapsrådet, 2002). In the cover letter, it was stated that by filling in the questionnaire,
the participants gave their consent. Furthermore, this requirement involves that participants
can withdraw at any time without any negative consequences (Vetenskapsrådet, 2002). As
previously mentioned, it was stated in the cover letter that participants could discontinue at
any time (appendix B; appendix D).

16
The third requirement involves that all data should be kept as confidential as possible and
that all personal data should be kept in a way that keeps unauthorised persons from
accessing the data. Further, it requires that results should be presented in a way that prevents
others from identifying participants, in order to keep participants anonymous (Swedish
research council, 2017; Vetenskapsrådet, 2002). The data was stored in a password-protected
Google account and on a password-protected laptop. Further, to ensure that no participants
would be identified, no questions were asked that could possibly identify the participants.
Moreover, it was stated in the cover letter that the results would be presented in a way that
further would keep any participant from being identified (appendix B; appendix D).

Finally, the fourth requirement involves that gathered data are only to be used for the
purpose of the current study (Vetenskapsrådet, 2002). This was established by addressing
that data only would be used for the purpose of this study, and then would be deleted when
the thesis was completed (appendix B; appendix D).

The questions about body appreciation was from the BAS-2 in Swedish (Lemoine et al.,
2018). The scale was developed from the first version of BAS, which was created to measure
body appreciation. BAS-2 was developed in order to highlight the positive aspects of body
image (Tylka & Wood-Barcalow, 2015b). However, as previously mentioned, two items of
BAS-2 in Swedish was modified in this study, to further highlight the positive approach, and
to ensure that ethical aspects were considered – that the participants did not take harm in
participating in the study (appendix B; appendix D). Furthermore, no question in the
questionnaire was made obligatory. This, in order to give participants the option to skip a
question if they would be uncomfortable answering it.

5 RESULTS
Participants were 153 persons ranging in age from 19 to 70 years (M=37.97, SD=14.22; table
3). The sample consisted of three quarters women (n=118, 77.1%) and one quarter men
(n=35, 22.9%). All participants identified as either man or woman. Participants varied in
physical activity, as activity minutes ranged from zero to 540 minutes per week, with three
quarters of the participants reaching the recommendation of 150 minutes (table 2). Further,
the majority of participants were sitting less than 25% of the day. The majority of participants
spent more than one hour on social medias per week. Further, body positive content was
viewed to a varying extent. However, the majority viewed body positive content to at least
some extent (table 2).

17
Table 2: Descriptive statistics of categorical variables in the total sample, in men, and in women.

n (%)

Variable All, n=153 Men, n=35 Women, n=118

Physical activity (recommendation)a

<150 minutes 36 (23.5) 9 (25.7) 27 (22.9)
≥150 minutes 117 (76.5) 26 (74.3) 91 (77.1)
Missing 0 0 0

Sedentary lifestyleb
75% or more 47 (30.7) 11 (31.4) 36 (30.5)
50% 42 (27.5) 10 (28.6) 32 (27.1)
25% or less 64 (41.8) 14 (40.0) 50 (42.4)
Missing 0 0 0

Viewing of body positive contentc

Never 19 (12.4) 8 (22.9) 11 (9.3)
Seldom 36 (23.5) 12 (34.3) 24 (20.3)
Sometimes 54 (35.3) 11 (31.4) 43 (36.4)
Often 41 (26.8) 4 (11.4) 37 (31.4)
Always 2 (1.3) 0 (0.0) 2 (1.7)
Missing 1 0 1

Time spent on social mediad

Less than 10 min 3 (2.0) 2 (5.7) 1 (0.8)
11-30 min 6 (3.9) 1 (2.9) 5 (4.2)
31-60 min 34 (22.2) 11 (31.4) 23 (19.5)
61-120 min 39 (25.5) 10 (28.6) 29 (24.6)
121-180 min 33 (21.6) 6 (17.1) 27 (22.9)
More than 181 min 38 (24.8) 5 (14.3) 33 (28.0)
Missing 0 0 0

aActivity minutes in an average week by recommendation, measured using the variables physical
exercise and everyday activities (Folkhälsomyndigheten, 2016).
bTime sitting down in an average day, expressed in percent.

cCurrent frequency of viewing body positive content.

dTime spent on social media in an average week.

18
Table 3: Descriptive statistics of continuous variables in the total sample, in men, and in women.

Characteristics N (missing) Range Md M ± SD

Age (years)
All 149 (4) 19-70 33 37.97 ± 14.22
Men 33 (2) 21-70 33 40.67 ± 16.075
Women 116 (2) 19-70 33.5 37.21 ± 13.631

Physical activitya
All 153 (0) 0-540 255 263.53 ± 149.01
Men 35 (0) 15-510 225 252.43 ± 146.68
Women 118 (0) 0-540 262.5 266.82 ± 150.15

General social media

usageb 146 (7) 0-70 36 34.25 ± 11.43
All 34 (1) 0-52 29 28.06 ± 12.67
Men 112 (6) 5-70 37 36.13 ± 10.37
Women

Body appreciationc
All 151 (2) 0-40 22 21.54 ± 9.11
Men 35 (0) 0-38 26 23.49 ± 9.61
Women 116 (1) 2-40 21 20.95 ± 8.91

Abbreviations: N=sample size, Md=median, M=mean, SD=standard deviation.

a Activity minutes in an average week, measured using the variables physical exercise and everyday

activities (Folkhälsomyndigheten, 2016).

b Measured with the scale general social media usage subscale (Rosen et al., 2013).

c Measured with the body appreciation scale (Tylka & Wood-Barcalow, 2015b).

5.1 Relationship between social media usage and body appreciation

There was a small negative relationship between body appreciation and time spent on social
media, indicating that the less time spent on social media, the better body appreciation the
participants had (r=–0.169, p=0.039; table 4). Furthermore, there was no relationship
between general social media usage and body appreciation (r=–0.013, p=0.877).

5.1.1 Gender specific relationships

Among men, there was a positive relationship between time spent on social media and body
appreciation, indicating that the more time spent on social media, the better body
appreciation the men tended to have (r=0.108, p=0.536; table 4). However, this relationship
was small and not statistically significant. Further, there was a medium negative relationship
between time spent on social media and body appreciation among women (r=–0.337,
p<0.001). Thus, the less time women spent on social media, the better their body

19
appreciation tended to be. There was a positive relationship between general social media
usage and body appreciation among men, indicating that the more the men used social
media, the better their body appreciation tended to be (r=0.178, p=0.314). However, this
relationship was small and statistically nonsignificant. Moreover, there was no relationship
between general social media usage and body appreciation among women
(r=–0.033, p=0.730; table 4).

Table 4: Correlations between social media usage and body appreciation in total sample, and
separately in men and women, using Pearson’s correlation coefficient.

Body appreciation

All Men Women

Variable r p n r p n r p n

Time spent on –0.169 0.039 151 0.108 0.536 35 –0.337 <0.001 116
social media

General social –0.013 0.877 146 0.178 0.314 34 –0.033 0.730 110
media usage

Abbreviations: r=Pearson’s correlation coefficient, p=probability value, n=sample size.

The assumptions of additivity and linearity and of normality were assessed, and revealed that
correlation analyses using Pearson’s correlation coefficient could be performed. Scatterplots
revealed that there were no curvilinear relationships. Furthermore, all values of skewness
and kurtosis were between -2 and 2. Hence, the assumption of normality was also met.

5.2 Relationship between social media usage – time spent on social

media – and body appreciation controlled for confounding
A hierarchical multiple linear regression was conducted to predict body appreciation based
on time spent on social media, age, gender, viewing of body positive content, physical
activity, and sedentary lifestyle. The regression statistically significantly improved the ability
to predict the body appreciation from the first step in the hierarchy to the second step
(F(6,139)=2.757, p=0.015; table 5).

The time spent on social media accounted for 4,4% of the variation in body appreciation
(adjusted R2=0.044; table 5). However, when analysing time spent on social media, age,
gender, viewing of body positive content, physical activity, and sedentary lifestyle, these
predictors accounted for 6.8% in body appreciation (adjusted R2=0.068). Hence, age, gender,
viewing of body positive content, physical activity, and sedentary lifestyle accounted for 2.4%
of the variance in body appreciation. Of the variance in body appreciation, 93.2% remains
unaccounted for.

20
In the first step of the hierarchy, as the time spent on social media increased by one standard
deviation, body appreciation decreased by 0.224 standard deviations, indicating a negative
relationship; less time spent on social media was associated with better body appreciation
(Standardised b=–0.224, p=0.007; table 5). In the second step of the hierarchy, after
adjusting for age, gender, viewing of body positive content, physical activity, and sedentary
lifestyle, the effect that time spent on social media had on the variance in body appreciation
changed; as the time spent on social media increased by one standard deviation, body
appreciation decreased by 0.179 standard deviations (Standardised b=–0.179, p=0.037).
Thus, there still was a negative relationship between time spent on social media and body
appreciation after controlling for confounding.

Table 5: Hierarchical multiple regression analysis of predictors of body appreciation, n=146.

Model B (95% CI) SE B Standardised b p

Step 1

Constanta 26.644 (22.731, 30.558) 1.980 - <0.001

Time spent on –1.536 (–2.636, –0.437) 0.556 –0.224 0.007

social media

Step 2

Constanta 19.940 (12.121, 27.760) 3.955 - <0.001

Time spent on –1.228 (–2.382, –0.074) 0.583 –0.179 0.037

social media

Age 0.091 (–0.014, 0.196) 0.053 0.147 0.088

Genderb –0.510 (–3.986, 2.727) 1.753 –0.024 0.772

Viewing of body –0.340 (–1.864, 1.184) 0.771 –0.039 0.660

positive content

Physical activity 0.008 (–0.001, 0.018) 0.005 0.141 0.093

Sedentary lifestyle 0.337 (–0.853, 1.526) 0.602 0.047 0.577

Note: in model 1, adjusted R2=0.044; in model 2, adjusted R2=0.068 and F(6,139)=2.757, p=0.015).
Abbreviations: B=unstandardized regression coefficient; CI=confidence interval; SE B=standard error
for B; b=beta, standardized regression coefficient.
aConstant=the intercept, where the regression line crosses the y axis.

bCoding: men=0, women=1.

After assessing the scatterplot of predicted values and errors of the regression model, the
assumptions of additivity and linearity, and homoscedasticity were concluded to be met.
Further, the Durbin-Watson test revealed a value of 1.769. Hence, the assumption of
independent errors was met. The values of skewness and kurtosis for all variables were
between –2 and 2, therefore, the assumption of normality was met. There was no prevalent
problem with multicollinearity in the regression analysis. The VIF value of each predictor was
just above one, and the tolerance value of each predictor was above 0.8. Further, the average

21
VIF was 1.133 – close to one. A regression analysis could not be performed using general
social media usage as the independent variable, as the assumption of additivity and linearity
was violated.

5.2.1 Relationship controlled for confounding among women

A hierarchical multiple linear regression solely conducted on women was also conducted to
predict body appreciation among women, based on time spent on social media, age, viewing
of body positive content, physical activity, and sedentary lifestyle. The regression statistically
significantly improved the ability to predict body appreciation from the first step in the
hierarchy to the second (F(5,107)=4.183, p=0.002; table 6).

Among women, the time spent on social media accounted for 9.8% of the variance in body
appreciation (adjusted R2=0.098; table 6). However, when analysing time spent on social
media, age, viewing of body positive content, physical activity, and sedentary lifestyle, these
predictors accounted for 12.4% in body appreciation (adjusted R2=0.124). Thus, age, viewing
of body positive content, physical activity, and sedentary lifestyle accounted for 2.6% of the
variance in body appreciation. Additionally, 87.6% of the variance in body appreciation is
accounted by other factors.

In the first step of the hierarchy among women, as the time spent on social media increased
by one standard deviation, body appreciation decreased by 0.325 standard deviations,
indicating a negative relationship. Hence, less time spent on social media was associated with
better body appreciation (Standardised b=–0.325, p<0.001; table 6). In the second step of
the hierarchy, when adding age, viewing of body positive content, physical activity, and
sedentary lifestyle, the effect time spent on social media had on the variance in body
appreciation among women changed; as the time spent on social media increased by one
standard deviation, body appreciation decreased by 0.297 standard deviations (Standardised
b=–0.297, p=0.002). Thus, there still was a negative relationship between time spent on
social media and body appreciation after controlling for confounding.

A scatterplot of predicted values and errors of the regression model revealed that the
assumptions of both additivity and linearity, and homoscedasticity were met. The Durbin-
Watson test revealed a value of 1.838. Thus, the assumption of independent errors was met.
Furthermore, all values of skewness and kurtosis ranged between –1 and 1. Hence, the
assumption of normality was met. Lastly, there were no problems with multicollinearity in
the regression analysis conducted among women. The VIF value of each predictor was just
above one. Additionally, all tolerance values were above 0.8, and the average VIF for women
was 1.127, which is close to one. A regression analysis among women using general social
media usage as the independent variable could not be performed, as the assumption of
additivity and linearity was not met.

22
Table 6: Hierarchical multiple regression analysis of predictors of body appreciation in women, n=113.

Model B (95% CI) SE B Standardized b p

Step 1

Constanta 28.963 (24.449, 33.477) 2.778 - <0.001

Time spent on –2.259 (–3.494, –1.025) 0.623 –0.325 <0.001

social media

Step 2

Constanta 22.385 (13.391, 31.380) 4.537 - <0.001

Time spent on –2.059 (–3.346, –0.772) 0.649 –0.297 0.002

social media

Age 0.050 (–0.071, 0.170) 0.061 0.o78 0.416

Viewing of body –0.288 (–1.959, 1.382) 0.843 –0.033 0.733

positive content

Physical activity 0.011 (0.000, 0.021) 0.005 0.183 0.048

Sedentary lifestyle 0.581 (–0.689, 1.852) 0.641 0.084 0.366

Note: in model 1, adjusted R2=0.098; in model 2, adjusted R2=0.124 and F(5,107)=4.183, p=0.002.
Abbreviations: B=unstandardized regression coefficient; CI=confidence interval; SE B=standard error
for B; b=beta, standardized regression coefficient.
aConstant=the intercept, where the regression line crosses the y axis.

6 DISCUSSION
The aim of this study was to examine if there was a relationship between social media usage
and body appreciation in the Swedish adult population, and to investigate whether there were
any differences across gender on this relationship. Further, the aim was to examine whether
this potential relationship was evident after controlling for age, gender, physical activity,
sedentary lifestyle, and viewing of body positive content. There was an ambiguity in the
relationships between social media usage and body appreciation; the results suggest that
there was no relationship between social media usage (general social media usage) and body
appreciation, but a small tendency that the less time spent on social media, the better body
appreciation the participants had. When analysing men and women separately, this negative
relationship was only observed among women, and suggested to be moderately strong.
Moreover, after controlling for age, gender, viewing of body positive content, physical activity
and sedentary lifestyle, the negative relationship between social media usage (time spent on
social media) and body appreciation was somewhat weaker than before controlling for
confounding. However, the relationship was still statistically significant.

23
6.1 Methodological discussion
The quantitative approach was deemed appropriate in this study, since the aim was to
examine relationships between different phenomena. However, this approach cannot
generate answers that involves a deeper understanding regarding the phenomena studied
(Bryman, 2012), which can be seen as a limitation. Additionally, the quantitative strategy was
appropriate, as a deductive approach was applied. By using a deductive approach, social
media usage and body appreciation could be examined through the theory SOC, and the
hypothesis that there would be an association between social media usage and body
appreciation – especially among women – could be tested. The study design both had
advantages and disadvantages. Given the limited time frame and resources being scarce, the
design was advantageous. On the contrary, a disadvantage with this study design was that no
causal indications could be detected.

6.1.1 Sample and data collection

A major limitation regarding this study was related to the study sample. Because the
sampling technique was not a random one, it was unlikely to be representative of the source
population. The fact that the link to the questionnaire was shared on the author of this
study’s Facebook page could further result in a non-representative sample. Those most active
on Facebook had the highest chance of seeing the post and answering the questionnaire,
compared to those least active on Facebook. Therefore, there may have been an
overrepresentation of people who are active on social media. The effects of this could have
been increased as the questionnaire only was available for a week; this could not be
prevented due to the limited timeframe. However, as these limitations were predicted, the
Facebook post was shared by several people, which might have both increased the number of
participants – and resulted in a broader representation of characteristics. Due to the COVID-
19 virus, sharing questionnaires on Facebook was deemed most appropriate. Moreover, the
sample size was small. As the Swedish adult population consists of about 8 250 000 people
(Statistics Sweden, 2020), the study sample of 153 people is only approximately 0.002% of
the total population. These two limitations regarding the study sample could affect the
results, and lead to misleading conclusions being drawn.

Further, no response rate could be calculated, as it was not possible to find out how many of
the available sample actually took part in the study. Hence, it could not be established to
which extent response bias occurred (Bruce et al., 2018). It is, however, reasonable to believe
that response bias occurred in this study. For example, people interested in the topic could
have been more willing to answer the questionnaire. Additionally, three quarters of the
sample were women, which is not in line with the source population – as half of the source
population are women (Statistics Sweden, 2020). An interesting observation was that two
participants indicated that they did not use social media, even though the target population
were Swedish adults with Facebook accounts – as the questionnaire was shared on Facebook.
The link to the questionnaire could for example have been sent by email, or shown otherwise,
to the participants, by someone who had seen the Facebook post.

24
6.1.2 Measures, processing of data, and analysis
A strength regarding this study was that most of the questions included in the questionnaire
came from previous studies, and thus, had been proven to have good reliability and validity
(Lemoine et al., 2018; Gattario & Frisén, 2019). However, some weaknesses also occurred.
Firstly, one of the response alternatives (several times a day) in the general social media
subscale was missing from the questionnaire. This could have resulted in a not entirely
representatively reporting of general social media usage. However, the missing alternative
indicated one of the most frequent usage, and the two response alternatives closest were once
a day and several times an hour. It could be argued that an answer indicating less usage
would affect the results to a greater extent, as these response alternatives had more time
elapsing between each alternative, for example between once a month, several times a
month, and once a week. Additionally, as the nine questions were created as a multiple-
choice grid, all questions had the same nine response alternatives (appendix B; appendix D).
As the nine questions were made into an index, higher values of the index still indicated
greater usage of social media. However, previous quality assessments was in this study
inaccurate, as the same response alternatives not were included. On the other hand, the
reliability assessment in this study indicated good reliability.

Secondly, the question regarding viewing of body positive content could be – although
adopted from previous research – considered to be leading. The question read “How often do
you currently view body positive content on social media in your everyday life?” and could be
perceived to suggest that viewing of body positive content is something desired. This could
have led to participants overreporting their viewing of body positive content, which could in
turn bias the results (Bruce et al., 2018). However, as previous research has shown that
viewing of body positive content improves body appreciation, it was not considered harmful,
as it perhaps could inspire participants to view this type of content. Thirdly, as the general
social media usage subscale and the question regarding viewing of body positive content were
in English, they had to be translated into Swedish – which could be viewed as a limitation.
The back-translation method was used, in an attempt to fully grasp the meaning of the
questions. However, having professional translators responsible for the translation could
possibly have improved the quality of the translation. As no translators were available, two
highly fluent both English- and Swedish speakers were consulted. Lastly, the body
appreciation scale did not include the exact wording as the original Swedish version, due to
ethical reasons. Thus, the reliability and validity assessment done by previous studies was not
applicable to this study. However, the reliability assessment performed in this study revealed
good reliability.

As some concepts in this study could be seen as ambiguous, unfamiliar, or difficult to grasp,
definitions of social media, body positive content, and body appreciation were included in the
questionnaire. In order to ensure an accurate measurement, including definitions in the
questionnaire is important (Bruce et al., 2018). Including definitions was done in order for
every participant to understand the concepts and in order to for them to answer the
questions based on the same understandings as everyone else participating. However, as
some definitions were complex, the participants could still have had difficulties grasping the
meaning of the concepts, which could have led to misleading results.

25
A strength of this study was that the data was not manually imported to IBM SPSS Statistics.
Thus, no errors due to the human factor were made. There were no variables with a
substantial amount of missing values. However, one of the variables with the most missing
values was age. This could be due to the fact that this question was the first one in the
questionnaire, and could perhaps be easily missed. Moreover, the questions included in the
general social media usage index had missing values, which could have been because it was
not an ideal fit in Google Forms. Because there were nine response alternatives to the
questions, participants had to scroll sideways in order to see all options, which could have
been seen as irritating. However, presenting the questions as a multiple-choice grid was
deemed as the best option, as the alternative – presenting each question on its own – would
have made the questionnaire seem lengthy, which is not favourable (Bruce et al., 2o18). On
the other hand, the multiple-choice grid could have been perceived as lengthy as it was, and
thus, have felt time-consuming to fill in. The missing values could likely have been avoided if
the questions were made obligatory. However, in order to ensure that participants did not
feel uncomfortable answering any question, no question was made obligatory.

The analyses conducted in this study were considered to be appropriate in order to answer
the research questions. However, a limitation was that when conducting correlational
analyses among men, data from only 34 to 35 participants were analysed, as only 35 men
answered the questionnaire. Had a larger sample of men been studied, the result might have
differed; furthermore, a regression analysis would have been possible to conduct. As only a
third of the sample size needed for a regression analysis was available among men, this was
not feasible. Moreover, viewing of body positive content was analysed as a confounding in the
regression analyses, although it might not be best described as a confounding factor, as it
could be on the causal pathway between social media usage (time spent on social media) and
body appreciation. More time spent on social media usage could reasonably lead to more
viewing of body positive content, which could affect body appreciation – or vice versa. Thus,
viewing of body positive content may be a moderator, which would mean that viewing of
body positive content could change the size of the relationship between social media usage
(time spent on social media) and body appreciation (Field, 2018). A strength was that a
regression analysis could be conducted among women, as the recommended sample size was
large enough solely among women. This might have led to results being closer to the truth
than if solely a regression analysis would have been conducted on the whole study sample.

6.1.3 Quality and ethical considerations

The external validity in this study was limited, due to several factors. First, there was no
random sample, and thus, the whole source population was likely not represented in the
study sample. Second, the sample size was small. Moreover, as the study design was cross-
sectional, data was gathered at one time-point. These three factors could contribute to the
results of this study not being generalisable to the target population, to different time-periods
and locations. Even though questions had been modified in both the index of general social
media usage and the index of body appreciation, both indexes had α values above 0.8, which
can be considered acceptable while assessing the reliability (Field, 2018). However, no other
indications of the reliability were done.

26
To increase the validity, the face validity of the questionnaire was assessed by asking two
peers how understandable, relevant and reasonable the questionnaire looked. Measures were
predominantly derived from previous research, as the construct validity in some measures
already had been tested. Some of the questions derived from previous research were however
modified, which limited the ability to state that the measures in this study were valid. It
would be unreasonable to believe that these questions would measure the exact same thing as
the original questions. For instance, the original questions that were written in English might
have a slightly different meaning in Swedish, even though effort was put to avoid this.
Further, as the wording of two questions were modified in the BAS-2 in Swedish, it could be
reasoned that the measure did not completely measure what it originally was intended to
measure. However, the original BAS-2 is a modification of the BAS and aimed to further
highlight body appreciation (Tylka & Wood-Barcalow, 2015b). The same reasoning was
considered when modifying BAS-2 in Swedish in the present study. The well-being of the
participants and the ethical aspects were valued higher than the validity of the measurement.

Regarding the ethical considerations, the potential disadvantage of participating mentioned

in the cover letter was that some questions could be perceived as sensitive. Making sure that
ethical standpoints are followed is a vital part of the research process (Swedish research
council, 2017). As the participants well-being was prioritised, the anonymity, confidentiality,
voluntariness, and the possibility to discontinue was highlighted in the cover letter.
Moreover, the question regarding gender could have been considered sensitive. Therefore,
three response alternatives were included, man, woman, and I do not identify as either man
or woman. No other alternatives were included in order to reassure that no participant could
be identified, as such alternatives were thought to be rare.

6.2 Result discussion

The participants in this study spent more time on social media compared to previous
research (Sherlock & Wagstaff, 2019). Moreover, the participants in this study had a lower
body appreciation compared to participants previously studied (Tylka & Wood-Barcalow,
2015b). As presented above, the results indicated that there may be a relationship between
social media usage and body appreciation. However, as social media usage was measured
using both time spent on social media and general social media usage, an ambiguity in the
results was seen, as it was shown that there was an association between time spent on social
media and body appreciation – but no relationship between general social media usage and
body appreciation. This was in line with previous findings, which have shown that the more
time spent on Instagram, the more body disturbance women experience (Sherlock &
Wagstaff, 2019). Furthermore, previous research has also shown an ambiguous view of the
association, as it has been shown that Facebook usage both is associated to body image
(Rutledge et al., 2013), and is not (Strubel et al., 2018). Previous research has suggested that
the time spent on social media might not be the most predictive factor of body image, but
rather how the time on social media is spent (Choukas-Bradley et al., 2019; Stein et al.,
2019). However, this suggestion could not be examined in this study.

27
The findings in this study – although statistically nonsignificant – suggested that men’s body
appreciation could be positively associated with social media usage. This would be in line
with previous research, which indicates that men do not struggle with body dissatisfaction to
the same extent as women do (Conner et al., 2004; Gonzaga et al., 2o19). However, the
findings among men in this study are not trustworthy, as the probability of arriving at the
wrong conclusion was considerably large. In order to make any conclusions about this,
studies including larger samples of men are needed. If a positive relationship would be
confirmed in larger studies, these results could perhaps be explained by higher levels of SOC
in the male participants, as high levels of SOC are related to weight satisfaction (Swan et al.,
2016). On the contrary, even though social media usage – time spent on social media – was
positively associated with body appreciation among men, high SOC is associated with lower
usage of smartphones for social interactions (Sharabi et al., 2016). However, as previously
mentioned, the present study did not identify the specific usage of social media.

When making stratified correlations, the results indicated that there was a positive –
although nonsignificant – relationship between social media usage (general social media
usage) and body appreciation in men, and no relationship in women. The fact that the results
also indicated that there was no relationship between social media usage (general social
media usage) and body appreciation in the total study sample was therefore because both
men and women were examined together. Similarly, in men, there was a small positive, yet
nonsignificant, relationship between social media usage (time spent on social media) and
body appreciation, while there in women was a medium negative relationship. The small
negative relationship between social media usage (time spent on social media) and body
appreciation in the total study sample was thus also due to the fact that men and women were
examined together. Thus, there could be a difference across genders. However, the total
sample size predominantly consisted of women and thus, distorted the results.

The regression analyses revealed that the negative association between social media usage
(time spent on social media) and body appreciation – seen in the correlation analyses and in
the first step of the two regression analyses – remained after controlling for confounding.
However, the results of the regression analysis conducted on the whole study sample
indicated that age, gender, viewing of body positive content, physical activity, and sedentary
lifestyle slightly confounded the relationship between social media usage (time spent on
social media) and body appreciation among the study sample. Age was positively associated
with body appreciation, thus, suggesting that older age was related to better body
appreciation. This was in line with previous research, as previous research has shown that
body appreciation increases with age (Halliway, 2015). An explanation to why this was could
be that SOC is developed fully around the age of 30, and that high levels of SOC is protective
against mental ill-health (Antonovsky, 1987; Hochwälder, 2013; Mato & Tsukasaki, 2017).
More physical activity and less sedentary lifestyles were associated with better body
appreciation, which was in line with previous research (Neumark-Sztainer, 2006). This could
also be explained by SOC, as high SOC is related to physical activity among adolescents, and
to weight satisfaction among adults (Moksnes et al., 2012; Swan et al., 2016). Using social
media could reasonably be associated with both physical activity and sedentary lifestyle,
which thus could affect SOC and body appreciation. Viewing of body positive content was
negatively associated with body appreciation –in contrast to previous research, which suggest

28
that this kind of content increases body appreciation, while other kind of content, like beauty
and fitness decreases body appreciation (Cohen et al., 2019; Sherlock & Wagstaff, 2019).
Those who had lower body appreciation might, for example, have been viewing body positive
content to a greater extent than those with higher body appreciation, in order to increase
their body appreciation, but because of the study design, this could not be revealed. However,
even though the model significantly improved the ability to predict body appreciation,
individually, these factors were statistically nonsignificant.

Further, the results also indicated that age, viewing of body positive content, physical activity,
and sedentary lifestyle slightly confounded the relationship between social media usage –
time spent on social media – and body appreciation among women. These factors had similar
influences on the relationship between social media usage (time spent on social media) and
body appreciation among the total study sample, with the difference being that physical
activity and sedentary lifestyle had larger effects on body appreciation solely among women,
while age and viewing of body positive content had slightly smaller effects on body
appreciation solely among women. The fact that viewing of body positive content was more
predictive of body appreciation among the whole study sample than solely among women,
although only slightly, was surprising, as the concept body positivity is aimed at women
(Tylka & Wood-Barcalow, 2015a). However, only physical activity was statistically
significantly associated to body appreciation, although the model statistically significantly
improved the ability to predict body appreciation.

Comparing the two regression analyses, it was established that the negative association
between social media usage (time spent on social media) and body appreciation was stronger
when conducted solely among women. However, looking at the correlation analyses, this was
explained by a completely different direction of the relationship across gender. The results do
not suggest that men’s body appreciation was better than women’s, merely that the more
time spent on social media, the better the body appreciation tended to be in men – and
poorer body appreciation in women. Further, it was not possible to conclude anything about
this, as the association in men was statistically nonsignificant, as there were only 35 men
participating in the study, and as no regression analysis could be performed among men.
Comparing men and women would not be fair, as an incomplete picture would be presented.

SOC could be argued to explain how well people manage stressors on social media and how
well they cope with demands present in these settings, as people with a high sense of
manageability are likely to be able to cope with such stimuli (Antonovsky, 1987). The
component meaningfulness could be argued to be linked to social media usage and body
appreciation. Perceived body image demands from social media settings, like beauty
standards and norms, could either be perceived as welcomed challenges, or burdens –
depending on the level of SOC. Receiving contradictory perspectives of body image in social
media could arguably lead to information being perceived as unstructured and inconsistent.
This could perhaps lower the sense of comprehensibility among people, which could
debatably be damaging for young adults who still have not fully developed SOC. However,
contradictory perspectives, like body positive content and beauty standards, could arguably
be less harmful to the well-being of young adults than solely viewing content related to norms
and beauty standards. As the results revealed that there was a negative association between

29
social media usage and body appreciation among women, the components of SOC could
arguably help in explaining this relationship; demands from social media could be perceived
as ambiguous and difficult to live up to, which could lead to difficulties in perceiving stimuli
as comprehensible and manageable, and thus, lead to negative effects on body appreciation.

6.2.1 Future research and practical implications

Future research on this topic could measure SOC to enable drawing conclusions based on
how SOC may explain this relationship. It would also be valuable to study the relationship
between social media usage and body appreciation using a larger, and random, sample than
used in this thesis, to enable drawing trustworthy conclusions and being able to generalise
results to larger populations. Future research could further study possible protective factors
of body appreciation to understand the effects these have. Additionally, research could focus
on examining the time spent on social media in order to enable giving practical advice based
on how much time could be spent on social media without risking the health of the users.
Public health professionals could benefit from the findings of this study, as the study shows a
negative relationship between social media usage and body appreciation among women.
Thus, interventions could be developed, targeting the usage of social media, which women
could benefit from. In this study, participants spent more time on social media and had lower
body appreciation compared to previous studies (Sherlock & Wagstaff, 2019; Tylka & Wood-
Barcalow, 2015b). Therefore, women, in particular, could benefit from decreasing the time
spent on social media. One strategy could be reaching out to schools, as this is an arena
where many young people can be reached, who have not yet fully developed their SOC. By
reaching out to young people, body appreciation might be promoted, and body dissatisfaction
might be prevented; by extension, mental health problems might be reduced. Moreover, a
strategy could be to encourage physical activity through social media, as physical activity was
associated with body appreciation. This could be especially suitable in a time of social
distancing, due to COVID-19, as people might spend more time in their homes and depend
on social media to uphold social interaction.

7 CONCLUSIONS
There was an ambiguity in the relationships between social media usage and body
appreciation; there was a negative relationship between social media usage (time spent on
social media) and body appreciation – however, there was no relationship between social
media usage (general social media usage) and body appreciation. The negative relationship
between social media usage (time spent on social media) and body appreciation was only
observed among women when analysing genders separately. After controlling for age, gender,
viewing of body positive content, physical activity, and sedentary lifestyle, there still was a
negative relationship between social media usage (time spent on social media) and body
appreciation.

30
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APPENDIX A; COVER LETTER
APPENDIX B; QUESTIONNAIRE

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APPENDIX C; COVER LETTER IN SWEDISH

1
APPENDIX D; QUESTIONNAIRE IN SWEDISH

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Box 883, 721 23 Västerås Tfn: 021-10 13 00
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