**2. The evolution of beauty standards**

The idea of a healthy and beautiful body underwent several changes throughout the ages. By the end of the Middle Ages the ideal feminine body emphasized its reproductive role with an underscoring of motherhood, as Botticelli's artistic representation of the *Birth of Venus* (1485) warrants. The beautiful and the desired female always featured a lady with a round body due to fat deposits in the waist, thighs, belly and breasts, round and full breasts (Castilho, 2001). Famines and lack of food were not infrequent during the period and a round-bodied female symbolized the strong woman with sufficient energy to face the vicissitudes of the time and protect her family (Almeida et al., 2005; Andrade & Bosi, 2003).

At the start of the 16th century any artifice to seek or enhance beauty was liable to punishment. Beauty was God's gift and the face should reveal the soul's innocence. Hands should be long, white and dainty, and tight corsets were mandatory so that the female bosom could be graceful and her body elegant. In the 17th century etiquette and body posing were highly appreciated. Moreover, beauty was the female's asset although male aesthetics distanced itself from the signs of power in which it was enmeshed. More radical changes of concepts occurred in the 18th century. Mirrors became popular and with them the possibility of observing the entire body, or rather, the body's profile, balance and movements, with a consequent increase in sensitiveness and awareness of one's own body. Walking was recommended by physicians so that one's posture could be strengthened and legs and arms mobilized (Vigarello, 2006).

In the 19th century other parts of the body began to be focused and notions of beauty limelighted shape and profile. Sales and use of cosmetics and make-ups increased throughout the century and the physical model of the female profile now comprised a tight waist and a puffed up bosom. The discovery of oxygen may have shown that large breasts symbolized life. By the end of the century while special emphasis was bequeathed to the legs, the beach was the site of leisure and rest (Vigarello, 2006).

The idealized female image of the beginning of the 20th century was represented by two opposite standards: the first one comprised an erotic profile which could be found in the finde-siècle cafés full of females exhibiting rounded contours and pronounced tights; the second revealed a slim and thin profile. The latter definitely supplanted the former and

Bulimia nervosa affects males and females, although the latter are more prone to the disease. This is due to the fact that women have more conflicts related to meals, weight and body shape. Conflicts indeed change the female adolescents' emotional state; in their turn, they present a distorted body image and low self-esteem (Affenito & Kerstetter, 1999; Gucciardi et al., 2004; Mond et al., 2004). Although many bulimic syndrome cases have been reported in young women under 18 years, the occurrence of such eating disorder is also on the increase in males (Affenito & Kerstetter, 1999; Alvarez-Rayon et al., 2009; Appolinário & Claudino, 2000; Costa et al., 2008; Gucciardi et al., 2004; Jauregui-Lobera et al., 2008;

Several authors report that patients with bulimic events are also highly concerned with weight gain. The patient is prone to use non-appropriate compensatory methods even twice a week. Self-evaluation of body image in these patients is greatly affected by societyidealized images of body shape and weight (Alvarez-Rayon et al., 2009; Cordás, 2004; Costa et al., 2008; Gucciardi et al., 2004; Jauregui-Lobera et al., 2008; Miranda, 2000; Pedrinola,

The idea of a healthy and beautiful body underwent several changes throughout the ages. By the end of the Middle Ages the ideal feminine body emphasized its reproductive role with an underscoring of motherhood, as Botticelli's artistic representation of the *Birth of Venus* (1485) warrants. The beautiful and the desired female always featured a lady with a round body due to fat deposits in the waist, thighs, belly and breasts, round and full breasts (Castilho, 2001). Famines and lack of food were not infrequent during the period and a round-bodied female symbolized the strong woman with sufficient energy to face the vicissitudes of the time and protect her family (Almeida et al., 2005; Andrade & Bosi, 2003). At the start of the 16th century any artifice to seek or enhance beauty was liable to punishment. Beauty was God's gift and the face should reveal the soul's innocence. Hands should be long, white and dainty, and tight corsets were mandatory so that the female bosom could be graceful and her body elegant. In the 17th century etiquette and body posing were highly appreciated. Moreover, beauty was the female's asset although male aesthetics distanced itself from the signs of power in which it was enmeshed. More radical changes of concepts occurred in the 18th century. Mirrors became popular and with them the possibility of observing the entire body, or rather, the body's profile, balance and movements, with a consequent increase in sensitiveness and awareness of one's own body. Walking was recommended by physicians so that one's posture could be strengthened and legs and arms

In the 19th century other parts of the body began to be focused and notions of beauty limelighted shape and profile. Sales and use of cosmetics and make-ups increased throughout the century and the physical model of the female profile now comprised a tight waist and a puffed up bosom. The discovery of oxygen may have shown that large breasts symbolized life. By the end of the century while special emphasis was bequeathed to the legs, the beach

The idealized female image of the beginning of the 20th century was represented by two opposite standards: the first one comprised an erotic profile which could be found in the finde-siècle cafés full of females exhibiting rounded contours and pronounced tights; the second revealed a slim and thin profile. The latter definitely supplanted the former and

Kaufman, 2000).

2002; Thompson & Chad, 2000).

mobilized (Vigarello, 2006).

was the site of leisure and rest (Vigarello, 2006).

**2. The evolution of beauty standards** 

advertisements featuring slim females became abundant. In fact, several massage methods were introduced to delete excesses in rounded profiles. It was during this period that a relationship between age, weight and height was established even though hard and fast rules were inexistent (Vigarello, 2006).

The end of the First World War brought about the female's plain and free shapes which displaced the erstwhile curve ideals. Women's wear of the 1920s abandoned the curvy outlines and corsets. Bodices were set aside. Since women started to support their breasts with vests that flattened their profile, during this period beauty was almost characterized by the absence of secondary female sexual traits. The female profile had an extended shape, legs were up for view and hairdressings were high (Castilho, 2001).

Fashion magazines of the 1920s demonstrated an association between professional life style and beauty care. Swimming became more frequent and dynamic moving half-naked bodies were exposed for anyone to look at and appreciate. Such a condition had an important influence on the concept of beauty since beauty became synonymous to a slim and muscular body with elegant and graceful movements. As a consequence, women started to maintain strict diets and extenuating physical exercises to decrease their body mass (Castilho, 2001; Vigarello, 2006).

In the wake of such a deep concern for weight loss the 1926 *New York Times* advertised that the New York Science Academy was calling a two-day conference to study "the explosion of food disturbances". Table 1 shows a 10-year historical series in which the ideal weight of women, height 1.60m, was suggested. The table below reveals the loss of weight trend according to the magazine *Votre Beauté*.


Table 1. Description of the ideal weight for women, height 1.60 m, at the beginning of the 20th century

Table 2 shows some measurements that the female figure, height 1.60 m, was expected to have in the 1930s, as described in the magazines *Votre Beauté* and *Marie Claire*. A trend had been introduced so that rates became smaller and smaller, corroborating the suggestion of progressive slimness (Vigarello, 2006). Progressive slimness of the female body throughout the ages may also be deduced from requirements on the agenda of Miss America Contest. In 1921 the Body Mass Index (BMI) of most of the candidates was 21.2 whereas in 1940 it decreased to 19.5. Specialized magazines exhibited the perfect body profile of film stars, and female editors were vying in giving counsels to the readers that all women may possess a


Table 2. Measurements of the female figure, height 1.60 m

Bulimia Nervosa and Dissatisfaction of Adolescent's Body Shape 89

amplify dissatisfaction with one's body, especially among children and young people

Since the two-year-old child is already self-aware of its identity and recognizes its body image reflected in the mirror, the body image may be developed concomitantly to the development of the human body (Castilho, 2001). As a rule, body images are dynamic, changeable and directly related to the outside world (Tavares, 2003). The distortion of body perception may occur when the subjects overestimate or underestimate their body size and form. Social and cultural influences, pressures by the social media and the continuous search for an ideal body standard associated with achievements and happiness are the main causes of changes in body image and cause deep dissatisfaction in individuals, especially in

Young people undergo constant psychological, emotional, somatic and cognitive changes which contribute towards deep concern with physical appearance and a craze for the ideal body (Tavares, 2003). The body dissatisfaction developed by adolescents may be related to changes in their self-image and self-esteem, coupled to excessive preoccupations with weight, body form and fat. The above alterations and concerns show that there is a discrepancy between the perception and the desire for a specific body size and shape which may predispose young people to develop psychological disorders (Almeida et al., 2005; Conti et al., 2010; Neumark-Sztainer et al., 2006; Smolak et al., 1999). Food intake, self-esteem and physical and cognitive performance depend on the intensity of this dissatisfaction and may be the cause

It should be underscored, however, that disturbances in body perception are not merely a trait proper to young people who develop some type of eating disorder (Branco et al., 2006). In fact, body dissatisfaction, excessive concern with weight and a history of restrictive diets during adolescence are predisposing factors for the development of eating disorder behaviour such as bulimia nervosa, anorexia nervosa and binge eating disorder (Stein, et al., 1998). The social media, parents and friends are accountable for social comparisons on the physical aspects and idealizing concepts of slimness. They are thus related with the development of body dissatisfaction and, consequently, with low self-esteem, limitations in psychological and social performance and depression conditions (Robinson et al., 2001;

The social media is accountable for food behaviour disorders or the body image. In fact, it not merely broadcasts images of perfect body forms but stimulates the intake of non-healthy food. Since magazines, films and advertisements publish images of young people with slim, muscular bodies, they induce individuals to establish an idea of beauty which is totally personal, characterized by unreachable aesthetic standards, in spite of all the diversity and

Whereas by the end of the 20th century, human manikins weighed 8% less than the average women at that time, currently they weigh 23% less. The difference may be associated with a decrease in the models' weight but also with women's weight gain in general. Body dissatisfaction, taken to be a standardized item in Western women, may be attributed to an increasing social and cultural pressure imposed by the social media in its portrayal of the ideal physical profile such as an unreal slimness for females and a muscular body for males (Becker et al., 2002; Rodin, et al., 1985; Stice et al., 2002). Such body image corresponds to

(Striegel-Moore et al., 2000, Striegel-Moore, 2001).

women (Conti et al., 2005a,b).

Sands & Wardle, 2003; Stice, et al., 2000).

singularity presented (Saikali et al., 2004).

**3. Aetiology and the establishment of body dissatisfaction** 

of altering several aspects in the subjects' life (Smolak & Levine, 2001).

beautiful body if discipline, physical culture and adequate diets were practiced. Their motto was that "there are no ugly women but women who do not take care of their body" (Vigarello, 2006). Make-up had a basic role during the first half of the 20th century. In fact, the female face was considered uncared for in its absence. Concern with cellulite and creases was followed by repairing and aesthetic surgeries (Vigarello, 2006).

Body cult from the 1950s onward became a rage and won an unprecedented social dimension. Democratization of the beauty stance was rife. The social media exerted a great influence on people, spread the craze for fashion, expanded the consumption of beauty products, broadcasted the changes that occurred in the bodies of famous people who underwent plastic surgery and idealized physical appearance as a basic factor in female and male identity (Castilho, 2001).

In 1960 publicity on beauty products and the like made up 60 to 70% of women's fashion magazines, or rather, the double of the number in the 1930s. Further, as from the 1960s, the male body underwent a slimming process and men started to be concerned more and more with their aesthetics. Simultaneously the start of the feminization of body building could be observed. Consequently, beauty was not a criterion restricted to define the female or the male gender since both sought to model their bodies on slimness and by athletic and defined shapes (Almeida et al., 2005; Andrade & Bosi, 2003; Ferriani et al., 2005; Oliveira & Bosi, 2003). Linear shapes became a warrant of efficiency, agility, elegance and flexibility.

Cosmetics, make-up, aesthetic surgery and physical exercises triggered men and women to have an attractive body profile. Excuses for such complaints as being "not according to the figure" were severely rejected. An ugly person is a person who wants to be ugly and only those who want to age will get old. The body figure is shown to be a personal success since "fat and unsightly subjects do not exist; only lazy ones do" (Castilho, 2001).

The above shows that people may adopt any strategy to have the body they desire, including extremely restrictive diets and abuse in anorexigenous drugs, laxatives and diuretics. The use of anabolic hormones, excessive physical activities and numberless surgeries for the correction of small body defects may be the subjects' strategies to have an adequate muscular mass.

A study undertaken in the state of São Paulo, Brazil, with men and women featuring normal weight showed that 50% were unsatisfied with their bodies and 67% of the females would undergo plastic surgery to have the body they desire. This information corroborates the fact that Brazil is second (after the USA) in the number of cosmetic plastic surgeries (Finger, 2003). Such dissatisfaction reveals that the feminine body's ideal is gradually distancing itself from current female profiles (Hesse-Biber et al., 1987).

The fact that the number of obese people has tremendously increased in Western countries, including Brazil, exemplifies the situation previously described. The main causes are mainly an increase in the intake of hypercaloric food with high saturated fat rates and a sedentary life style that triggered an increase in leisure and a decrease in physical activities (Schwartz & Brownell, 2004; Stettler, 2004). Whereas in general people have increased their body mass, the social media insists in broadcasting the progressively slim person. Thus, current beauty standards require slimmer anthropometric measurements (Morrison et al., 2004; Schwartz & Brownell, 2004).

Although the physical consequences of obesity have been adequately described, the psychological and social consequences require further investigation even though they have already been established in the literature (Fonseca & Matos, 2005). Body cult is directly associated with power, beauty and social mobility and thus an increase in body mass may

beautiful body if discipline, physical culture and adequate diets were practiced. Their motto was that "there are no ugly women but women who do not take care of their body" (Vigarello, 2006). Make-up had a basic role during the first half of the 20th century. In fact, the female face was considered uncared for in its absence. Concern with cellulite and creases

Body cult from the 1950s onward became a rage and won an unprecedented social dimension. Democratization of the beauty stance was rife. The social media exerted a great influence on people, spread the craze for fashion, expanded the consumption of beauty products, broadcasted the changes that occurred in the bodies of famous people who underwent plastic surgery and idealized physical appearance as a basic factor in female and

In 1960 publicity on beauty products and the like made up 60 to 70% of women's fashion magazines, or rather, the double of the number in the 1930s. Further, as from the 1960s, the male body underwent a slimming process and men started to be concerned more and more with their aesthetics. Simultaneously the start of the feminization of body building could be observed. Consequently, beauty was not a criterion restricted to define the female or the male gender since both sought to model their bodies on slimness and by athletic and defined shapes (Almeida et al., 2005; Andrade & Bosi, 2003; Ferriani et al., 2005; Oliveira & Bosi, 2003). Linear shapes became a warrant of efficiency, agility, elegance and flexibility. Cosmetics, make-up, aesthetic surgery and physical exercises triggered men and women to have an attractive body profile. Excuses for such complaints as being "not according to the figure" were severely rejected. An ugly person is a person who wants to be ugly and only those who want to age will get old. The body figure is shown to be a personal success since

The above shows that people may adopt any strategy to have the body they desire, including extremely restrictive diets and abuse in anorexigenous drugs, laxatives and diuretics. The use of anabolic hormones, excessive physical activities and numberless surgeries for the correction of small body defects may be the subjects' strategies to have an

A study undertaken in the state of São Paulo, Brazil, with men and women featuring normal weight showed that 50% were unsatisfied with their bodies and 67% of the females would undergo plastic surgery to have the body they desire. This information corroborates the fact that Brazil is second (after the USA) in the number of cosmetic plastic surgeries (Finger, 2003). Such dissatisfaction reveals that the feminine body's ideal is gradually distancing

The fact that the number of obese people has tremendously increased in Western countries, including Brazil, exemplifies the situation previously described. The main causes are mainly an increase in the intake of hypercaloric food with high saturated fat rates and a sedentary life style that triggered an increase in leisure and a decrease in physical activities (Schwartz & Brownell, 2004; Stettler, 2004). Whereas in general people have increased their body mass, the social media insists in broadcasting the progressively slim person. Thus, current beauty standards require slimmer anthropometric measurements (Morrison et al., 2004; Schwartz &

Although the physical consequences of obesity have been adequately described, the psychological and social consequences require further investigation even though they have already been established in the literature (Fonseca & Matos, 2005). Body cult is directly associated with power, beauty and social mobility and thus an increase in body mass may

was followed by repairing and aesthetic surgeries (Vigarello, 2006).

"fat and unsightly subjects do not exist; only lazy ones do" (Castilho, 2001).

itself from current female profiles (Hesse-Biber et al., 1987).

male identity (Castilho, 2001).

adequate muscular mass.

Brownell, 2004).

amplify dissatisfaction with one's body, especially among children and young people (Striegel-Moore et al., 2000, Striegel-Moore, 2001).
