The Media Effect: Implications for Manifesting Maintainable Body Image in the Context of Global Fashion Industry

*Arooj Rashid*

## **Abstract**

The media 'effect' on consumer behaviour has long been of interest to many researchers. In part, this has been related to how movies, magazines and television programmes portrayed thinness in the nineteenth and twentieth century, a concept which has been consistently emphasised and promoted to women, thus resulting in increased body dissatisfaction. Prior to the existence of media, a curvaceous body was considered as a sign of wealth and an ideal body image. More recently, with the emergence of the Internet, there has been increasing debate over portraying a healthier body image. However, no research to date has addressed the implications of manifesting a maintainable body image in the context of the global fashion industry. Thus, to fill this gap, qualitative ethnographic approach (netnography) of studying online behaviour and consumer perception was undertaken. The chapter briefly outlines the relevance of clothing and the evolution of the ideal body image over the last decade, indicating how the ideal body image has changed, but also shows how different media channels have had an effect using television and social media examples.

**Keywords:** media effect, promotion, body image, global fashion industry

## **1. Introduction**

The media effect on the ideal body image has been part of a key debate over the past decade. In part, this is because body image is related to body dissatisfaction and has been linked to several critical physical and mental health problems, such as depression, low self-esteem, bulimia and anorexia [1–3]. More recently, some studies have also started focusing on plus-size body shape, particularly with reference to the shopping experience; however, this study considers the implications for manifesting a maintainable body shape and image, supported by a series of examples based on the media channels and netnography using social media as the key medium of investigation.

## **2. Literature review: setting the scene—the changing roles of the ideal body image**

In this social world, clothing has been described as the second skin for a person, reflecting their social status, a concept that is prevalent throughout history [4].

When associated with a trend or fashion, it is described as a way of expressing a lifestyle that revolves around activities and interests and it relates to self-expression and covering of the body. The self-expression and covering of the body and the desire to have a body shape are influenced by a range of factors, such as cultural values, impacting on gender, age and social attitude, social norms [5] and media [6]. Furthermore, the desire for a particular body shape or views can also be described as a subjective matter, as everyone has different views and a liking for a particular shape. The views can change depending on the education, experience and understanding of a different lifestyle or the reading habits [7].

In the 1990s until 2010, print media and televised images were the key medium that started to have an increasing effect on the body image, describing thinness as attractive [4, 8]. For example, exposure to popular fashion magazines that contained messages focused on beauty and fashion (e.g. *Elle*, *Vogue*, and *InStyle*) was correlated with negative moods and higher body dissatisfaction in women [9]. Furthermore, even people in music videos, cartoon characters [10], movie and television actresses, *Playboy* centrefolds, and Miss America Pageant winners have all become increasingly thinner over the past decades [11–14], impacting young women's body dissatisfaction [15].

Consequently, much attention has been paid towards body image and its impact, particularly in the literature of health, fitness [16] and psychology [3, 8, 17]. In part, this is because body image is described as body dissatisfaction, a desire for thinness and muscularity, self-objectification and the use of more appearance comparisons than non-users [18]. Body image is thus linked to several critical physical and mental health problems, such as depression, low self-esteem, bulimia, anorexia, etc. [3, 19–21]. However, the media's manifesting of a maintainable body image is an under-researched area, in particular with reference to the global fashion industry. Therefore, supported by a series of case studies, qualitative interviews and netnography, this chapter will highlight how the media could manifest a maintainable body image and change consumers' perspective, thereby making a contribution to the literature of marketing and communication.

This chapter focuses on the two key mediums of television and the Internet (social media in particular), indicating how the ideal body image and shape have changed over the years and providing the implications for portraying a more maintainable body shape. The chapter is split into the following sections. Section 1 provides an overview of the chapter, highlighting the gap in the literature it seeks to fill, followed by the articulation of the objective. Section 2 reviews the existing literature with the aim of setting the scene regarding the changes and the recent developments that have occurred in the UK fashion industry. Following this, in Section 2, the ideal body shape in the fashion industry is analysed, starting with a historical overview of how curvaceous was once deemed ideal, followed by how thinness became the new ideal, thereby showing how a maintainable body shape is becoming a new trend in the fashion media. Section 3 discusses the methodology. Section 4 outlines the findings regarding the implications for manifesting a maintainable body image, supported by netnography. Finally, Section 5 concludes and discusses the limitations.

#### **2.1 Historical overview: evolution of the ideal body shape and the fashion industry**

The concept of the ideal body shape has changed significantly since the early 1900s [22] when a woman with curves was considered as having the ideal body shape. For example, Aphrodite, the goddess of sexual love and beauty, was often portrayed with curves. Furthermore, in the seventeenth and eighteenth centuries,

**159**

*The Media Effect: Implications for Manifesting Maintainable Body Image in the Context…*

wherein even older people began copying the trends of younger people.

Following this revolutionary change, the first great depression descended on the economic climate, and with this, the fashion changed, replacing flappers with feminine clothing. During this period, more developments were emerging, i.e. cinema and jazz music became the key source of entertainment. Advertisements in magazines and newspapers started to play an important role, making consumers more beauty conscious [29]. After World War II, many celebrities became iconic role models representing the iconic body shape, such as Marilyn Monroe, Jane Russell and Elizabeth Taylor, while other cultural phenomena such as the *Playboy* centrefold [30] also added to the portrayal of the curvaceous hourglass figure. However, the definition of the ideal body image and the media exposure has evolved significantly over the last two decades, particularly relating to body image and eating disturbance in women. Research has shown that media depictions have made a contribution to the current thin beauty ideal by manifesting 'attractive' females (i.e. models, actresses and pop stars). For example, in 2006, British clothing stores started stocking the waiflike size four, which was similar to the US size zero. Fashion retailers such as Banana Republic, initially owned by Gap, also started to advertise size zero clothes on their website in 2006. Furthermore, numerous studies have shown significant correlations between consuming fashion magazines and female body dissatisfaction and a desire for thinness [6, 9]. Tiggemann and Zaccardo [31] confirmed that mass media has been a powerful and pervasive force, and there is extensive research that indicates the link between media exposure and body dissatisfaction [32], supported by meta-analyses [33] and experimental evidence [34, 35]. Across these studies, there is reliable evidence of a

a curvaceous figure was also a sign of wealth and a luxurious lifestyle, as only those from a high-class society could afford complex and costly garments [23] and consume meat, milk and alcohol; only a small group of people were representatives of a high-class society. Meanwhile, those with a lower status often remained at home and did household work [24], surviving mainly on plain water, cereals and vegetables [4, 25]. Consequently, the plump figure at the time was considered as the 'ideal' body shape, with a round stomach being emphasised as a symbol of fertility [26]. Being pale-skinned also represented being rich, as the complexion indicated that people were provided with enough support to do the household work. In other words, women from the rich society could afford servants and/or maids, as opposed to those from the lower classes, who had to work in the sun. The ideal body during this middle age was idealised by the artists of the time [27], as there were no television and magazines at the time. For example, the Flemish painter Paul Rubens was the namesake for the term 'Rubenesque', meaning plump or rounded [28], as he often portrayed women with curvy body types. His contemporary paintings were widely appreciated, essentially because the large body shape represented wealth. To gain that body shape in reality, the corset became a popular undergarment among women in the western world from the late Renaissance until the twentieth century [22]. However, as society's views of a woman's body changed over time, so did the shape and the construction of the corset [22]. For instance, by the nineteenth century, the plump shape figure was replaced by a voluptuous hourglass figure. During this period, the S-bend corset became popular, which reached down the hips and thrust the bust forward. Thereafter, during the twentieth century, a very defined shift towards an increasingly young, athletic and slender body occurred. This shift emerged after the World War I. Women who worked during the war were becoming financially stable and sought social independence, which included driving cars, wearing skimpy dresses and makeup, drinking alcohol and smoking in public. The 1920s saw the rising trend of the flappers, and this reflected the shift towards the western world's desire for a slim physique [22]. This era was also marked as the rebellious 'youth revolutionary era',

*DOI: http://dx.doi.org/10.5772/intechopen.89239*

#### *The Media Effect: Implications for Manifesting Maintainable Body Image in the Context… DOI: http://dx.doi.org/10.5772/intechopen.89239*

a curvaceous figure was also a sign of wealth and a luxurious lifestyle, as only those from a high-class society could afford complex and costly garments [23] and consume meat, milk and alcohol; only a small group of people were representatives of a high-class society. Meanwhile, those with a lower status often remained at home and did household work [24], surviving mainly on plain water, cereals and vegetables [4, 25]. Consequently, the plump figure at the time was considered as the 'ideal' body shape, with a round stomach being emphasised as a symbol of fertility [26]. Being pale-skinned also represented being rich, as the complexion indicated that people were provided with enough support to do the household work. In other words, women from the rich society could afford servants and/or maids, as opposed to those from the lower classes, who had to work in the sun. The ideal body during this middle age was idealised by the artists of the time [27], as there were no television and magazines at the time. For example, the Flemish painter Paul Rubens was the namesake for the term 'Rubenesque', meaning plump or rounded [28], as he often portrayed women with curvy body types. His contemporary paintings were widely appreciated, essentially because the large body shape represented wealth. To gain that body shape in reality, the corset became a popular undergarment among women in the western world from the late Renaissance until the twentieth century [22]. However, as society's views of a woman's body changed over time, so did the shape and the construction of the corset [22]. For instance, by the nineteenth century, the plump shape figure was replaced by a voluptuous hourglass figure. During this period, the S-bend corset became popular, which reached down the hips and thrust the bust forward. Thereafter, during the twentieth century, a very defined shift towards an increasingly young, athletic and slender body occurred. This shift emerged after the World War I. Women who worked during the war were becoming financially stable and sought social independence, which included driving cars, wearing skimpy dresses and makeup, drinking alcohol and smoking in public. The 1920s saw the rising trend of the flappers, and this reflected the shift towards the western world's desire for a slim physique [22]. This era was also marked as the rebellious 'youth revolutionary era', wherein even older people began copying the trends of younger people.

Following this revolutionary change, the first great depression descended on the economic climate, and with this, the fashion changed, replacing flappers with feminine clothing. During this period, more developments were emerging, i.e. cinema and jazz music became the key source of entertainment. Advertisements in magazines and newspapers started to play an important role, making consumers more beauty conscious [29]. After World War II, many celebrities became iconic role models representing the iconic body shape, such as Marilyn Monroe, Jane Russell and Elizabeth Taylor, while other cultural phenomena such as the *Playboy* centrefold [30] also added to the portrayal of the curvaceous hourglass figure.

However, the definition of the ideal body image and the media exposure has evolved significantly over the last two decades, particularly relating to body image and eating disturbance in women. Research has shown that media depictions have made a contribution to the current thin beauty ideal by manifesting 'attractive' females (i.e. models, actresses and pop stars). For example, in 2006, British clothing stores started stocking the waiflike size four, which was similar to the US size zero. Fashion retailers such as Banana Republic, initially owned by Gap, also started to advertise size zero clothes on their website in 2006. Furthermore, numerous studies have shown significant correlations between consuming fashion magazines and female body dissatisfaction and a desire for thinness [6, 9]. Tiggemann and Zaccardo [31] confirmed that mass media has been a powerful and pervasive force, and there is extensive research that indicates the link between media exposure and body dissatisfaction [32], supported by meta-analyses [33] and experimental evidence [34, 35]. Across these studies, there is reliable evidence of a

*Promotion and Marketing Communications*

women's body dissatisfaction [15].

to the literature of marketing and communication.

When associated with a trend or fashion, it is described as a way of expressing a lifestyle that revolves around activities and interests and it relates to self-expression and covering of the body. The self-expression and covering of the body and the desire to have a body shape are influenced by a range of factors, such as cultural values, impacting on gender, age and social attitude, social norms [5] and media [6]. Furthermore, the desire for a particular body shape or views can also be described as a subjective matter, as everyone has different views and a liking for a particular shape. The views can change depending on the education, experience and

In the 1990s until 2010, print media and televised images were the key medium that started to have an increasing effect on the body image, describing thinness as attractive [4, 8]. For example, exposure to popular fashion magazines that contained messages focused on beauty and fashion (e.g. *Elle*, *Vogue*, and *InStyle*) was correlated with negative moods and higher body dissatisfaction in women [9]. Furthermore, even people in music videos, cartoon characters [10], movie and television actresses, *Playboy* centrefolds, and Miss America Pageant winners have all become increasingly thinner over the past decades [11–14], impacting young

Consequently, much attention has been paid towards body image and its impact,

particularly in the literature of health, fitness [16] and psychology [3, 8, 17]. In part, this is because body image is described as body dissatisfaction, a desire for thinness and muscularity, self-objectification and the use of more appearance comparisons than non-users [18]. Body image is thus linked to several critical physical and mental health problems, such as depression, low self-esteem, bulimia, anorexia, etc. [3, 19–21]. However, the media's manifesting of a maintainable body image is an under-researched area, in particular with reference to the global fashion industry. Therefore, supported by a series of case studies, qualitative interviews and netnography, this chapter will highlight how the media could manifest a maintainable body image and change consumers' perspective, thereby making a contribution

This chapter focuses on the two key mediums of television and the Internet (social media in particular), indicating how the ideal body image and shape have changed over the years and providing the implications for portraying a more maintainable body shape. The chapter is split into the following sections. Section 1 provides an overview of the chapter, highlighting the gap in the literature it seeks to fill, followed by the articulation of the objective. Section 2 reviews the existing literature with the aim of setting the scene regarding the changes and the recent developments that have occurred in the UK fashion industry. Following this, in Section 2, the ideal body shape in the fashion industry is analysed, starting with a historical overview of how curvaceous was once deemed ideal, followed by how thinness became the new ideal, thereby showing how a maintainable body shape is becoming a new trend in the fashion media. Section 3 discusses the methodology. Section 4 outlines the findings regarding the implications for manifesting a maintainable body image, supported by netnography. Finally, Section 5 concludes and

**2.1 Historical overview: evolution of the ideal body shape and the fashion** 

The concept of the ideal body shape has changed significantly since the early 1900s [22] when a woman with curves was considered as having the ideal body shape. For example, Aphrodite, the goddess of sexual love and beauty, was often portrayed with curves. Furthermore, in the seventeenth and eighteenth centuries,

understanding of a different lifestyle or the reading habits [7].

**158**

discusses the limitations.

**industry**

small-to-moderate negative effect of the thinness ideal portrayed within magazines and television programmes. More recent correlational research has established a similar link between time spent on the Internet and body dissatisfaction in adult and adolescent women [16, 36–38].

The present study focuses on exposure to television and social media (Facebook and Instagram), indicating the implications for manifesting a maintainable body shape.

#### **2.2 The television industry**

In the literature on communication and psychology, many researchers have shown increasing interest towards television viewing, particularly concerning gender views [34, 39, 40] and its impact on eating disorders [41]. For example, Wille et al. [39] examined television viewing, fat stereotyping and body shape standards and suggested that because young children are more likely than adolescents or adults to model viewed behaviour, it is reasonable to expect that young children would model the ideal body shape they observe on television. On the other hand, Botta [42] examined television images and adolescents' views and suggested that the existence of the ideal thin body shape does have an impact on television viewers. In part, adolescents are prone to be more vulnerable to the thin-promoting messages because they are at a time in their lives when they may be seeking outside information to form a self-identity [21, 43].

Furthermore, the literature on promotion and communication also looks into commercialisations [44] and reality shows, suggesting how the television and film industry can be driven by commercialisations and entertainment content such as television programmes [44, 45]. Vazquez et al. [44] denote that characters in commercials and/or hosts and characters in reality shows often become celebrities in their own right and celebrities are a popular means of promoting fashion products such as lifestyle trends and beauty or clothing products, e.g. Piers Morgan on *Good Morning Britain* and the characters of *Love Island*. Adding to this, Manwaring [46] contributes how, in 2010, Heidi Montag of *The Hills* discussed her plastic surgery procedure in one of the *Time Magazine* interviews, highlighting how she used to bring pictures of movie stars to the plastic surgeon to request a body part to be made. More recently, in *Good Morning Britain*, the actress Katie Price revealed she had received 16 surgeries, which can be considered an addition. In addition, on November 8, 2018, *Good Morning Britain* portrayed a show where a plus-size woman modelled some lingerie. In the show, the reality show star Helen Wood suggested that models should be skinny. However, no research to date has explored the implications of manifesting a maintainable body shape.

This section focused on television, particularly reality shows. The next section will focus on social media, due to the number of bloggers promoting a healthy lifestyle.

#### **2.3 The social media effect**

Previously, many authors have shown increasing interest towards airbrushing and the computerised edited photos displayed in magazines and television advertisements [23] and their impact on young women [18, 38, 47]. Recently, several authors have suggested that Facebook should be deemed as one of the most popular social media platforms for young women [18, 38], who tend to spend around 2 h per day on Facebook. Social media sites Facebook and Instagram are particularly known to impact young women because they allow users to create public and/or semipublic personal profiles by providing their information and uploading their photos [48]. These two sites are also known for allowing users to edit their photos; for example,

**161**

*The Media Effect: Implications for Manifesting Maintainable Body Image in the Context…*

Instagram has several filtering options, which users can use before uploading a photo or video [16, 38]. The filtering option and the opportunity to 'like' and make comments on the photo have resulted in individuals feeling the pressure to enhance the photo prior to displaying it, which has implications for social comparison and self-presentation [49, 50]. Social presentation is a process derived from the evaluative presence of other people and other viewers. In other words, individuals compare themselves with the cultural ideal of beauty and thinness presented in the

However, this social presentation can also have a positive effect, particularly when many fitness and lifestyle bloggers are trying to make a positive impact, such as Carly Rowena, Lazy Girl Running and Kayla Itsines, promoting ways to remain healthy yet making it seem fun. Furthermore, some authors have also started to show interest in the effect of plus-size models displayed in the media [52], finding how viewers consider plus-size to be more realistic as opposed to the ideal thin body shape. However, manifesting a maintainable body image in the media remains as an under-researched area, particularly as displaying plus-size models on television is starting to increase

To investigate the media's effect on consumer attitude and preferences towards a maintainable body image, this study took an ethnographic approach of studying online behaviour, described by Kozinets [53] as 'netnography' [54]. Netnography applies ethnographic approaches to online behaviour, drawing on publicly accessible online social interactions in the same way that an ethnographer observes human behaviour in the field [53]. In other words, it refers to studying and understanding the consumption-related aspects of customers' lives online [53, 55]. Similar approaches have been used previously in qualitative studies of online health-related discussion boards. The sampling framework was consumers' interaction and engagement on social media platforms, reading a large number of comments expressing a range of reactions to changes in body shape and images posted on Facebook (FB) and/or Instagram (IG), particularly focusing on online pure-play retailers, plus-size clothing retailers, sport brands and international online retailers. Other sources, such as Good Morning Britain and BBC, were also observed on the social media platforms to examine whether consumers had similar responses or whether they differed. Populations from which social media research data are drawn cannot be generalised. Accordingly, it should be acknowledged that views expressed on social media platforms are those of the general audience, representing a wide range of audience that either finds the body shape negative or positive, empowering the society. In doing so, it was deemed important to observe how many comments were made and how frequently certain reactions were made by the consumers in order to identify how a post and an image on the media affected the audience. To generate a manageable data sample, there was a pragmatic need for three body shapes or images that the study could focus on. Thus, using an opportunistic approach [54], this study focused on three key body shapes: 'super-skinny', 'plus-size' and 'fitness built body shape'. Fitness built body shape particularly focused on the body shape and size that can be managed after childbirth or similar. To attain a maintainable body shape, fitness routine is imperative, as is healthy food intake, etc., and this is very rarely promoted on the media including social media unless a personal trainer has created a personal brand and has numerous followers on Instagram and social media.

In terms of the choice of social media platform, Facebook was deemed important because numerous sources [54] have indicated that there are about 2.41 billion

media, which can result in dissatisfaction with their own body [51].

the debate on unhealthy body figures and consumers' lack of preference.

*DOI: http://dx.doi.org/10.5772/intechopen.89239*

**3. Methodology**

#### *The Media Effect: Implications for Manifesting Maintainable Body Image in the Context… DOI: http://dx.doi.org/10.5772/intechopen.89239*

Instagram has several filtering options, which users can use before uploading a photo or video [16, 38]. The filtering option and the opportunity to 'like' and make comments on the photo have resulted in individuals feeling the pressure to enhance the photo prior to displaying it, which has implications for social comparison and self-presentation [49, 50]. Social presentation is a process derived from the evaluative presence of other people and other viewers. In other words, individuals compare themselves with the cultural ideal of beauty and thinness presented in the media, which can result in dissatisfaction with their own body [51].

However, this social presentation can also have a positive effect, particularly when many fitness and lifestyle bloggers are trying to make a positive impact, such as Carly Rowena, Lazy Girl Running and Kayla Itsines, promoting ways to remain healthy yet making it seem fun. Furthermore, some authors have also started to show interest in the effect of plus-size models displayed in the media [52], finding how viewers consider plus-size to be more realistic as opposed to the ideal thin body shape. However, manifesting a maintainable body image in the media remains as an under-researched area, particularly as displaying plus-size models on television is starting to increase the debate on unhealthy body figures and consumers' lack of preference.

## **3. Methodology**

*Promotion and Marketing Communications*

and adolescent women [16, 36–38].

tion to form a self-identity [21, 43].

**2.3 The social media effect**

implications of manifesting a maintainable body shape.

**2.2 The television industry**

shape.

small-to-moderate negative effect of the thinness ideal portrayed within magazines and television programmes. More recent correlational research has established a similar link between time spent on the Internet and body dissatisfaction in adult

The present study focuses on exposure to television and social media (Facebook and Instagram), indicating the implications for manifesting a maintainable body

In the literature on communication and psychology, many researchers have shown increasing interest towards television viewing, particularly concerning gender views [34, 39, 40] and its impact on eating disorders [41]. For example, Wille et al. [39] examined television viewing, fat stereotyping and body shape standards and suggested that because young children are more likely than adolescents or adults to model viewed behaviour, it is reasonable to expect that young children would model the ideal body shape they observe on television. On the other hand, Botta [42] examined television images and adolescents' views and suggested that the existence of the ideal thin body shape does have an impact on television viewers. In part, adolescents are prone to be more vulnerable to the thin-promoting messages because they are at a time in their lives when they may be seeking outside informa-

Furthermore, the literature on promotion and communication also looks into commercialisations [44] and reality shows, suggesting how the television and film industry can be driven by commercialisations and entertainment content such as television programmes [44, 45]. Vazquez et al. [44] denote that characters in commercials and/or hosts and characters in reality shows often become celebrities in their own right and celebrities are a popular means of promoting fashion products such as lifestyle trends and beauty or clothing products, e.g. Piers Morgan on *Good Morning Britain* and the characters of *Love Island*. Adding to this, Manwaring [46] contributes how, in 2010, Heidi Montag of *The Hills* discussed her plastic surgery procedure in one of the *Time Magazine* interviews, highlighting how she used to bring pictures of movie stars to the plastic surgeon to request a body part to be made. More recently, in *Good Morning Britain*, the actress Katie Price revealed she had received 16 surgeries, which can be considered an addition. In addition, on November 8, 2018, *Good Morning Britain* portrayed a show where a plus-size woman modelled some lingerie. In the show, the reality show star Helen Wood suggested that models should be skinny. However, no research to date has explored the

This section focused on television, particularly reality shows. The next section will focus on social media, due to the number of bloggers promoting a healthy lifestyle.

Previously, many authors have shown increasing interest towards airbrushing and the computerised edited photos displayed in magazines and television advertisements [23] and their impact on young women [18, 38, 47]. Recently, several authors have suggested that Facebook should be deemed as one of the most popular social media platforms for young women [18, 38], who tend to spend around 2 h per day on Facebook. Social media sites Facebook and Instagram are particularly known to impact young women because they allow users to create public and/or semipublic personal profiles by providing their information and uploading their photos [48]. These two sites are also known for allowing users to edit their photos; for example,

**160**

To investigate the media's effect on consumer attitude and preferences towards a maintainable body image, this study took an ethnographic approach of studying online behaviour, described by Kozinets [53] as 'netnography' [54]. Netnography applies ethnographic approaches to online behaviour, drawing on publicly accessible online social interactions in the same way that an ethnographer observes human behaviour in the field [53]. In other words, it refers to studying and understanding the consumption-related aspects of customers' lives online [53, 55]. Similar approaches have been used previously in qualitative studies of online health-related discussion boards. The sampling framework was consumers' interaction and engagement on social media platforms, reading a large number of comments expressing a range of reactions to changes in body shape and images posted on Facebook (FB) and/or Instagram (IG), particularly focusing on online pure-play retailers, plus-size clothing retailers, sport brands and international online retailers. Other sources, such as Good Morning Britain and BBC, were also observed on the social media platforms to examine whether consumers had similar responses or whether they differed.

Populations from which social media research data are drawn cannot be generalised. Accordingly, it should be acknowledged that views expressed on social media platforms are those of the general audience, representing a wide range of audience that either finds the body shape negative or positive, empowering the society.

In doing so, it was deemed important to observe how many comments were made and how frequently certain reactions were made by the consumers in order to identify how a post and an image on the media affected the audience. To generate a manageable data sample, there was a pragmatic need for three body shapes or images that the study could focus on. Thus, using an opportunistic approach [54], this study focused on three key body shapes: 'super-skinny', 'plus-size' and 'fitness built body shape'. Fitness built body shape particularly focused on the body shape and size that can be managed after childbirth or similar. To attain a maintainable body shape, fitness routine is imperative, as is healthy food intake, etc., and this is very rarely promoted on the media including social media unless a personal trainer has created a personal brand and has numerous followers on Instagram and social media.

In terms of the choice of social media platform, Facebook was deemed important because numerous sources [54] have indicated that there are about 2.41 billion monthly active users as of the second quarter of 2019, with Facebook being the largest social network worldwide. Active users are those who have logged in on Facebook and have carried out the following activities: follow a group or organisation, 55% of US baby boomers and senior survey respondents followed a group or organisation in 2013, and 40% of those respondents posted and watched videos [56]. Statistics from 2017 [57] indicate that 40.7% of users accessed Facebook to communicate with a group. A group can involve a TV programme, BBC news and other pages related to world affairs. Communication with the group is the largest factor for this study, as this is where the data is generated from. However, another activity that also contributed towards generating the findings was 'read, watch and share news about the world', with 52.03% of users logging in on Facebook and carrying out this activity as per 2017 statistics [58].

Instagram was another social media platform that was chosen to observe online behaviour using the netnography approach, with about 60 million photos being uploaded to Instagram every day [59]. Instagram was deemed as a useful platform as this new digital environment has especially empowered women to market themselves as brands. Furthermore, the most important aspect is the extensive growth of fitness bloggers manifesting fitness routines (i.e. Carly Rowena, Lazy Girl Running) and the increasing exposure of fashion brands using plus-size models, i.e. Boohoo, JD Williams, Shein, Next, etc. Using a diverse range of primary social sites ensured the availability of triangulated perspectives that also delivered data on the convergence and divergence of a maintainable body image [1, 60].

The data were then thematically evaluated using the template analysis method [61], observing online pure-play retailer, sport retailers, plus-size fashion brand and an American fashion retailer. Meanwhile, the content analysis approach was dismissed, which involves counting the amount of time frequency of a variable or a word that occurs and is considered useful when identifying the similarities and differences within the structure of the research subject [62]. As a result, the data for this study were evaluated through a systematic recognition of themes or meaning patterns, which is referred to by [61] as a *meaning-making process*. Due to reasons of confidentially, posts that were observed have not been identified [63].

### **4. Findings**

This section will present the findings concerning consumers' perspectives on various body shapes and the implications for maintaining a body image, using information drawn from the netnography that involved observing Facebook and Instagram. The findings are structured in these two themes: manifesting plus-size body image and the portrayal and effect of skinny models; however, more results and findings can be found in Appendix 1.

#### **4.1 Manifesting plus-size body image**

As mentioned in Section 3.4, social presentation involves individuals comparing themselves with the culturally ideal body shape, which has previously been associated with 'thin', resulting in individuals with dissatisfaction towards their own body. From observing the social media platforms, it appears that fashion industry has actively started producing product lines that are tailored for the plus-size market but has also started promoting plus-size models on social media, e.g. Boohoo, Very and JD Williams. However, plus-size clothing and models are yet not promoted as frequently as skinny models are; for example, on Instagram (IG), Boohoo only posts 2 or 3 photos of plus-size out of 31 or more photos posted in a week's turnaround.

**163**

*The Media Effect: Implications for Manifesting Maintainable Body Image in the Context…*

argued that 'the fashion industry can not neglect the plus size'.

'She is beautiful, this would suit my curves' (IG, 2019).

(FB, 2018) and would have been referred to as such by many.

inspiring to get the health back on track'.

**4.2 The portrayal and effect of skinny models**

post, and some have had no comments at all.

mantra of 'nothing tastes as good as skinny feels' far too far.

associating this with obesity.

social media.

From the netnography it is evident that promoting plus-sizes on social media is done for positive reasoning, for example, a female respondent on social media

Furthermore, throughout history, the plus-size body shape has been considered as the ideal body shape and one that represented wealth. However, from the findings it is evident that this is no longer the case in the current society. For example, the posts on social media appear to be fostering debate about how plus-size is associated with being unhealthy and obese, e.g. a male respondent on Facebook stated that 'big is beautiful is a deluded phrase and that plus-size can lead to stroke diseases and cancer' (FB, 2018). Another female respondent has also stated on a different Instagram photo that 'obesity is unhealthy and promoting it is irresponsible' (IG, 2019). While some comments are also empowering, i.e. 'She is nailing it', and

In contrast to the negative comments, another female respondent argued to a post on social media platform stating 'plus-size is not obese but an average size of a women; however, the fashion industry is compelled to use this terminology as anorexia size is deemed to be average' (FB, 2018). This indicates how the use of the terminology 'plus-size', 'unedited' and clothing' can create a buzz on

Further buzz was spotted on social media when a fashion online pure-play retailer was slammed for photoshopping and adding using 'butt pads' on models in 2018 to promote its plus-size collection. Comments were mainly related to 'how the image represented a plus-size, even though the model was fairly slim or skinny'

In another social media news, a sport brand was accused recently by the journalist for promoting obesity using a plus-size mannequin. The general public defended the fashion brand by stating on social media platform 'that the marketing reflects their body' and 'Happy that the brand is doing this for normal people like myself,

Furthermore, more comments were made relating to how rather than individuals supporting plus-size, they could perhaps encourage a fitness regime. A similar debate rose on September 20, 2018, when the host Piers Morgan criticised that '*Cosmopolitan* was promoting dangerous and wrong image' by manifesting an American model who weighed around 300 lbs (21.4 st) and was a US size 22 [64],

Since the 1990s, with the discovery of Kate Moss, the fashion industry has been extensively involved in promoting skinny models. Over the years, the trend of skinny has led to an impact on younger girls and women, who have taken her

More recently, the fashion industry has started making some effort by taking the action of banning super-skinny models in some countries. For example, France banned anyone with a body mass index (BMI) below a certain level from working as a model. Posts related to this generally received positive feedback on Facebook. For example, an individual on Facebook commented, 'Thank god we need to see healthy women on the runways' (FB, 2015). However, majority of the posts relating to France banning super-skinny models have not received as many comments as would a post on social media manifesting a negative image or an image that is not generally approved by the general public. For example, the majority of the posts relating to France banning super-skinny models have only had a few individuals sharing the

*DOI: http://dx.doi.org/10.5772/intechopen.89239*

#### *The Media Effect: Implications for Manifesting Maintainable Body Image in the Context… DOI: http://dx.doi.org/10.5772/intechopen.89239*

From the netnography it is evident that promoting plus-sizes on social media is done for positive reasoning, for example, a female respondent on social media argued that 'the fashion industry can not neglect the plus size'.

Furthermore, throughout history, the plus-size body shape has been considered as the ideal body shape and one that represented wealth. However, from the findings it is evident that this is no longer the case in the current society. For example, the posts on social media appear to be fostering debate about how plus-size is associated with being unhealthy and obese, e.g. a male respondent on Facebook stated that 'big is beautiful is a deluded phrase and that plus-size can lead to stroke diseases and cancer' (FB, 2018). Another female respondent has also stated on a different Instagram photo that 'obesity is unhealthy and promoting it is irresponsible' (IG, 2019). While some comments are also empowering, i.e. 'She is nailing it', and 'She is beautiful, this would suit my curves' (IG, 2019).

In contrast to the negative comments, another female respondent argued to a post on social media platform stating 'plus-size is not obese but an average size of a women; however, the fashion industry is compelled to use this terminology as anorexia size is deemed to be average' (FB, 2018). This indicates how the use of the terminology 'plus-size', 'unedited' and clothing' can create a buzz on social media.

Further buzz was spotted on social media when a fashion online pure-play retailer was slammed for photoshopping and adding using 'butt pads' on models in 2018 to promote its plus-size collection. Comments were mainly related to 'how the image represented a plus-size, even though the model was fairly slim or skinny' (FB, 2018) and would have been referred to as such by many.

In another social media news, a sport brand was accused recently by the journalist for promoting obesity using a plus-size mannequin. The general public defended the fashion brand by stating on social media platform 'that the marketing reflects their body' and 'Happy that the brand is doing this for normal people like myself, inspiring to get the health back on track'.

Furthermore, more comments were made relating to how rather than individuals supporting plus-size, they could perhaps encourage a fitness regime. A similar debate rose on September 20, 2018, when the host Piers Morgan criticised that '*Cosmopolitan* was promoting dangerous and wrong image' by manifesting an American model who weighed around 300 lbs (21.4 st) and was a US size 22 [64], associating this with obesity.

#### **4.2 The portrayal and effect of skinny models**

Since the 1990s, with the discovery of Kate Moss, the fashion industry has been extensively involved in promoting skinny models. Over the years, the trend of skinny has led to an impact on younger girls and women, who have taken her mantra of 'nothing tastes as good as skinny feels' far too far.

More recently, the fashion industry has started making some effort by taking the action of banning super-skinny models in some countries. For example, France banned anyone with a body mass index (BMI) below a certain level from working as a model. Posts related to this generally received positive feedback on Facebook. For example, an individual on Facebook commented, 'Thank god we need to see healthy women on the runways' (FB, 2015). However, majority of the posts relating to France banning super-skinny models have not received as many comments as would a post on social media manifesting a negative image or an image that is not generally approved by the general public. For example, the majority of the posts relating to France banning super-skinny models have only had a few individuals sharing the post, and some have had no comments at all.

*Promotion and Marketing Communications*

carrying out this activity as per 2017 statistics [58].

gence and divergence of a maintainable body image [1, 60].

confidentially, posts that were observed have not been identified [63].

monthly active users as of the second quarter of 2019, with Facebook being the largest social network worldwide. Active users are those who have logged in on Facebook and have carried out the following activities: follow a group or organisation, 55% of US baby boomers and senior survey respondents followed a group or organisation in 2013, and 40% of those respondents posted and watched videos [56]. Statistics from 2017 [57] indicate that 40.7% of users accessed Facebook to communicate with a group. A group can involve a TV programme, BBC news and other pages related to world affairs. Communication with the group is the largest factor for this study, as this is where the data is generated from. However, another activity that also contributed towards generating the findings was 'read, watch and share news about the world', with 52.03% of users logging in on Facebook and

Instagram was another social media platform that was chosen to observe online behaviour using the netnography approach, with about 60 million photos being uploaded to Instagram every day [59]. Instagram was deemed as a useful platform as this new digital environment has especially empowered women to market themselves as brands. Furthermore, the most important aspect is the extensive growth of fitness bloggers manifesting fitness routines (i.e. Carly Rowena, Lazy Girl Running) and the increasing exposure of fashion brands using plus-size models, i.e. Boohoo, JD Williams, Shein, Next, etc. Using a diverse range of primary social sites ensured the availability of triangulated perspectives that also delivered data on the conver-

The data were then thematically evaluated using the template analysis method [61], observing online pure-play retailer, sport retailers, plus-size fashion brand and an American fashion retailer. Meanwhile, the content analysis approach was dismissed, which involves counting the amount of time frequency of a variable or a word that occurs and is considered useful when identifying the similarities and differences within the structure of the research subject [62]. As a result, the data for this study were evaluated through a systematic recognition of themes or meaning patterns, which is referred to by [61] as a *meaning-making process*. Due to reasons of

This section will present the findings concerning consumers' perspectives on various body shapes and the implications for maintaining a body image, using information drawn from the netnography that involved observing Facebook and Instagram. The findings are structured in these two themes: manifesting plus-size body image and the portrayal and effect of skinny models; however, more results

As mentioned in Section 3.4, social presentation involves individuals comparing themselves with the culturally ideal body shape, which has previously been associated with 'thin', resulting in individuals with dissatisfaction towards their own body. From observing the social media platforms, it appears that fashion industry has actively started producing product lines that are tailored for the plus-size market but has also started promoting plus-size models on social media, e.g. Boohoo, Very and JD Williams. However, plus-size clothing and models are yet not promoted as frequently as skinny models are; for example, on Instagram (IG), Boohoo only posts 2 or 3 photos of plus-size out of 31 or more photos posted in a week's turnaround.

**162**

**4. Findings**

and findings can be found in Appendix 1.

**4.1 Manifesting plus-size body image**

On the one hand, Instagram appears to have more actively engaging customers, criticising or making comments about skinny models, by making comments such as 'does it come with a body to match', 'I better look like this in it or I'll be fuming', 'I have stuck to the diet 2 days now', and 'Why don't I look like this' (IG, 2019). These comments were particularly made under pictures with models wearing bikini.

Furthermore, the maintainable body shape is often found to be questionable as it is not clear whether it relates more closely to a plus-size or super-skinny. However, there are many fitness influencers who are now trying to promote a healthy lifestyle and a maintainable body shape suggesting different fitness routines e.g. squads and other legs work out, followed by some empowering comments e.g. 'Need to build my strength to rock this!!' (IG, 2018), This is awesome I am just starting my fitness journey and seeing your post gave me the extra kick, I need too stick to it! (IG, 2017). On the other hand, some influencers are also trying to promote 'being confident in embracing the curves', which could be due to several reasons, e.g. postpartum and hormones, while empowering them to try staying healthy by fitness routines. This is also deemed to contribute towards mind and soul.

By observing the social media platform, it is has emerged that these influencers are not only promoting a fitness routine but are also suggesting how one should feel confident about their body shape, manifesting maintainable body shape and image. For example, a UK London-based fitness trainer 'Carly Rowena' often posts stories on Instagram about 'how people should do as they feel and how they should feel confident about their body shape and skin' (IG Story, 2019). Furthermore, the comments made under the personal blog are also fairly positive, encouraging and empowering and, thus, indicating the influence of a personal brand on consumers as opposed to clothing brands.

Another known fitness trainer 'Kayla Itsines' is an Australian blogger with many followers, who promotes the emotional rollercoaster one may go through when trying to maintain a lifestyle and body shape after giving birth. Their posts are followed by many positive comments and baby posts by other individuals, spreading words of wisdom and positivity.

## **5. Conclusion and discussion**

The focus of this chapter was on the implications of manifesting a maintainable body shape in the global fashion industry. The data was drawn focusing on two. Each channel is supported by data analysed using netnography, drawing information from comments made in the online communities on Facebook and Instagram.

The study particularly focused on the two body shapes of plus-size and skinny models. In part, this was important, as skinny models were traditionally preferred in the global fashion industry, whereas now plus-size models are being more frequently promoted.

Based on the findings drawn from social media platforms, it is evident that some consumers on online communities are not fully happy with the promotion of plus-size model, even if a fashion brand shares only so often, e.g. one photo a week. While many health studies have identified how being overweight can be due to health issues such as hormones or DNA, comments on social media indicate that this should not be manifested on the mass media as this may not be a true representation or a maintainable body shape, contradicting previous studies that argued similarly about thinness [33–35] (see **Figure 1** as an example). From a brand's perspective, it can be assumed that due to consumer's critics and comments

**165**

and clothing.

**Figure 1.**

*The Media Effect: Implications for Manifesting Maintainable Body Image in the Context…*

related to health issues and obesity, fashion brands are pushed to share only limited photos on plus-size or using slimmer models to promote plus-size clothing, which is also resulting in complaints and shaming the media. However, these results vary depending on the type of fashion brand it is, i.e. if the brand is recognised for selling plus-size, then the negative comments are less as opposed to if brand is targeting a young, slimmer body shape. Thus, a contribution can be made to the literature

From the findings and comments, it appears that social media platform has many active users and majority of the active users follow fashion brands to view the latest trend, i.e. new bikini, new dresses, etc. However, some of the comments under the post relates to wanting a particular body shape or if wearing a particular clothing product would make them slimmer, etc., going in hand with previous studies (see [6, 9]). Adding to this, majority of the comments do relate to wanting to buy the product as well. This indicates how a body shape and clothing products impact consumer's behaviour and cognitive thinking process. However, from the findings, it was also evident that clothing products such as bikini's often trigger more comments related to body shape and image as oppose to those with a dress (see **Figure 2**). Thus, this can also contribute to literature of fashion promotion

Finally, it can be concluded that plus-size body image gains more negative attention as opposed to slimmer body shape, despite that fashion industry is constantly criticised for promoting skinner fashion model. However, there are now personal influencers on Instagram that are collaborating with sport fashion brands to pro-

mote their fitness product line and maintainable body shape and image.

of promotion, communication and body image.

*An example of the portrayal of plus-size model online. Source: Boohoo.com (2019).*

*DOI: http://dx.doi.org/10.5772/intechopen.89239*

*The Media Effect: Implications for Manifesting Maintainable Body Image in the Context… DOI: http://dx.doi.org/10.5772/intechopen.89239*

**Figure 1.** *An example of the portrayal of plus-size model online. Source: Boohoo.com (2019).*

related to health issues and obesity, fashion brands are pushed to share only limited photos on plus-size or using slimmer models to promote plus-size clothing, which is also resulting in complaints and shaming the media. However, these results vary depending on the type of fashion brand it is, i.e. if the brand is recognised for selling plus-size, then the negative comments are less as opposed to if brand is targeting a young, slimmer body shape. Thus, a contribution can be made to the literature of promotion, communication and body image.

From the findings and comments, it appears that social media platform has many active users and majority of the active users follow fashion brands to view the latest trend, i.e. new bikini, new dresses, etc. However, some of the comments under the post relates to wanting a particular body shape or if wearing a particular clothing product would make them slimmer, etc., going in hand with previous studies (see [6, 9]). Adding to this, majority of the comments do relate to wanting to buy the product as well. This indicates how a body shape and clothing products impact consumer's behaviour and cognitive thinking process. However, from the findings, it was also evident that clothing products such as bikini's often trigger more comments related to body shape and image as oppose to those with a dress (see **Figure 2**). Thus, this can also contribute to literature of fashion promotion and clothing.

Finally, it can be concluded that plus-size body image gains more negative attention as opposed to slimmer body shape, despite that fashion industry is constantly criticised for promoting skinner fashion model. However, there are now personal influencers on Instagram that are collaborating with sport fashion brands to promote their fitness product line and maintainable body shape and image.

*Promotion and Marketing Communications*

wearing bikini.

as opposed to clothing brands.

words of wisdom and positivity.

**5. Conclusion and discussion**

frequently promoted.

On the one hand, Instagram appears to have more actively engaging customers, criticising or making comments about skinny models, by making comments such as 'does it come with a body to match', 'I better look like this in it or I'll be fuming', 'I have stuck to the diet 2 days now', and 'Why don't I look like this' (IG, 2019). These comments were particularly made under pictures with models

Furthermore, the maintainable body shape is often found to be questionable as it is not clear whether it relates more closely to a plus-size or super-skinny. However, there are many fitness influencers who are now trying to promote a healthy lifestyle and a maintainable body shape suggesting different fitness routines e.g. squads and other legs work out, followed by some empowering comments e.g. 'Need to build my strength to rock this!!' (IG, 2018), This is awesome I am just starting my fitness journey and seeing your post gave me the extra kick, I need too stick to it! (IG, 2017). On the other hand, some influencers are also trying to promote 'being confident in embracing the curves', which could be due to several reasons, e.g. postpartum and hormones, while empowering them to try staying healthy by fitness

By observing the social media platform, it is has emerged that these influencers are not only promoting a fitness routine but are also suggesting how one should feel confident about their body shape, manifesting maintainable body shape and image. For example, a UK London-based fitness trainer 'Carly Rowena' often posts stories on Instagram about 'how people should do as they feel and how they should feel confident about their body shape and skin' (IG Story, 2019). Furthermore, the comments made under the personal blog are also fairly positive, encouraging and empowering and, thus, indicating the influence of a personal brand on consumers

Another known fitness trainer 'Kayla Itsines' is an Australian blogger with many

The focus of this chapter was on the implications of manifesting a maintainable body shape in the global fashion industry. The data was drawn focusing on two. Each channel is supported by data analysed using netnography, drawing information from comments made in the online communities on Facebook and Instagram. The study particularly focused on the two body shapes of plus-size and skinny models. In part, this was important, as skinny models were traditionally preferred in the global fashion industry, whereas now plus-size models are being more

Based on the findings drawn from social media platforms, it is evident that some consumers on online communities are not fully happy with the promotion of plus-size model, even if a fashion brand shares only so often, e.g. one photo a week. While many health studies have identified how being overweight can be due to health issues such as hormones or DNA, comments on social media indicate that this should not be manifested on the mass media as this may not be a true representation or a maintainable body shape, contradicting previous studies that argued similarly about thinness [33–35] (see **Figure 1** as an example). From a brand's perspective, it can be assumed that due to consumer's critics and comments

followers, who promotes the emotional rollercoaster one may go through when trying to maintain a lifestyle and body shape after giving birth. Their posts are followed by many positive comments and baby posts by other individuals, spreading

routines. This is also deemed to contribute towards mind and soul.

**164**

## **5.1 Limitations**

The study has identified several challenges and limitations in doing this research. The findings can only be generalised according to the size of the sample. For instance, the process of identifying suitable posts on social media was deemed to be difficult as not many are directly related to fashion. Secondly, the process can be time-consuming as it involves going through comments and extracting patterns and meaning while looking at different sources and comments.

#### **Figure 2.**

*An example of a product that attracts less comments related to body shape and more related to the actual product. Source. Shein.com, 2019.*

## **Appendix 1**


**167**

**Author details**

Maintainable body

Nottingham Trent University, Nottingham, England

provided the original work is properly cited.

\*Address all correspondence to: arooj.rashid@ntu.ac.uk

Arooj Rashid

*The Media Effect: Implications for Manifesting Maintainable Body Image in the Context…*

**Key views**

2019)

2019)

2019)

out

it! (IG, 2017)

2015)

© 2019 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/ by/3.0), which permits unrestricted use, distribution, and reproduction in any medium,

• Can I have her body please thanks (IG, 2019) • *I better look like this in it or I'll be fuming* • How do regular people wear this?! (IG, 2019) • *Thank god we need to see healthy women on the runways*

• too much for holiday? Will I look just like her in this? Haha (IG,

• It might look better if she had sum meat on her bones (IG,

• obviously not for swimming, just to show off by the pool (IG,

• You look awesome but you always have :-\* beautiful inside and

• You're killing it! So happy for you and your progress! (IG, 2017) • This is awesome I am just starting my fitness journey and seeing your post gave me the extra kick in the back, I need too stick to

• It's not just the exercise...that girl looks like that because she's very careful of what she is eating. Everyone can do these exercises everyday but won't look like that if their diet is not 'perfect'. Plus I believe she was born with a slim figure and now

• *Thank god we need to see healthy women on the runways* (FB,

• Need to build my strength to rock this!! (IG, 2018)

• *I have stuck to the diet 2 days now.* • *Why don't I look like this*

• if only I had this body lmao (IG, 2019) • If only I have a body shape like that (IG, 2019)

she has perfected it (IG, 2019)

*DOI: http://dx.doi.org/10.5772/intechopen.89239*

2018

2019; Facebook,

Instagram, 2017, 2019; Facebook, 2018, 2019

**Participant Body shape and image**

Skinny models Instagram,


*The Media Effect: Implications for Manifesting Maintainable Body Image in the Context… DOI: http://dx.doi.org/10.5772/intechopen.89239*

## **Author details**

*Promotion and Marketing Communications*

The study has identified several challenges and limitations in doing this research. The findings can only be generalised according to the size of the sample. For instance, the process of identifying suitable posts on social media was deemed to be difficult as not many are directly related to fashion. Secondly, the process can be time-consuming as it involves going through comments and extracting patterns

*An example of a product that attracts less comments related to body shape and more related to the actual* 

**Key views**

brand, IG, 2019)

(IG, 2019)

• *The fashion industry cannot neglect the plus-size* (IG, 2019) • *Big is beautiful is a deluded phrase and that plus-size can lead to* 

• hey lovely We were scrolling through and think you're

absolutely gorgeous ☺ DM us, we'd love to collaborate (Fashion

• Do you think it's ok to put obese models?? They are shocking

• I'm all for body confidence being a 14 myself I like to see curvy models but this looks like it doesn't fit she needs the bigger size

*stroke diseases and cancer* (FB, 2018) • Confidently Unhealthy (IG, 2019)

and looks very unhealthy (IG, 2019) • Chubby but it's really beautiful (IG, 2019)

and meaning while looking at different sources and comments.

**5.1 Limitations**

**166**

**Appendix 1**

*product. Source. Shein.com, 2019.*

**Participant Body shape and image**

2019; Facebook,

2018

Plus-size Instagram,

**Figure 2.**

Arooj Rashid Nottingham Trent University, Nottingham, England

\*Address all correspondence to: arooj.rashid@ntu.ac.uk

© 2019 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/ by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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statistics/309228/boomer-senior-social-

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bjgp18X696161

worldwide/

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[46] Manwaring A. Reality television and its impact on women's body image [Online Theses and Dissertations]. Paper 50; 2011. Available from: https://

[47] Kim JW, Chock MT. Body image 2.0: Associations between social grooming on Facebook and body image concerns. Computers in Human Behavior. 2015;**48**:331-339. DOI: 10.1016/j.

[48] Fardouly J, Vartanian LR. Negative comparisons about one's appearance mediate the relationship between Facebook usage and body image concerns. Body Image. 2015;**12**:82-88. DOI: 10.1016/j.bodyim.2014.10.004

[49] Chua THH, Chang L. Follow me and like my beautiful selfies: Singapore teenage girls' engagement in selfpresentation and peer comparison on social media. Computers in Human Behavior. 2016;**55**:190-197. DOI: 10.1016/j.chb.2015.09.011

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bodyim.2014.07.002

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[51] Bell. Social media and female body image [Unpublished master's

encompass.eku.edu/etd/50

chb.2015.01.009

IJBG.2019.097389

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consumers responses towards TV carácter based fashion related social media content. International Journal of Business and Globalisation. 2018;**22**(1):53-73. DOI: 10.1504/ IJBG.2019.097389

*Promotion and Marketing Communications*

[30] Mazur A. U.S. trends in feminine beauty and over-adaption. The Journal of Sex Research. 1986;**22**:281-303. DOI: mood and body dissatisfaction. Journal of Social and Clinical Psychology. 2004;**23**:23-44. DOI: 10.1521/

[38] Tiggemann M, Slater A. NetGirls: The Internet, Facebook, and body image concern in adolescent girls. International Journal of Eating Disorders. 2013;**46**:630-634

Trautwein U, Oschatz K, Scheiter K, Nagengast B. Gender stereotypes in a children's television program: Effects on girls' and boys' stereotype endorsement,

math performance, motivational dispositions, and attitudes. Frontiers in Psychology. 2018;**9**:2435. DOI: 10.3389/

[40] Anschutz D, Engels RCME, Becker ES, Van Strien T. The effects of TV commercials using less thin models on young women's mood, body image and actual food intake. Body Image. 2009;**6**:270-276. DOI: 10.1016/j.

jscp.23.1.23.26991

[39] Wille E, Gaspard H,

fpsyg.2018.02435

bodyim.2009.07.007

[41] Harrison K. Television viewing, fat stereotyping, body shape standards, and eating disorder symptomatology in grade school children. Communication Research. 2000;**27**:617-640. DOI: 10.1177/009365000027005003

[42] Botta RA. The mirror of television: A comparison of Black and White adolescents' body image. Journal of Communication. 2000;**50**:144-159

[43] Ashbach C. Media influences and personality development: The inner image and the outer world. In: Zillmann D, Bryant J, Huston AC, editors. Media, Children and the Family: Social Scientific, Psychodynamic and Clinical Perspectives. Hillsdale, NJ:

Erlbaum; 1994. pp. 117-128

[44] Vazquez D, Cheung J, Xu X. Investigating Chinese audience-

[31] Tiggemann M, Zaccardo M. Exercise to be fit, not skinny: The effect of fitspiration imagery on women's body image. Body Image. 2015;**15**:61-67. DOI:

10.1080/00223980209604820

10.1016/j.bodyim.2015.06.003

bodyim.2008.09.001

jscp.2009.28.1.9

[32] Lin L, Reid K. The relationship between media exposure and antifat attitudes: The role of dysfunctional appearance beliefs. Body Image. 2009;**6**:52-55. DOI: 10.1016/j.

[33] Levine MP, Murnen SK. Everybody knows that mass media are/are not [pick one] a cause of eating disorders: A critical review of evidence for a causal link between media, negative body image, and disordered eating in females. Journal of Social and Clinical Psychology. 2009;**28**:9-42. DOI: 10.1521/

[34] Wood K, Baker J, Thompson J. Body image dissatisfaction in pre-adolescent

Murnen SK. The effect of experimental presentation of thin media images on body satisfaction: A meta-analytic review. The International Journal of Eating Disorders. 2002;**31**:1-16

[36] Blair CE, Kelly NR, Serdar KL, Mazzeo SE. Does the Internet function like magazines? An exploration of image-focused media, eating pathology,

and body dissatisfaction. Eating Behaviors. 2012;**13**:398-401. DOI: 10.1016/j.eatbeh.2012.06.003

[37] Tiggemann M, McGill B. The role of social comparison in the effect of magazine advertisements on women's

children. Journal of Applied Developmental Psychology. 1996;**17**:85-100. DOI: 10.1016/ S0193-3973(96)90007-6

[35] Groesz LM, Levine MP,

**170**

[45] Homer PM. Product placements: The impact of placement type and repetition on attitude. Journal of Advertising. 2009;**38**(3):21-32. DOI: 10.2753/JOA0091-3367380302

[46] Manwaring A. Reality television and its impact on women's body image [Online Theses and Dissertations]. Paper 50; 2011. Available from: https:// encompass.eku.edu/etd/50

[47] Kim JW, Chock MT. Body image 2.0: Associations between social grooming on Facebook and body image concerns. Computers in Human Behavior. 2015;**48**:331-339. DOI: 10.1016/j. chb.2015.01.009

[48] Fardouly J, Vartanian LR. Negative comparisons about one's appearance mediate the relationship between Facebook usage and body image concerns. Body Image. 2015;**12**:82-88. DOI: 10.1016/j.bodyim.2014.10.004

[49] Chua THH, Chang L. Follow me and like my beautiful selfies: Singapore teenage girls' engagement in selfpresentation and peer comparison on social media. Computers in Human Behavior. 2016;**55**:190-197. DOI: 10.1016/j.chb.2015.09.011

[50] Webb JB, Butler-Ajibade P, Robinson SA. Considering an affect regulation framework for examining the association between body dissatisfaction and positive body image in Black older adolescent females: Does body mass index matter? Body Image. 2014;**11**:426-437. DOI: 10.1016/j. bodyim.2014.07.002

[51] Bell. Social media and female body image [Unpublished master's thesis]. Bridgewater, Massachusetts: Bridgewater State University; 2016. Retrieved from: http:// vc.bridgew.edu/cgi/viewcontent. cgi?article=1137&context=honors\_proj

[52] Beale K, Malson H, Tischner I. Deconstructing "real" women: Young women's readings of advertising images of "plus-size" models in the UK. Feminism and Psychology. 2016;**26**(3):1-9. DOI: 10.1177/0959353516639616

[53] Kozinets R. On netnography: Initial reflections on consumer research investigations of cyberculture. In: Alba J, Hutchinson W, editors. Advances in Consumer Research. Vol. 25. Provo, UT: Association for Consumer Research; 1998. pp. 366-371

[54] Elvey R, Voorhees J, Bailey S, Burns T, Hogson D. GPs' views of health policy changes: A qualitative 'netnography' study of UK general practice online magazine commentary. British Journal of General Practice. 2018;**68**(671):441-448. DOI: 10.3399/ bjgp18X696161

[55] Heinonen K, Medberg G. Netnography as a tool for understanding customers: Implications for service research and practice. Journal of Services Marketing. 2018;**32**(6):657-679. DOI: 10.1108/JSM-08-2017-0294

[56] Numbers of Monthly Active Facebook Users Worldwide as of 2nd Quarter 2019 (in millions) [Internet]. 2019. Available from: https://www. statista.com/statistics/264810/numberof-monthly-active-facebook-usersworldwide/

[57] Most Popular Social Networks Activities of Baby Boomer and Senior Internet Users in the United States in 2013 [Internet]. 2013. Available from: https://www.statista.com/ statistics/309228/boomer-senior-socialnetwork-activities/

[58] Most Popular Facebook Activities in the United States as of October 2017 [Internet]. 2017. Available from: https:// www.statista.com/statistics/275788/ share-of-facebook-user-activities/

[59] 16 Statistics to Show Why Instagram Marketing is Crucial [Internet]. 2019. Available from: https://oursocialtimes. com/16-statistics-to-show-whymarketers-need-instagram/

[60] Speziale HS, Streubert HJ, Carpenter DR. Qualitative Research in Nursing: Advancing the Humanistic Imperative. China: Lippincott Williams and Wilkins; 2011

[61] King N, Horrocks C. Interviews in Qualitative Research. London, UK: Sage Publications; 2010

[62] Dwyer L, Gill A, Seetaram N. Handbook of Research Methods in Tourism: Quantitative and Qualitative Approaches. Cheltenham, UK: Edward Elgar Publishing; 2012

[63] Rashid A, Barnes L, Warnaby G. Management perspective on country of origin. Journal of Fashion Marketing and Management. 2016;**2**(2):230-244

[64] Sherdian E. Piers Morgan Tells Plus-Size Model Tess Holliday She 'Needs Help' as Bitter Feud Continues [Internet]. 2018. Available from: https:// www.mirror.co.uk/3am/celebrity-news/ piers-morgan-tells-plus-size-13280115

**173**

**Chapter 9**

**Abstract**

diagnosis of many diseases.

**1. Introduction**

web pages ([1], p. 579).

Marketing Communication and

Marketing communication in the health sector is the communication of the products or services produced by health organizations to the potential users and convincing them about the benefits to be provided. Although the use of the concept of health services and promotion is controversial, promotional activities in health services are different from promotion activities in other sectors. Public relations (PRs) rather than advertising are in the forefront of promotion activities in the health sector. Health institutions, especially hospitals, are highly complex systems both in terms of services provided and organizational structure. The aim of this study is to reveal the importance of promotion activities in health care and their different aspects from other sectors. In this context, the international literature on health marketing was searched, and this content was created. As a result, the aim of promotion in health services is not to direct the patient unnecessarily to consumption but to inform patients, to convince them about benefits of the services, and to facilitate their service delivery by increasing their participation in the service process. If promotion tools are used correctly in health care, they can help in early

**Keywords:** promotion, marketing, health care, communication, consumer

Modern marketing requires much more than developing a good product or service, making attractive pricing, and making available products or services accessible. Businesses have to communicate with existing and potential stakeholders and the public. Businesses in public communication; be going to say what, how, where, when, how often, and to whom should well planned. Consumers are actively using communication tools such as hundreds of cable and satellite broadcasts, thousands of magazines and newspapers, and millions of

Marketing communication is a very popular topic today. No field of marketing is changing as fast and drastic as marketing communication. Because with the emer-

Marketing communication (promotion) can be defined as the process of information transmission between the seller and the potential buyer or other people ([3], p. 344). In other words, marketing communication can be defined as the means used by the company to communicate with customers and other stakeholders ([2], p. 426). Promotion is one of the marketing mix; the right products and/or services

gence of concepts such as online, mobile, and social media marketing,

customer participation is increasing day by day ([2], p. 425).

Promotion in Health Services

*Aykut Ekiyor and Fatih Altan*

## **Chapter 9**

*Promotion and Marketing Communications*

[58] Most Popular Facebook Activities in the United States as of October 2017 [Internet]. 2017. Available from: https:// www.statista.com/statistics/275788/ share-of-facebook-user-activities/

[59] 16 Statistics to Show Why Instagram Marketing is Crucial [Internet]. 2019. Available from: https://oursocialtimes. com/16-statistics-to-show-whymarketers-need-instagram/

[60] Speziale HS, Streubert HJ,

and Wilkins; 2011

Publications; 2010

Elgar Publishing; 2012

Carpenter DR. Qualitative Research in Nursing: Advancing the Humanistic Imperative. China: Lippincott Williams

[61] King N, Horrocks C. Interviews in Qualitative Research. London, UK: Sage

[62] Dwyer L, Gill A, Seetaram N. Handbook of Research Methods in Tourism: Quantitative and Qualitative Approaches. Cheltenham, UK: Edward

[63] Rashid A, Barnes L, Warnaby G. Management perspective on country of origin. Journal of Fashion Marketing and Management. 2016;**2**(2):230-244

[64] Sherdian E. Piers Morgan Tells Plus-Size Model Tess Holliday She 'Needs Help' as Bitter Feud Continues [Internet]. 2018. Available from: https:// www.mirror.co.uk/3am/celebrity-news/ piers-morgan-tells-plus-size-13280115

**172**
