Is the Fitness Industry Harming Us?: Why Messaging Needs to Change

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Background Context

Health and fitness professionals have the potential to enhance public health and improve the wellbeing and quality of life of many individuals5. After all, adoption of regular physical activity and sufficient nutrient intake has significant benefits for both psychological and physical health6,7,8.

Yet, despite the benefits, fitness pursuits are often not undertaken for the intention of improving health. One of the most common reasons to diet and exercise is to pursue contemporary appearance ideals9 in an attempt to improve appearance & self-esteem10. Body dissatisfaction is a particularly important reason for pursuing weight loss treatment among those with overweight and obesity – even when health issues related to excess weight are also at play11.

It is likely that these individuals are turning to fitness professionals for help.

This presents the following questions:

  • Does changing your appearance really change how you feel about yourself?
  • What are the impacts of promoting appearance ideals and associating them with health?
  • Might we be causing more harm than good?
  • Ultimately, are we really helping anyone?

This statement will argue that the fitness industry may be unwittingly perpetuating harm by:

  1. Promoting narrow appearance ideals
  2. Endorsing pathological eating and exercising behaviours, and
  3. Contributing to weight stigma

In a later follow-up statement, this will be expanded on to argue that:

  1. Coaches have a unique opportunity to contribute to a global public health problem by reducing body dissatisfaction and promote a positive body image
  2. An interdisciplinary approach is needed to mitigate risk and enhance protective factors

Key Definitions

  • Body Image: a complex multidimensional construct comprising perceptual, cognitive, affective, and behavioural components1.
  • Positive Body Image: appreciation for the body and its functions, acceptance of the body (including aspects that are inconsistent with idealised images), recognition that beauty comes in all shapes and sizes, caring for the body and filtering information in a body-protective manner2.
  • Body Dissatisfaction: a negative attitude towards one’s own body resulting from a perceived discrepancy between the actual and ideal body image3.
  • Health and Fitness professional: Umbrella term that covers coaches, personal trainers, nutritionists, dieticians.
  • Intuitive Eating: an adaptive eating style guided by attunement to one’s bodily cues (e.g., hunger, satiety) rather than by emotional or external cues (e.g., sadness, dietary rules) to largely determine what, when, and how much to eat4.

Body Image: What’s The Harm?

Body image is a complex multidimensional construct12, with components that are:

  • perceptual
  • cognitive
  • affective
  • behavioural

Every single one of us has a body image.

Whether we are aware of it or not, our body image plays a large role in how we see ourselves and experience our lives. Our body image can have a beneficial effect on our wellbeing, or be a cause of significant distress. In a world where physical appearance is treated as social currency, how we feel about our looks can influence the way we interact with others, how we treat our bodies, our participation in important life activities and even our academic and career aspirations13.

Figure from: Cash, T. F. (2012). Cognitive-behavioral perspectives on body image. In T. F. Cash (Ed.), Encyclopaedia of body image and human appearance (pp. 334–342). Elsevier Academic Press. 14
© 2023 American Psychological Association. All rights reserved.

Negative Body Image

Positive Body Image

Prevalence

Due its prevalence and significance, negative body image has been posed as a ‘grand challenge’ – a large-scale, complex, enduring problem that affects large populations and has a strong social component40.

The question remains: what role does the fitness industry play in this challenge?

The Mis-sold Ideal

The fitness industry is largely a body image focused market, frequently communicating body weight, shape and appearance messages. It’s a growing market, reflected in the increase of fitness advertising in recent years41.

Fitness professionals often report feeling pressure to ‘look the part’ and rely on their appearance in order to attract clients42. A huge avenue for this is social media, where ‘fitspiration’ (images, quotes and advice about fitness and nutrition) is posted43. While fitspiration is designed to have a positive and inspirational effect on intentions to engage in health seeking behaviours, evidence suggests that this may not be the case.

Photo by Jordan Whitfield on Unsplash

Fitspiration content often contains objectifying images that depict an idealised thin-athletic female body type and hyper-muscular male body type44. Viewing fitspiration can increase pressure on individuals to attain these physiques and internalisation of these ideals may be detrimental to one’s physical and mental health45,46. Promoting a very limited range of body types carries the strong implication that only a certain body type can be fit and healthy, which contribute to weight stigma and undermine the potential for fitspiration content to move individuals towards healthier lifestyle choices47.

Image credit: House of Commons Report (reference 39)

Work by Schaefer & Thompson112 has suggested that self-objectification can increase risk of disordered eating and other negative outcomes. Self-objectification is defined as a learned self-schema (cognitive framework about ourselves) based on “the importance of one’s body and appearance relative to other aspects of the self”.

It is likely that gender moderates the relationship between self-objectification and disordered eating, with women having disproportionately high rates of disordered eating. In fact, the original proposal of objectification theory in the late 90s was an attempt to explain how social environments and the viewing of people as aesthetic objects, may contribute to this difference.

One manifestation of self-objectification is “self-surveillance”, which is the continual monitoring of one’s appearance. This is theorised to lead to increased body shame when women perceive their bodies as discrepant with feminine beauty ideals113, resulting in more disordered eating attitudes and behaviours48.

Body shame is associated with:

  • disordered eating49
  • depression50
  • substance abuse51
  • sexual dysfunction52

Men can, and do, experience shame about their bodies, however the links between body shame and self-objectification function differently in men and women53. Tiggemann and Kuring (2004) demonstrated that Australian men who highly valued attributes such as strength and physical coordination reported more body shame than men who did not highly value these attributes54, which suggests that men may experience body shame when they perceive themselves to be falling short of cultural appearance standards for a larger, muscular physique.

There is a relationship between fit-ideal internalisation and body dissatisfaction, dieting and bulimic behaviours. And this relationship can be mediated by both body surveillance and social comparison111. Arguably, an industry that promotes the importance of appearance may be significantly contributing to disordered eating attitudes and behaviours.

Is it Actually Motivational?

Although individuals may describe themselves as more inspired to engage in physical activity after viewing fitspiration images, research has shown that exposure does not increase participants’ likelihood of engaging in higher levels of exercise, implying that fitspiration may not motivate actual exercise behaviour55. On the contrary, individuals often experience decreased satisfaction with their current fitness levels56 and their likelihood of attaining these ideals.

Not to mention, not all sources of motivation are equally helpful. The reasons people have for engaging in health and fitness pursuits can influence not only their persistence and likelihood of success, but also their physical and psychological and well-being57. According to Organismic Integration Theory58, individuals engage in behaviour for reasons that range from extrinsically endorsed (such as weight and appearance) to internalised and self-determined (such as healthand enjoyment).

Figure: Based on the motivation continuum: Organismic Integration Theory Taxonomy of Regulatory Styles (Center for Self-Determination Theory, 2017).119

Those who internalise ideal physiques portrayed in media, and report higher body dissatisfaction, are less likely to exercise for fitness and health reasons and more likely to exercise as a way of managing or altering weight and appearance59. Not only are extrinsic motivations insufficient to promote long term engagement and weight loss maintenance60, but may directly contribute to harm. Engagement in weightlifting or exercise to gain weight were associated with the highest odds of muscularity-oriented disordered eating behaviours in males and females61.

“The Unattainable Goal”

For those that are focused on aesthetics, we need to ask whether the fitness industry is setting an unattainable goal. Consider that influencers and fitness professionals are typically telling their audiences, either implicitly or explicitly, that by following their advice, the audience too can achieve a physique like theirs. And this is likely never possible for most people, for a variety of reasons.

The most obvious and extreme examples include cases where an unethical influencer will promote their physique as something to aspire to, while omitting to disclose (or even outright denying114) that they take performance enhancing drugs (PEDs). But beyond such cases, even when people are aiming to do good, the goal is still unattainable for most.

First, those with the most idealised physiques are outliers by definition. And their physique is a function of not only fat mass and muscle mass, but muscle insertion points, anthropometric proportions, etc. So even after dieting, others can’t look exactly like them. And this is not to mention genetic differences in the ability to tolerate training/dieting, preferences for what individuals are interested in, or external factors. The “expert” they are following likely has a physique that is just not attainable.

That brings us onto the next concern: does the industry endorse pathological eating and exercise behaviours?

Photo by Miti on Unsplash

Endorsement of Harmful Dieting Practices

Disordered eating behaviours, such as unhealthy weight control practices and binge eating, are highly prevalent in the population. The consequences are significant62, such that the degree of psychosocial impairment caused by disordered eating is similar to that of a clinically recognised eating disorder63. Many of the practices aimed at achieving the ‘ideal’ body may perpetuate these behaviours and become a catalyst for harm.

Achieving an appearance ideal necessitates engaging in dietary restraint, which can be rigid or flexible in nature64:

  • Rigid Control: An all-or-nothing approach to eating characterised by the avoidance of calorie-dense foods, regimented calorie counting, and fasting.
  • Flexible Control: A balanced approach to eating characterised by conscious and intentional food choices, monitoring portion sizes, eating to satisfaction, and compensating by eating more or less when needed.

Fitness practitioners will often endorse flexible dietary control65, which is generally considered a more adaptive and sustainable alternative to rigid approaches66. In some studies, flexible dietary restraint has been associated with lower levels of disordered eating67 and psychological distress68, and higher levels of self-regulation and sustained weight loss69.

Yet research has not consistently supported the link between flexible control and positive health outcomes70. In fact, several studies have observed that rigid and flexible control are usually positively correlated with each other, since both require the exertion of cognitive restraint71. Yet research has not consistently supported the link between flexible control and positive health outcomes. In fact, several studies have observed that rigid and flexible control are usually positively correlated with each other, since both require the exertion of cognitive restraint. These constructs are measured by the Cognitive Restraint Scale and are suggested to share a variance of up to 52%73. 

Table from: Tylka et al., 201574
Copyright © 2015 Elsevier Ltd. All rights reserved.

Consider one item from the Flexible Control subscale:

“I pay a great deal of attention to changes in figure or body build.”

Given what we know about the implications of overvaluation of weight and shape, it is not difficult to see how this could potentially be problematic. It seems that the benefits of flexible control are only apparent once we remove the sizable conceptual overlap with rigid control.

This calls into question whether it is possible to promote flexible restraint without simultaneously promoting rigid restraint. In reality, most people do not utilise purely rigid or purely flexible strategies for dieting. Not to mention, a macro-based, “flexible” diet is not necessarily synonymous with flexible restraint.

In a study75 examining the effects of adopting a rigid versus flexible dieting approach in a healthy, resistance-training population, the authors emphasised that:

“Once again, it should be noted that flexible restraint as a whole is distinct from “macro-based dieting.” Within the resistance trained and physique-minded community, it is not uncommon for macro-based dieting to be a highly rigid dieting practice. While food choice may be autonomous, the rigidity of hitting very specific macronutrient targets can pathologize into a more negative relationship with food and body image. Neither of these pathologies lead to long-term successful weight maintenance and further research is needed to clarify the ideal level of flexibility and rigidity amongst dieting behaviors.”

In fact, “I count calories as a conscious means of controlling my weight” is an item on the RC scale, not the FC scale. Accruing evidence challenges recommendations to engage in flexible dietary restraint, as these strategies do not consistently promote healthier eating behaviour, well-being, or weight maintenance. A number of researchers are now cautioning against promoting flexible control, favouring intuitive eating as an adaptive approach to dietary management76.

The Pursuit of Muscularity

Achieving the fitness ideal involves the pursuit of a more muscular appearance77, which extends beyond fat loss to include muscularity-oriented behaviours78. To increase muscle mass, leanness, and muscularity, as well as decrease body fat, individuals have reported engaging in weight training, protein overconsumption, “bulk” and “cut” food intake cycles, elimination dieting, and intermittent fasting79. Although these behaviours are not inherently harmful, they have potential to become pathological80, particularly when undertaken with the intent to achieve more muscular appearance81.

Although males are typically much more concerned over their level of muscularity than females82, research suggests that women who endorse attitudes and behaviours geared towards attaining the female muscular ideal may be susceptible to experiencing eating disorder symptoms and negative emotional states83.

At surface level, these behaviours are considered ‘healthy’. Uninformed practitioners are likely to miss the signs of muscularity-oriented disordered eating84, resulting in delayed seeking of treatment and perpetuation of harm85.

When Pursuing Appearance Ideals is Not Harmful

Now for the question on everyone’s mind…

When is the pursuit of appearance ideals not likely to be harmful?

Can we chase physique goals and come out better for it?

Understanding the concept of ‘appearance investment’ can help us to answer this question. Thomas Cash, a prolific researcher in the field of body image, distinguished between two kinds of appearance investment86:

  1. Self-evaluative: the extent to which an individual defines or measures themselves by their physical appearance.
  2. Motivational: the importance of maintaining an attractive appearance & the extent to which individuals engage in behaviours to manage their appearance.

Motivational appearance investment is considered to be a more benign form of appearance investment that is less likely to result in dysfunction. It’s important to note that a positive body image does encompass care for one’s appearance. Totally giving up on your appearance is probably not conducive to developing respect and appreciation for oneself, as this may be a form of avoidance.

The difference between adaptive and maladaptive modification of appearance comes down to:

  • The reasons behind it (seeking social approval vs expression of personal style),
  • The lengths you go to achieve it (the amount of time and energy it requires), and
  • How you feel in the absence of it (the degree of anxiety and psychosocial impairment)
ExampleMaladaptiveAdaptive
Going to a yoga classPrimary intention is to ‘tone’ the body, feels guilty if a class is missed, organises day around itEnjoys how it makes one’s body feel, not the end of the world if a class is missed
Wearing makeupTo cover up perceived flaws, feels anxious without it, spends significant amounts of money on itTo enhance natural features, still feels fine without it
Lifting weightsTo ‘sculpt’ the body and feel better around more attractive othersTo improve health, celebrate what the body can do, enjoyment & mastery

So who is more susceptible to maladaptive appearance investment?

It is likely that it comes down to two key factors:

  1. Self-evaluation
  2. Emotional regulation

The necessary foundation of protective factors is likely to include self-compassion, self-acceptance and body appreciation.

The rationale for this suggestion is best expanded upon in a follow-up article, but supporting evidence includes:

  • Those who appreciate their body have been shown to be more aware of their bodily needs such as internal hunger and satiety signals, which seems to lead to both intuitive eating and well-being87.
  • Self-evaluation and emotion regulation may impact on weight loss, behaviour change and longer-term weight management88.
  • People suffering with eating, body image, and weight concerns, have been found to experience high levels of self-criticism and shame, and lower self-compassion. Recent studies suggest that helping individuals develop self-reassurance and self-compassionate capabilities may help buffer against the pervasive effects of shame and self-criticism in a number of physical and mental health conditions89, including eating and body image-problems90.
  • Research highlights the role of irrational beliefs in negative body image, exercise addiction and eating pathology91,92. It is suggested that Unconditional Self Acceptance, in particular, may have an important role in the prevention of muscle dysmorphia and negative body image93, as it is theoretically akin to positive rational acceptance94, and proposed as a healthier alternative to self-esteem95.

Weight Stigma

Weight bias refers to the negative beliefs, attitudes, and stereotypes that are held about people who live in larger bodies96, such as people of higher weight are lazy and lack willpower97. This bias is prevalent in the industry98 and a common attitude amongst health professionals99, who often believe people are responsible for their own weight and fail to lose weight because of poor self-discipline100. A survey of people living with overweight or obesity in the UK by Brown et al. (2022)118 found that of the respondents:

  • 88% reported being stigmatised due to their weight
  • 42% felt uncomfortable talking to their GP (family physician) about their weight
  • Only 26% reported that they felt “… treated with dignity & respect by HCPs when seeking advice or treatment about their weight.”

Research indicates that internalisation of modern appearance ideals is a predictor of fat phobia and weight control blame101. Research indicates that students and professionals in the fitness and exercise science fields tend to place high importance on achieving the ideal athletic body type, and express negative attitudes towards larger bodies, including associating them with being lazy, weak and unattractive102.

Weight biases are problematic as they can lead to weight stigma, the social devaluation and discrimination of an individual due to their weight103. Some believe stigma and shame will motivate people to lose weight when, in fact, researchers have found the opposite to be true. Weight discrimination actually increases risk for obesity104, and is associated with exercise avoidance105, maladaptive eating behaviours106 and worse psychological health107, including greater anxiety, stress108, depression109, and body dissatisfaction110.

“But it will motivate them to change!”

When bringing up the harm of stigmatizing messages about weight, one of the common pushbacks offered is that although stigmatizing statements are tough to hear, they are in fact a net positive because it “motivates people to change”.

The claim is that by saying something stigmatizing we can motivate people to lose weight, eat healthier, go to the gym, go on a diet, etc.

Such statements, while widespread, are completely at odds with the evidence.

Consider that research shows us that:

  • Weight stigma increases calorie consumption.115
  • Internalized bias is associated with poorer weight loss and weight loss maintenance.118
  • Internalizing negative weight-based stereotypes leads to worse, not better, eating behaviours.116
  • Those who experience weight stigma are more likely to avoid the gym.117
  • The most effective and motivating public health messages were those that focused on making healthy behavioral changes without reference to body weight.118

What Message is the Industry Giving People?

There will always be unethical actors in all industries, including health and fitness, that will knowingly spread problematic messages simply for profit. But those people aren’t reading articles like this. Our focus is on the many individuals who want to do good, and feel they are doing good, but are perhaps unaware of some inadvertent ways in which people can be affected by our messages.

And so the problem is mostly not the outright, direct abusive shaming of people. Rather it’s something more insidious, that arises from the things we post, the advice we give, the content we create, and the things we tell people we value about them or ourselves.

Whether that comes in the form of ‘fitspiration’ posting, “what I eat in a day” vlogs, or only evaluating/discussing people in terms of their body composition, the result is the same. We are spreading a message, implicitly, that in order to be “part of the group” that is the fitness community, you need to be shredded enough, or jacked enough, or follow the same behaviours as others.

And given that we all want to belong to groups and feel part of a community, what such implicit messages are really saying is “if you want to be healthy, accepted, or dare I say loved, you need to look like this”.

So ultimately, we need to ask ourselves: Is that a message we wish to spread? Or to question?

Summary of Key Points

  • Our body image can have a beneficial effect on our wellbeing, or be a cause of significant distress.
  • People with negative body image frequently engage in unhealthy behaviours such as extreme dieting, overeating, and compensatory behaviours to control their weight
  • Contrary to popular belief, positive body image is not linked to disengagement in healthy activity, eating, and self-care. Rather than encouraging individuals to ‘give up’ on themselves,promoting a positive body image is likely to lead to increased participation in health-seeking behaviours.
  • Some research indicates that approximately 60% of women and 40% of men have a negative body image.
  • The fitness industry is largely a body image focused market, frequently communicating body weight, shape and appearance messages.
  • While “fitspiration” is designed to have a positive and inspirational effect on intentions to engage in health seeking behaviours, evidence suggests that viewing “fitspiration” can increase pressure on individuals to attain these physiques and internalisation of these ideals may be detrimental to one’s physical and mental health.
  • “Self-surveillance”, the continual monitoring of one’s appearance, may lead to increased body shame when women perceive their bodies as discrepant with feminine beauty ideals, resulting in more disordered eating attitudes and behaviours.
  • Pursuing appearance goals may not be inherently harmful, but rather depends on whether the appearance investment is “self-evaluative” or “motivational” in nature.
  • A positive body image does encompass care for one’s appearance. Totally giving up on your appearance is probably not conducive to developing respect and appreciation for oneself, as this may be a form of avoidance.
  • While some may believe stigma and shame will motivate people to lose weight, in fact, research shows that the opposite is true.
  • The problem is mostly not the outright, direct abusive shaming of people. Rather it’s something more insidious, that arises from the things we post, the advice we give, the content we create, and the things we tell people we value about them or ourselves.

Concluding Thoughts

The majority of health and fitness industry professionals care for their clients and are committed to helping them achieve their goals.

In this Statement, we have raised concern about whether taking a physique-first approach is truly helpful. This is an invitation to challenge our assumptions about health and appearances and critically examine the ideals we promote, and the ways that we coach.

To truly step up to the challenge of helping people improve their health and quality of life, we need to go beyond macros and weight loss. Suggestions for how we might go about that will be laid out in an upcoming part two to follow this Statement.

For now, we’d love to hear your thoughts…

What do you think about the questions raised? What’s your view of the messaging within the fitness industry? How can professionals move forward in the most effective way possible?

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