Accessing Body Shaming in Adolescents: A Scale Development and Psychometric Properties in Pakistani Adolescents

Body shaming is a very sensitive but common phenomenon in the current era. It mainly affects adolescents as in this age range they experience drastic physical e.g. bodily changes. The current study aimed to investigate the sensitivity of body shaming and its rising prevalence among adolescents. 36 items were initially created from an open-ended interview with 20 individuals, 10 boys and 10 girls, ages ranging from 15 to 19 years. After content validity was done, a pilot study was carried out on a self-report measure of body shaming on a sample of 10 participants (5 boys and 5 girls). After that, a sample of 350 participants (boys 50%, girls 50%) aged around 15 to 19 years (M=17.25, SD= 1.14) was tested for psychometric properties of the Body Shaming Victimization Scale (BSVS). Factor analysis generated three factors of the Body-Shaming Victimization Scale (BSVS): Poor Self-image, Social Isolation, and Fear of Social Rejection. The scale was found to have good internal consistency, construct validity, and reliability. Most girls were found to score higher on this scale.

According to the World Health Organization (WHO) 2024, adolescence is the developmental phase existing between childhood and adulthood, as they define adolescence as a person aged between 10 and 19  (WHO, 2024). It is a critical period of life, including different factors that affect the lifestyle (Sawyer et al., 2012). Generally, adolescence is characterized into 3 stages: Early adolescence (about 11- 13 years old), middle adolescence (around 14-17 years old), and late adolescence (approximation age 17- 19 years) (Moshman, 2020) but now a new and fourth stage of emerging adulthood has been introduced for the age range of 18- 25, but it is a conditional and controversial stage (Arons & Seligman, 2024; Salmela-Aro, 2011).

The phase of transition from childhood to adulthood consists of many changes, such as physical, psychological, social, and sexual changes. Extensive research has centered on this age period and confirmed that these transformations are fundamental to the human experience (Lerner & Steinberg, 2009). During childhood years, boys and girls are similar in terms of their weight and height, but in their adolescent years, gender differences can be seen. From age around 10 to 14, a girl gets taller but not heavier than boys, but after 14, boys become taller and heavier than girls, although individual differences may also occur (González-Carrasco et al., 2017). Both weight and height can be very sensitive issues for some adolescents, as in our societies, the preference is that men are expected to be taller than women and women are expected to have a thin and delicate physique (Perez-Lopez et al., 2010).

This era has given new standards to society, which also includes the mindset of society about achieving perfectionism in terms of beauty (Buetow & Wallis, 2017). In a society, body shaming arises when society sets standards that must be achieved by the individual, and those who can’t meet those standards become the victim of body shaming in the end (Albertson et al., 2015). Literature discovered that the childhood and adolescence shame experiences can become fundamental to one's self-identity and ultimately their life story, serving as a foundation for everyday expectations and inferences as well as having a significant impact on one's social relationships (Berntsen & Rubin, 2006; Matos et al., 2012).

Body Shaming is defined as a practice in which people are judged and shamed because of their bodies (Carter et al., 2020). To mock or attack someone because of their physical appearance is also included in body shaming (Evelianti et al., 2020). It is a popular negative term that is commonly used as a social interaction for people on social media (Schlüter et al., 2023). An example of it could be calling someone fat, denouncing weight, body shape, skin color, height, etc. and so much more related to their physical appearance (Puluhulawa & Husain, 2021), that makes people more uncomfortable and insecure about their physical appearance and leads them to distance themselves from their environment as well as results in less interaction with people around them (Stacey, 2017). These comments can be seen in both digital and real world.

Body shaming is not only targeted to fat shaming, people with lean bodies or with unusual specific body parts e.g. flat or enlarged chest, thin lips, etc. are also victimized by body shaming e.g. (you are too skinny, you need to have more flesh covering your bones, your legs seem ugly, etc.) so it is not specific to one type but it is an umbrella term which contains different aspects like weight, fat, height, color etc. (Soleman & Elindawati, 2019). Furthermore, body shaming has also been classified as “trolling” which is a type of cyber harassment (Lumsden & Morgan, 2017). More commonly, body shaming affects adolescents in their early adulthood, e.g, when they are body-shamed by their surroundings, which include their friends and family (Sambasivan et al., 2019).

It is a reality of adolescents that they want to be accepted by their peers, so they try to have the right body, clothes, hair, and everything else to be accepted (Warrington & Younger, 2011). Women tend to have more negative body image as compared to men (Brennan et al., 2010), as it has been seen that girls start to show an increase in their body dissatisfaction by the age of 14 (Bearman et al., 2006). Young girls are continuously told that their life would improve if they had ideal beauty, but when they try to attain it and fail, they develop negative emotions, which lead them toward hopelessness and depression (Moon et al., 2018). Moreover, college-aged girls are more likely to develop negative beliefs about their bodies (Warnick et al., 2022).

The impact of body shaming is adverse as it can lead to poor self-assessment, low self-confidence (Evelianti et al., 2020), sensitivity e.g. easy crying, frustration, and anxiety, decreased self-acceptance, low self-esteem, decreased body satisfaction, and depressive symptoms (Fauzia & Rahmiaji, 2019; Gam et al., 2020; Mustafa et al., 2022), self-objectification, appearance anxiety (Evans, 2010), eating disorders, and increased level of insecurity (Flak, 2021; Sugiati, 2019). Further, some findings from cross-cultural studies have also highlighted significant differences across the world (Swami et al., 2010). When opposed to Western countries, feelings like anxiety and shame are generally regarded to be greater and play a bigger role in social situations in East Asia (Fang et al., 2016), because people in East Asia depend on one another as a result of their collectivistic culture, making it significant for them to engage in self-monitoring and self-criticism into a parental group (Eisen & Ishii, 2019).

Method

Scale Development

This study developed a reliable Body Shaming Victimization Scale (BSVS) for adolescents on Pakistani cultural standards, which was done in four phases i.e., item generation, expert validation, pilot study, and establishing psychometric properties.

Phase I: Item Generation

In this phase, item generation for the development of a scale (BSVS) was done. Body shaming of any kind related to appearance, including height, weight, size, or color, was the topic of exploration. Qualitative interviews with an open-ended approach were employed to explore the construct of body shaming with adolescents (both boys and girls, with ages ranging from 15 to 19 years). Different colleges were approached to seek their permission, and they were assured of confidentiality. After gaining permission, the researcher introduced herself and briefed them about the aim of the current research. Those participants who agreed to take part in the study were interviewed, and they were interviewed on the body shaming construct. For instance, you have seen people around you who are body shamed. What do you think, and what other insecurities do they tend to have? Twenty interviews were conducted randomly with adolescents studying at the intermediate level, and their responses were gathered. Furthermore, the total gathered responses were analyzed, and phrases were listed. Afterward, the phrases were rephrased and converted into items, which resulted in a total of 36 items.

Phase-II: Expert Validation

In this next step, items that were generated were further given to the experts who have 2 to 3 years of experience, for the purpose of evaluation on the basis of their clarity and relevance to their respective domains. i.e., whether they represent the particular domain for which they are gathered or not. A clear definition of body shaming was written at the start of the questionnaire to avoid any kind of confusion. The preliminary item pool was rated by the 8 experts, including clinical psychologists and psychometricians, to assess content validity for relevance, clarity, and representativeness on a 6-point rating scale, where 0 indicated (strong disagreement) and 5 indicated (strong agreement). Items that received fewer than 50% experts’ validation responses were revised or discarded based on the experts’ recommendations. As a result, the final 32 items demonstrated satisfactory content validity, were converted into a survey instrument for refinement, and pretesting involved selecting the response categories, ordering the items, writing instructions for the participants, selecting the mode of administration, and pretesting the survey by conducting interviews based on the cognitive interviewees’ feedback. After that, the scale was titled as Body-Shaming Victimization Scale (BSVS), prepared for Phase III: Pilot Testing to further assess item comprehensibility and preliminary psychometric properties.

Phase-III: Pilot Study

The refined scale was administered to a sample of 5 adolescent boys and 5 girls recruited from 2 colleges aged between 15 to 19 years, using a purposive sampling technique for item and instructions comprehension, and preliminary reliability of the Body-Shaming Victimization Scale (BSVS). It was converted into a self-reported measure with a 4-point Likert scale, 0 (not at all), 1 (seldom), 2(often), 3(more often), and the participants were asked to evaluate BSVS and which took approximately 15–20 minutes per participant and was conducted in small groups within classroom settings under researcher supervision. No item was discarded, and the pilot testing confirmed that the instrument was psycho-metrically sound, linguistically clear, and culturally relevant for adolescent respondents. The revised 32-item version was thus finalized for large-scale validation, involving Exploratory and Confirmatory Factor Analyses in subsequent phases.

Phase-IV: Establishing Psychometric Properties

This phase aimed to establish the psychometric properties of the Body Shaming Victimization Scale (BSVS) through a comprehensive statistical evaluation of its factor structure, reliability, and validity. This phase was conducted using one independent sample to ensure robustness and generalization of the findings.

Participants

A cross-sectional research design was used to develop and validate the psychometric properties of a tool named Body Shaming Victimization Scale in adolescents. The research was conducted with adolescents (N = 350) aged between 15-19 years studying in intermediate part 1 and 2 of government and private colleges of Lahore, recruited through purposive sampling, able to comprehend Urdu, and willing to participate voluntarily, and having no physical disabilities and diagnosed psychiatric or neurodevelopmental disorders, and those under psychiatric medication.

Measures

Demographic Form

A demographic form included the age, gender, education, family education, and occupation, no. of siblings, birth order, family system, as well as educational institute type, e.g., whether they are studying in government or private institutes.

Body Shaming Victimization Scale (BSVS)

Body shaming victimization scale (Ameer & Karamat, 2022) was developed on body shaming by exploring phenomenology. It comprises three factors, poor self-image (α = .79), social isolation (α = .73), and fear of social rejection (α = .64). It had 30 items, and response options were on a 4-point Likert-scale i.e., 0 (not at all), 1 (seldom), 2(often), and 3 (more often). The participants were asked to rate the statements that were related to body shaming. Possible scores ranged from 0 to 81, with higher scores meaning a higher level on the Body-Shaming Victimization Scale. Cronbach alpha for the Body Shaming Victimization Scale for current research was (α = .86), indicating good internal consistency of the scale.

Self-Injurious Behavior Scale (SIBS)

Self-Injurious behavior scale (Saleem & Saleem, 2017) was developed to measure self-injurious behavior in adolescents. It is an indigenous scale and was developed to measure self-injurious behavior in the Pakistani population. It consists of 17 items with a 4-point Likert rating, e.g., 0 (not at all), 1 (seldom), 2(often), and 3 (more often).

Procedure

First of all, the researchers approached different private and government colleges of Lahore and briefly described the aim and objectives of the current study. After that, those colleges that agreed to participate were further assured that the information gathered from their students would be kept confidential and would be used for only research purposes. After that, authorities were asked to randomly provide students in the first and second years. The researcher introduced herself and informed the participants about the aim of the study, and those participants who agreed to fill out the protocol were provided with the final testing material. Students were given all the instructions in Urdu verbatim and were asked to rate each item according to how much it bothered them. They took 15 to 20 minutes to fill out the form, and after that, they were given a few minutes for any queries or questions they had regarding the questionnaire. They were also asked to give their feedback afterward. Some of the students were curious about the results, some of them showed much interest in learning about body shaming results, and some of them were interested in learning the purpose of the study.

Results

Exploratory Factor Analysis (EFA)

An eigenvalue analysis was performed to find out the factor structure of the scale. On the basis of the Scree plot, a three and four-factor solution was used with a rotated component matrix. Furthermore, different factor loading values were used for this purpose, including .35 and .40. The factor loading of .35 gave a better result, and the three-factor solution provided a very clear picture of sub-scales. Principal Axis Factor (PAF) with Varimax rotation was used. It provided a clear picture of the factors (sub-scales) and provided the least dubious items. The final number of items was 30.

Figure 1: The Scree Plot Showed the Extraction of Factors for the Body-Shaming Victimization Scale on 350 Participants

After factor analysis, three factors were developed, which contained 14, 9, and 7 items. The factor loading of the items is given below.

Table 1: Factor Structure of 30 Items of BSVS on Adolescence with Rotated Component Matrix

Note. Factor loading > .35 was boldfaced.

Factors Description

Factor 1: Poor Self-Image

Based on the similarity between the items of these factors, it was given the name of poor self-image. It comprised 14 items and example items are: not taking pictures due to the fear of criticism, inferiority feelings, low confidence, thinking of oneself is not beautiful, not being happy with oneself, comparing oneself with others, harming oneself, use of different kind of medications for being slim or fat, being not satisfied with oneself, criticism of people regarding appearance, doing everything after consulting with others, people making fun of yourself, criticism of people and hating oneself.

Factor 2: Social Isolation

Factor two of the scale was given named social isolation, comprised of 9 items which included items related to it e.g. losing interest in doing something new and going somewhere, having fear of going among people, being fed up with people’s gossip, not finding anything interesting in your environment, not being able to choose something to wear, lost in thoughts, being alone due to the fear of people and feeling distressed.

Factor 3: Fear of Social Rejection

The third factor of this scale comprised of 7 items which contain the items related to the fear of social rejection such as not being able to face people, being easily exploited by people, feeling being stared at, being worried all the time about looking good, doing different acts in a way to gain people attention, looking into the mirror and feeling ashamed soon.

Table 2: Summary of Correlation and Descriptive Analysis (N = 350)

Note. PSI = Poor Self-Image, SI = Social Isolation, FSR = Fear of Social Rejection, BST = Body-Shaming Total.
*p < 0 .05, ***p < 0 .001

The factors of body shaming and poor self-image had a positive correlation with Social Isolation and Fear of Social Rejection. Positive correlation between body shaming and self-injurious behavior was found. The thirty components of the BSVS were analyzed in relation to the aggregate score of the BSVS items. The overall item score was calculated by summing the scores of all thirty components. The item-total correlations for each individual item within the BSVS varied between .32 and .59 (p<.001).

Reliability and Validity Testing of BSVS

Discriminant Validity. To show evidence of discriminant validity, self-injurious behavior was unrelated to fear of social rejection sub-scales of the BSVS (r = .16, p<0.05). 

Split-half Reliability. The odd-even method was used to determine the split-half reliability of the BSVS by dividing the scale into two halves, one containing all Odd items and the other comprising all even items. The correlation coefficient between the two halves was found statistically significant (r = .82, p<.001). The results showed significant gender differences in body shaming.  Girls (M = 28.59, SD = 12.76) reported a greater level of body shaming than boys (M = 24.52, SD = 13.30).        

Discussion

Adolescence is the period of development and growth that occurs between childhood and maturity. Adolescents undergo numerous transformations as they transition into adulthood, encompassing physical, cognitive, personality, and social development. The onset of puberty, which presently tends to occur earlier than in previous generations, signifies the commencement of the adolescent stage. Teenagers go through a substantial growth stage during adolescence because of the forced adaptations they must make, such as physical, emotional, cognitive, and social changes (Holmbeck, 2018). When adolescents are dealing with pressures like these shifts, they are frequently challenged with a variety of developmental changes. Finding oneself or one's identity is one task; the adolescent's identity is built by their desires, skills, beliefs, and personal background (Forrest-Bank et al., 2015). It is expected that an adolescent must create autonomy within his or her social environment in addition to looking for personal identity. A phenomenon, nowadays, that is most common in adolescents is body shaming, as adolescents face bodily change, e.g., in weight and size, etc., during this time period, and there are more chances of them becoming prey to body shaming.

In Pakistani culture, there is little work done on body shaming, and there is no such scale available on it, so for the purpose of measuring body shaming, a scale was developed according to Pakistani cultural standards. As this scale was to measure body shaming in adolescents’ phenomenology was explored from adolescents of both genders. After that, all steps of scale development were done, and a total of 32 items were selected in this scale. During the factor analysis, the three-factor solution gave a clear picture of the factor structure of the Body-Shaming Victimization Scale (BSVS). The scale was divided into 3 sub-scales on the basis of similarity among the items, and 2 items were discarded as they were dubious items. The final version of this scale includes 30 items with 3 sub-scales named Poor Self Image, Social Isolation, and Fear of Social Rejection.

Poor self-image represents a person’s inner view of himself about his appearance, how he perceives himself, and how he thinks of himself. It is when a person is unconvinced of their abilities and identity, minimizing or disregarding their positive traits. Believe they are inferior to their peers. Individuals often engage in self-deprecating discourse, employing descriptors such as unintelligent, overweight, unattractive, or unworthy of affection. They persistently partake in negative, critical, and self-reproachful dialogues with themselves (Pérez-Prieto et al., 2015).  People who have a positive body image are aware of how to take care of their bodies. In contrast, people who are unhappy with their bodies may not feel good about themselves or take care of themselves (Rosenberg, 2015).

When a person is continuously being body-shamed, they tend to develop a negative self-image. Criticizing or ridiculing someone for their perceived physical flaws or deficiencies is called body shaming. People with poor self-image can also be made fun of for their appearance when they are young and raised in families where there is a strong emphasis on having a certain ideal body. The practice of dieting or controlling your weight because of dissatisfaction with your body is viewed as normal in families where members are unhappy with their bodies (Hart et al., 2015).
When an individual is being publicly bullied for their appearance, they start to avoid putting themselves in those situations, and in the end, this result in social withdrawal and isolation. Having few people to communicate with on a regular basis constitutes social isolation.

(Holt-Lunstad et al., 2015). When an adolescent feels excluded from society and may have forgotten their own value, they are said to be socially isolated. A long-term body shame campaign can undermine someone's confidence by making them feel sorry for themselves. As a result of the belief that they are unworthy of happiness and respect, they isolate themselves from others or completely isolate themselves from the world (Gioia et al., 2020).

These individuals endure panic episodes and severe anxiety if not properly addressed. Such individuals start to avoid going out in public due to the fear of being body-shamed and receiving negative comments from others. It is more commonly found in adolescents as they are more prone to being the prey of body shaming and is more negatively effects by people’s jokes and comments regarding their appearance. After an unpleasant social encounter, adolescents may decide to isolate themselves, or perhaps they lack social skills or experience social anxiety. It can result in stress and loneliness, which can negatively affect both the physical and mental health of an adolescent.

Finally, the third factor, which is fear of rejection, represents a person’s fear of being rejected by others. Due to the worry of doing or saying something embarrassing, of not being liked, or of being unable to connect with others. Worrying excessively about what others think can lead to low self-esteem, lack of confidence, guilt, embarrassment, and embarrassment, and social anxiety can also lead to rejection fears. It increases anger, anxiety, despair, envy, and grief. A hostility-ridden state can also result in poor impulse control and lower performance in challenging intellectual activities (DeWall & Bushman, 2011). People who are prey to body shaming tend to develop a fear of being socially rejected by others. Adolescents who experience body shaming have more fear of being socially rejected.

During adolescence, an individual is forming new relationships with others. He loves to spend time with others and wants to be accepted and liked by others. They have more fear of being rejected socially, and it could be a traumatic experience of adolescent life, which could lead them towards multiple problems in their coming life. If children and adolescents exhibit timid, withdrawn, or anxious behavior or struggle with externalizing behaviors like aggressiveness that may result in being bullied for their appearance, followed by victimization, they may feel social rejection (Killen et al., 2012; Rubin et al., 2006). The results of the study revealed high consistency between all the variables. The t-test analysis results of the current study revealed that girls tend to experience more body shaming as compared to boys. As in previous literature, it is evident that girls are far more prone than boys to believe that their present weight is excessive, at least in part because they are exposed to skinny models on television, in publications, and in movies.

Limitations and Suggestions

The study was confined to colleges in Lahore, which may not reflect the diverse sociocultural and educational contexts of adolescents across Pakistan. There were many other problems caused by body shaming, e.g., poor self-image, social isolation, social rejection, as well as self-injurious behavior, which needs to be explored in our culture.  Furthermore, longitudinal studies need to be carried out to learn in-depth about the effects of body shaming on adolescents. Body shaming is a very sensitive and highlighted topic, as there is less work available on it in our culture, so it needs to be further investigated. Parents should be provided with proper awareness of this topic, as parents are the first and primary part of their children’s lives, so they can help their children deal with body shaming experiences, which, as a result, increases the mental health of the child and can boost their self-confidence and
self-esteem.

Furthermore, parents can also play a significant role in adolescents' self-harming behavior, through which their negative behavior can be prevented to some extent in adolescents. Furthermore, body shaming also needs to be explored at the school level as well as the university level because individuals are seen to be facing body shaming at these levels, too. The link between body shaming and academic performance could also be a topic of great importance and can be explored in further studies. In addition, surgical healthcare facilities should refrain from using language that elicits negative reactions or responses that can directly or indirectly lead to body-shaming (Uludag, 2022).

Conclusion

The current study has related and highlighted the sensitive topic of body shaming and its effects on adolescents. Body shaming is a multifaceted phenomenon involving criticism based on body size, shape, height, or color. Recognizing its prevalence and harmful effects, the present study focused on developing a standardized scale to assess these experiences among youth.
In this era of technology and social media, body shaming is also emerging, where the beauty standards and being in size and shape are affecting our youth in many negative ways, which should be considered and noticed, and adolescents should be provided help regarding their appearance fears and fears of not being accepted by others. Body shaming is more common in girls because they are thought to have a perfect ideal body and shape, which, as a result, affects their mental health in a very negative way.

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Received 16 April 2024
Revision received 20 November 2025