Why breast size dissatisfaction matters globally
The article below appeared in the March 1 issue of Health with Perdana, a regular column in The Star by Perdana University faculty members. This week’s article is contributed by Professor Viren Swami, Director and Adjunct Professor (Perdana University Centre of Psychological Medicine)
In many cultures around the world, women’s breasts are highly sexualised and fetishised. This affects how women feel about their bodies. Since at least the 1950s, studies have shown that many women were dissatisfied with their breast size, but these studies have typically been conducted in North America and Europe. In contrast, little is known about breast size dissatisfaction in other parts of the world.
To find out, the Breast Size Satisfaction Survey (BSSS) was set up in 2017. This was a collaborative project that ultimately involved 104 scientists working in 61 research sites across the globe. Together, we recruited a total of 18,541 women from 40 nations, making the BSSS the largest study of women’s breast self-image that has ever been conducted.
In each site, women who were asked to complete a standardised questionnaire, which included a measure of breast size dissatisfaction. Participants were shown a series of images of women varying in breast size and asked to select the image that most closely represented their current breast size and the breast size they would like to have. Women were considered to be experiencing breast size dissatisfaction if there was a discrepancy between these ratings.
Women in the study were also asked to complete several other scales, including measures of appearance and weight dissatisfaction, subjective happiness, self-esteem, and breast awareness. The latter included questions about breast self-examination frequency, confidence in noticing a change in one’s breasts, and how quickly participants would contact a health professional if they noticed a change in their breasts.
Our results, published in the journal Body Image, show that breast size dissatisfaction is a concern in every nation that we surveyed. In our total sample, the majority of women were dissatisfied with their current breast size, with 47.5% desiring larger breasts and 23.2% desiring smaller breasts. Only 29.3% of our sample were satisfied with their current breast size.
Although there was some variation across nations – for example, 73% of women surveyed in China wanted larger breasts compared with 28% in Norway – breast size dissatisfaction was common and relatively similar across nations overall. In Malaysia, 55% of women sampled wanted larger breasts and 23% wanted smaller breasts.
Importantly, the BSSS results also showed that breast size dissatisfaction was associated with greater appearance and weight dissatisfaction, poorer happiness, and lower self-esteem. We also found that breast size dissatisfaction was linked to more infrequent breast self-examination frequency and lower confidence in detecting a change in one’s breast, both of which has a detrimental impact on breast cancer detection. These associations were stable across all nations that we surveyed.
Based on our results, we concluded that breast size dissatisfaction is now a public health concern in many parts of the world, with important consequences for the psychological and physical well-being of women. What is needed now is greater academic attention to the issue of breast size dissatisfaction in other parts of the world and how such dissatisfaction might affect outcomes that we did not consider, such as participation in exercise and breastfeeding practices. We also urgently need culturally-sensitive interventions that help to restore and promote breast satisfaction.