Restrained eating behavior refers to individuals restricting their food intake for weight loss (Herman and Polivy, 1975; Westenhoefer et al., 2013), and is prevalent among college students (Han and Kahn, 2017). A Chinese app called Mint, which focuses on recording diets, reports that 7.65 million people are involved in restrained eating (Yang et al., 2021). In addition, restrained eating may lead to eating disorders (e.g., bulimia nervosa) and negative psychological emotions, such as anxiety and stress (Stice, 2002; Appleton and McGowan, 2006; Kalkan Ugurlu et al., 2021). Therefore, it is necessary to study the restrained eating behavior of college students and the factors influencing it.

Long-term exposure to the mass media can have a range of harmful effects on college students, such as feeling of isolation (Wright and Pritchard, 2009), anxiety (Garvin and Damson, 2008), and media internalized pressure (Ouyang et al., 2021). Media internalized pressure refers to the pressure that arises after an individual internalizes the ideal body shape which is promoted by the media and mentally compares it with his or her body shape (Stice et al., 2000; Thompson and Stice, 2001; Dittmar et al., 2009). It can relate to body dissatisfaction (Myers and Crowther, 2007), shame (Izydorczyk et al., 2020), stress (Sharp et al., 2014), and even bring about eating problems (Thompson and Heinberg, 1999; Morton et al., 2020). The tripartite influence model of sociocultural theory suggests that the media is one of the initial sources of influence that leads individuals to develop restrained eating behavior (Thompson et al., 1999; Thompson and Stice, 2001). Previous studies have demonstrated that images of slim bodies on television and idealized body size in software can affect individual eating behavior (Mills et al., 2002; Anschutz et al., 2008). This is particularly common among women (Fitzsimmons-Craft et al., 2016) and young adults (Wardle et al., 2006). Austin and Smith (2008) indicated that media internalized pressure can lead individuals to pay more attention to their body shape and create a desire for the ideal body shape, which may lead to restrained eating behavior.

Body esteem may mediate the relationship between media internalized stress and restrained eating behavior. Body esteem is a specific domain of overall self-esteem and refers to an individual's satisfaction with different aspects of the self-body or a positive or negative self-evaluation (Auslander et al., 2012; Lamb et al., 2021). On the one hand, some studies have confirmed that body esteem may relate to restrained eating behavior (Murray et al., 2016). The transdiagnostic theory of eating disorders proposed by Fairburn et al. (2003) suggests that when people are unable to meet the standards set for themselves, they develop negative evaluations of their bodies, which leads to lower body esteem and ultimately leads individuals to develop eating disorders. On the other hand, media internalized pressure may exert an influence on body esteem (Varnes et al., 2015). Flament et al. (2012) demonstrated that both appearance esteem and weight esteem play a mediating role between thin-ideal body shape and restricted eating behavior in female adolescents. When individuals perceive that their body figures are inconsistent with the toned and lean image advocated by the media, this lowers their body esteem and can easily trigger their restrained eating behavior to achieve the ideal figure (Karacan et al., 2014; Gattario et al., 2020).

Furthermore, previous research has demonstrated that social physique anxiety is associated with media internalized stress and restrained eating behavior (Frederick and Morrison, 1998; Ouyang et al., 2021). Social physique anxiety refers to the anxiety that arises from the fear that others will judge one's physique negatively (Hart et al., 1989). Hayes and Ross (1987) suggested that social physique anxiety may lead women to engage in unhealthy eating behaviors due to the pursuit of a thin-ideal body shape. In addition, Sharp et al. (2014) showed that excessive media internalized pressure is a cause of women's body dissatisfaction and social physique anxiety. Individuals who discover a discrepancy between their body shape and the ideal body shape advertised by the media may experience dissatisfaction and anxiety (Christian et al., 2021), and they are prone to more body shape management, such as restrained eating behavior (Thompson et al., 1999).

In addition, body esteem may correlate with social physique anxiety (Gregus et al., 2014). People who are dissatisfied with their physical image may feel anxious when facing others' evaluation of their physical image (Frederick and Morrison, 1996). Miller and Fry (2018) found that body esteem is significantly and negatively associated with social physique anxiety. Atalay and Gençöz (2008) argued that people who have negative perceptions of their body image are more likely to experience higher levels of social physique anxiety. People with high media internalized pressure are more likely to develop lower body esteem (Cordero, 2011) and higher social physique anxiety (Martin, 1999), which can eventually make them avoid showing their body image in public. In the end, they tend to further restrict their eating behaviors and make their image meet social standards (Cox et al., 1997).

Our study can further deepen the investigation of factors influencing restrained eating behavior. This study aims to explore the multiple mediating roles of body esteem and social physique anxiety between media internalized pressure and restrained eating behavior among college students. We have proposed the following hypotheses: (1) media internalized pressure is positively associated with college students' restrained eating behavior; (2) the higher the media internalized pressure, the more likely college students are to have lower body esteem and these students' restrained eating behavior will be more frequent, i.e., body esteem plays a mediating role between media internalized pressure and restricted eating behavior; (3) when college students experience greater media internalized pressure, the higher the social physique anxiety they feel and the more frequently restrained eating behavior they experience, i.e., social physique anxiety plays a mediating role between media internalized pressure and restrained eating behavior; and (4) the greater the media internalized pressure on college students, the more likely they may feel lower body esteem and likely to experience higher social physique anxiety, which makes them more likely to engage in restrained eating behavior, i.e., body esteem and social physique anxiety play chained mediating roles between media internalized pressure and restrained eating behavior. The conceptual model is presented in Figure 1.

This study investigated the association between media internalized pressure and restrained eating behavior, and the multiple mediating roles of body esteem and social physique anxiety in the relationship between media internalized pressure and restrained eating behavior among college students. We found that (1) there was a significant and positive association between media internalized pressure and restrained eating behavior; (2) body esteem mediated the effect of media internalized pressure on restricted eating behavior; (3) social physique anxiety mediated the effect of media internalized pressure on restricted eating behavior; and (4) body esteem and social physique anxiety play chained mediating roles between media internalized pressure and restrained eating behavior.

Our study found that media internalized pressure was positively related to restrained eating behavior in our college student sample. Similar to our previous studies, Chang et al. (2013) showed that the ideal body shape communicated by mass media leads to media internalized pressure in individuals, which can make them more prone to self-objectification (Slater and Tiggemann, 2015) and thus increase restrained eating behavior (Ashikali and Dittmar, 2010). It highlights the relationship between visual exposure to the media's thin-ideal body shape and restrained eating behavior. This is perhaps because media internalized pressure increases the likelihood of perceived body dissatisfaction, and this appearance pressure, in turn, contributes to restrained eating behavior (Myers and Crowther, 2007; Fuller-Tyszkiewicz et al., 2018).

We found that media internalized pressure can relate to restrained eating behavior through body esteem and social physique anxiety, respectively, which supports our hypotheses 2 and 3. According to the cognitive behavioral model of eating disorders, the thin-ideal body shape promoted by the media increases individuals' misperceptions of their bodies during self-evaluation, which may cause low body esteem and anxiety, and even lead individuals to adopt unhealthy eating behaviors, such as restrained eating behavior (Fairburnm, 1997). Previous studies have also indicated that the internalization pressure of ideal-thin body shape from the media may increase personal body dissatisfaction and decrease body esteem (Hawkins et al., 2004; Vartanian and Dey, 2013). In addition, we found a mediating role for social physique anxiety between media internalized pressure and restricted eating behavior. The mass media's promotion of the ideal body shape can lead individuals to pursue an unrealistically thin-ideal body shape, generating media internalized pressure and dissatisfaction with their body shape, which can lead to social physique anxiety and eventually adopt some restrained eating behavior to reduce this anxiety (Martins et al., 2007; Kertechian and Swami, 2016; Kalyva et al., 2021).

Finally, we found body esteem and social physique anxiety play a chained mediating role between media internalized pressure and restricted eating behavior. This result supports our hypothesis 4. Although the tripartite influence model of the sociocultural theory states that media internalized pressure is one of the causes of restrained eating behavior in individuals (Thompson et al., 1999), this study introduces body esteem and social physique anxiety into this model for the first time and examines the mechanisms by which all three play a role in restrained eating behavior in college students. The media promotion of a thin-ideal body shape leads individuals to evaluate their body shape from the perspective of others, and this inappropriate evaluation tends to lower body esteem and develop social physique anxiety in dissatisfaction with their bodies (Gregus et al., 2014), which leads to thoughts of changing their body shape and eventually results in restrained eating behavior.

This study has important implications. In theoretical aspects, first, we confirmed the relationship between media internalized pressure and restrained eating behavior among college students, extending the tripartite influence model of the sociocultural theory. Second, we applied body esteem and social physique anxiety to explain their association, which helps to understand the underlying mechanisms between these two variables. In practice, we can develop some strategies to avoid restrained eating and other unhealthy behaviors based on these influencing factors. First, social media should stop promoting a single strict aesthetic standard, and instead, should promote healthy beauty and lead people to a healthy lifestyle. Second, we can promote the physical and mental health of college students by promoting correct aesthetic concepts, so that they can be guided to correctly view the ideal body shape and discover their own beauty as disseminated by the media, and thus form correct body perceptions and self-evaluations. Third, we can intervene in mediating variables to reduce restrained eating behavior. Physical activity and restrained eating behavior are the two most commonly used methods of body management, but physical activity rarely produces negative effects (Boutelle et al., 2009; Schur et al., 2010). Encouraging college students to participate in physical activity can also help individuals improve self-confidence and self-esteem, which may reduce restrained eating behavior (Duncan et al., 2009). In addition, mindfulness, a self-regulation mental training method with Buddhist origins, has been shown to be effective in reducing anxiety and depression, and enhancing well-being, which may also help reduce restrained eating behavior (Kristeller and Wolever, 2010).

Despite these positive results, this study also has some limitations. First, this study is a cross-sectional study, so it does not draw a causal relationship between the variables. Future studies could examine the causal relationship between mediating variables and restrained eating behavior or design intervention experiments for mediating variables to test whether restrained eating behavior can be reduced. Second, our survey participants are all college students, and we hope that future research will be extended to include more samples (e.g., adolescents or working adults). Finally, this study adopted an online method of distributing questionnaires; the measurement environment cannot be guaranteed to be consistent and, therefore, may introduce bias. Future studies may consider distributing and collecting questionnaires on-site.

This study confirms the relationship between media internalized pressure, body esteem, social physique anxiety, and restrained eating behavior. There is a significant and positive association between media internalized pressure and restrained eating behavior among college students. Moreover, media internalized pressure can also increase the risk of restrained eating behavior through the parallel mediating effects of body esteem and social physique anxiety, as well as through the sequential mediating effects of body esteem and social physique anxiety.

The original contributions presented in the study are included in the article/supplementary material, further inquiries can be directed to the corresponding author/s.

The studies involving human participants were reviewed and approved by Ethics Committee of the School of Public Health at Cheeloo College of Medicine of Shandong University (20190912). The patients/participants provided their written informed consent to participate in this study.

TF and SX completed the writing of the introduction and discussion. JY completed the writing of the methods. TF completed the writing of results, data coding, cleaning, and the first draft of the manuscript. JW and GS completed the writing review and editing. All authors contributed to the article and approved the submitted version.

This research was supported by the Social Science Fund of Shandong Province, China (No. 18DTYJ02), the Teaching Research Project of Shandong University (No. XYJG2020025), and the Young Scholars Program of Shandong University.

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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