Numerous definitions have been stated for “body image”: Paul Schidler defined it as “the image and appearance of the human body that we form in the mind, that is, the way our body appears to us” (Schilder, 1935; Posavac and Posavac, 2002). Instead, according to Peter Slade, “the subjective image we have in our mind of the shape, size and feelings” is the real representation that each person has of his own body (Slade, 1988). The National Eating Disorders Collaboration says that body image is a combination of the thoughts and feelings that you have about your body (National Eating Disorders Collaboration, 2022).

Body image concept is tightly linked to body dissatisfaction, which, in turn, is closely related to eating behavior disorders (Aparicio-Martinez et al., 2019; Andersen and Swami, 2021; Jiménez-Limas et al., 2022). Moreover, body dissatisfaction can have implications on a person’s health as it is associated with depression, low self-esteem, anxiety, tobacco use, self-harm, alcohol and other substance abuse (Kostanski and Gullone, 1998; Baker et al., 2018; Bornioli et al., 2019).

The development of problems related to body image and eating disorders can be explained by the tripartite model of influence (Thompson et al., 1999; Keery et al., 2004) which identifies peers, parents, and mass media as primary sources of influence. According to the literature, these three sources of influence reinforced the “ideal of beauty,” emphasizing thinness for women and muscles for men (Griffiths et al., 2013). Sociocultural theory posits that influence is mediated by two factors: the internalization of beauty ideals and physical appearance comparisons (Thompson et al., 1999). Internalization occurs when an individual accepts society’s beauty ideals and adopts behaviors to attain that ideal (Thompson et al., 1999). This theory further suggests that the internalization of unattainable ideals, combined with ongoing physical appearance comparisons, can negatively impact body satisfaction (Thompson et al., 1999).

It has been shown that exposure to traditional media (television, cinema, and magazines) is strongly linked to body dissatisfaction (Uchôa et al., 2019; Marques et al., 2022). A large collection of research has shown a positive correlation between social media usage and low self-esteem (Bessenoff, 2006; Valkenburg et al., 2006; Santarossa and Woodruff, 2017), body dissatisfaction (Fardouly et al., 2015; Grogan, 2016; Holland and Tiggemann, 2016; Cohen et al., 2017; Hendrickse et al., 2017; Santarossa and Woodruff, 2017; Hogue and Mills, 2019; Revranche et al., 2022), eating disorders (Hummel and Smith, 2015; Holland and Tiggemann, 2016; Mingoia et al., 2017; He and Yang, 2022) and other psychological issues such as depression (Twenge et al., 2018; Leimonis and Koutra, 2022).

The harmful impact of exposure to media images on women’s body satisfaction is often attributed to social comparison (Levine and Murnen, 2009). Social comparison theory, as proposed by Festinger in 1954, asserts that humans have an innate tendency to assess their abilities and characteristics by comparing themselves to others, preferably those who are more similar to them, especially when there is no actual means of evaluation. Festinger (1954) delineated two primary forms of social comparison: ‘Downward comparison’ in which individuals compare themselves to those they perceive as less fortunate in some aspect, generally leading to improved mood and feelings of personal worth (Wills, 1991); and ‘Upward comparison’ in which individuals compare themselves to those they perceive as socially superior, typically resulting in negative mood and a potential threat to self-esteem (Gibbons and Gerrard, 1989; Wheeler and Miyake, 1992; Nerini et al., 2009).

Therefore, when applying this theory to social media, a space saturated with idealized images and beauty standards, individuals often find themselves comparing their own physical appearance to these models. This ‘upward’ comparison frequently leads to a self-perception of inadequacy, resulting in a negative evaluation of one’s physical appearance. As a consequence, this is reflected in the subsequent increase in levels of body dissatisfaction (Thompson et al., 1999; Tiggemann and McGill, 2004; Tiggemann and Slater, 2004; Nerini et al., 2009).

Social Networks are platforms, where people are exposed to content related to physical appearance, and excessive use of these is associated with a negative body image among adolescents (Revranche et al., 2022). This association derives from the internalization of the concept of the ideal body presented on the internet, self-objectification, peer feedback and social comparison (Revranche et al., 2022). A key feature that distinguishes contemporary social media from traditional media is its interactivity (Pempek et al., 2009). The active social behaviors in the form of “likes” and “comments” can be generated by Social Networking Site (SNS) users to represent acceptance and can be employed as indicators of popularity (Jong and Drummond, 2013). SNS is a place full of peers’ images and celebrities that create opportunities for social comparisons and internalization determinants of a “social definition of beauty” (Santarossa and Woodruff, 2017). This internalized ideal can become problematic because media content often does not reflect reality: as a result, incomplete, inaccurate and “misrepresented” issues are promoted (Geraee et al., 2015; Grogan, 2016).

Several studies (Holland and Tiggemann, 2016; Murray et al., 2016; Lonergan et al., 2019) identified specific aspects of SNS use related to body dissatisfaction and eating disorders among adolescents and young adults. Recent research has shown that exposure to photos on a platform called “Instagram” depicting the ideal of thinness (compared to images of plus-size women) increases women’s body dissatisfaction (Tiggemann et al., 2018). The use of filters or other digital alteration techniques represents another important photo-based activity that needs closer attention (Holland and Tiggemann, 2016). It also was found that who share modified photos (selfies) on social media are related to the overestimation of body shape and weight, body dissatisfaction, dietary restriction, and internalization of the ideal of thinness (McLean et al., 2015).

The Sociocultural Attitudes Toward Appearance Questionnaire third version (SATAQ - 3) is a tool for evaluating sociocultural pressure and internalization of the beauty standard (Heinberg et al., 1995). This instrument was developed by Heinberg, Thompson and Stormer in its first version in 1995 (Thompson et al., 2004) and has been updated several times (Thompson et al., 2004; Schaefer et al., 2015). The SATAQ, and its later versions, had psychometric qualities tested in populations from many different countries such as Spain, Iran, Brazil, India, France and Italy (Stefanile et al., 2011; Llorente et al., 2015; Rodgers et al., 2016; Neves et al., 2020; Sahlan et al., 2020; Lewis-Smith et al., 2021). Measuring internalization of thin ideal has received a great deal of attention because of the potential risk developing of an eating disorder (Warren and Akoury, 2020; Jankauskiene and Baceviciene, 2022; Negi et al., 2022). In 2011, Stefanile and colleagues validated the Italian version of the questionnaire obtaining good psychometric properties (factor loading, Cronbach alphas and convergent validity) (Stefanile et al., 2011). In 2019 the same authors validated the SATAQ-4-Revised which provides two versions (for female and male population) adapted to the new ideal of beauty that assesses the desire for a muscular and athletic physique (Stefanile et al., 2019).

According to Uchôa and colleagues, the SATAQ-3 measures the influence of traditional media such as television, cinema, and magazines. However, it does not evaluate the impact of the internet and social networks, which have become increasingly significant in the lives of adolescents (Uchôa et al., 2019). Furthermore, even the SATAQ-4 does not provide a comprehensive assessment of the influence of social networks, as it broadly examines the three components of the tripartite model of influence (peer, family, and media), dedicating only four specific questions to the “media” (Schaefer et al., 2015). To the best of our knowledge, no questionnaire in Italian language evaluates the sociocultural pressure and internalization of the beauty standard regardless of gender and based on social media.

Starting from the validation of the questionnaire SATAQ-SM in the female population (aim of this study), we plan to validate it also in the male population and finally in the general one in the next future.

The questionnaire was disseminated through social media, allowing anyone to participate voluntarily. We chose to include only women in our analysis as their numbers were higher compared to other genders (Women = 485; Men = 74); therefore, it would not have been possible to generalize the results to the entire population (Comrey and Lee, 1992; Clark and Watson, 1995). Their socio-demographic characteristics are summarized in Table 2. Most of the participants were under the age of 26 (N = 383; 78.97%). Moreover, 45.98% (N = 223) of the females were engaged or in a stable affective relationship. Also, 50.11% (N = 243) had a high school diploma while 28.04% (N = 136) had a middle school diploma.

The aim of the study was to validate the SATAQ-SM. The original SATAQ-3 consists of four subscales: Information, Pressures, Internalization-General and Internalization-Athlete. The factorial analysis conducted on the SATAQ-SM replicated the patterns of item loadings found in published studies using the original version of SATAQ-3.

Furthermore, the McDonald Omega values suggest excellent internal consistency, both for the four subscales and for an overall composite. These consistency levels are similar to those of the original version evaluated with Cronbach’s Alpha (Thompson et al., 2004). For example, the internal consistency for the Pressures subscale was 0.92 for SATAQ-SM and 0.92 for SATAQ-3. The value for the total subscale was 0.95 for SATAQ-SM and 0.96 for SATAQ-3.

Moreover, each item correlates with the subscale to which it belongs (factor loading). The inter-factor correlation, at 0.37, falls just slightly below 0.40 for Factor 1 (Information) and Factor 4 (Internalization-Athlete). Nonetheless, this correlation remains statistically significant. Based on the existing literature, we can affirm that these findings do not adversely affect the psychometric properties of the instrument.

These findings allow us to hypothesize that social media now assume a role akin to television and magazines in contemporary society. As demonstrated in literature, digital media has, in fact, taken over the position once held by television as the foremost source of news in many nations (Majo-Vazquez and González-Bailón, 2018). Furthermore, another study emphasizes the substantial embrace of social media by adolescents, resulting in a considerable decline in the consumption of conventional television programs and magazines (Twenge et al., 2019). This study goes on to highlight that the widespread integration of social media, especially among the iGen generation, has led to a marked decrease in the utilization of traditional TV programs and magazines (Twenge et al., 2019).

Additionally, correlation analysis between EAT-26 and SATAQ-SM revealed a noteworthy relationship. The findings indicate that there is an association between symptoms of eating disorders and the influence of social media on individuals’ perceptions of self. This correlation outcomes aligns with a recent systematic review showing that the misuse or intensive use of social media is linked to a range of negative effects including body dissatisfaction, low self-esteem, and notably, an increased likelihood of developing eating disorders (Vincente-Benito and Ramírez-Durán, 2023).

Finally, the correlation between RSES and SATAQ-SM shows that with an increase in self-esteem, the influence of social media on the perception of self is reduced. Recent evidence suggests that high self-esteem protects adolescents against the internalization of appearance ideals (Espinoza et al., 2019). Adolescence is a period of identity formation, self-expression and most important peer acceptance (Jankauskiene and Baceviciene, 2022). Media use is an important agent for online and offline developmental issues for adolescents (Gerwin et al., 2018).

However, despite the results discussed above, this study has several limitations. Firstly, the validation is based on an opportunistic female sample, and the results cannot be generalized to the entire general population. Further studies, not limited to cross-sectional designs, are needed to determine whether the questionnaire is adaptable to different contexts.

Secondly, the distribution of age groups is different from the actual Italian female population (under 25: 78.97% vs. 22.16%) (Istituto Nazionale di Statistica, 2023). Therefore, our sample is not adequately representative of all ages, so it may be optimal to validate the SATAQ-SM on specific age groups. On the other hand, there is evidence that the age group most actively using social media falls between 20 and 29 years old (We Are Social and Meltwater, 2023), a demographic well-represented in our sample. In future studies, it might be possible to address these limitations by administering the questionnaire in specific settings, such as educational projects at various schooling levels or within universities. Providing the questionnaire in locations frequented by older individuals could help capture a wider range of responses and mitigate potential age-related bias in social media use.

Nevertheless, in future studies, it might be possible to mitigate these limitations by administering the questionnaire in specific settings, such as educational projects at various levels of schooling or within universities. Providing the questionnaire in locations frequented by older individuals could help capture a broader range of responses and address potential age-related biases in social media use.

Third, since this study protocol did not have a test–retest analysis we could not determine the temporal stability of responses.

Despite these limitations, we believe that the current psychometric evidence provides support for using SATAQ-SM in research. Investigating the influence of social media on body image perception is a field with broad implications (Artoni et al., 2021). It has been a recent phenomenon, where social media has become an integral part of our everyday life. Hence, the researcher still has much to discover about the effects of social media on people.

In fact, the use of social media significantly impacts mental health. When used correctly, it can enhance connections, increase self-esteem, and improve a sense of belonging (Zsila and Reyes, 2023). Additionally, social media provide opportunities to enhance support for users by facilitating social connections. For instance, online communities offer spaces for discussions about health conditions, adverse life events, or everyday challenges (Ulvi et al., 2022).

Creating tools like the SATAQ-SM, which assess social media influence, can contribute to the prevention of mental health problems (Riehm et al., 2019). It’s important to note that demonizing platforms like Instagram and other social media is not productive. Different individuals use social media in various ways. Therefore, we can approach the experience of social media more consciously (Campisi et al., 2015).

This study attempts to validate SATAQ-SM, a translated and modified version of SATAQ-3 for women. The McDonald Omega values indicate excellent internal consistency for both the four subscales and the overall composite. These consistency levels are comparable to those of the original version, which was assessed using Cronbach’s Alpha (Thompson et al., 2004). The high data quality can be attributed to the well-designed original SATAQ-3 questionnaire. This adapted Italian version questionnaire could assist in investigating groups at greater risk for developing eating and body image disturbances in relation to social media use.

Regardless of the limitations explained previously, we believe that SATAQ-SM is an exciting research tool for future exploration on understanding the complex connection between social media usage and body image perception.

The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.

Ethical approval was not required for the studies involving humans in accordance with the local legislation Regione Emilia – Romagna AOU 0007852/20 (16/03/2020) and the Comitato Etico Area Vasta Emilia Nord (AVEN) requirements. The risk of identity theft is low, and the questionnaires administered were directed at the general population without generating a diagnosis or allowing the definition of psychopathological conditions. The studies were conducted in accordance with the local legislation and institutional requirements. Written informed consent for participation was not required from the participants or the participants’ legal guardians/next of kin in accordance with the local legislation Regione Emilia – Romagna AOU 0007852/20 (16/03/2020) and the Comitato Etico Area Vasta Emilia Nord (AVEN) requirements. All the participants provided written informed consent.

All authors listed have made a substantial, direct, and intellectual contribution to the work and approved it for publication.