Thinking meta-theoretically about the role of internalization in the development of body dissatisfaction and body change behaviors

• Internalization is a risk factor for maladaptive body change behaviors.
• Previous research supports internalization as both a moderator and mediator.
• No single theory incorporates both roles, despite substantial research support.
• A moderated mediation model integrates internalization as a state and a trait.

Internalization of societal standards of physical attractiveness (i.e., internalization of the thin ideal for women and internalization of the mesomorphic ideal for men) is a widely studied and robust risk factor for body dissatisfaction and maladaptive body change behaviors. Substantial empirical research supports internalization as both a mediator and a moderator of the relation between societal influences and body dissatisfaction. In this paper, a primer on mediation and moderation is followed by a review of literature and discussion of the extent to which internalization can theoretically fulfill the roles of both mediation and moderation. The literature review revealed a stark contrast in research design (experimental versus non-experimental design) when alternate conceptualizations of internalization are adopted. A meta-theoretical, moderated mediation model is presented. This model integrates previous research and can inform future empirical and clinical endeavors.