This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Korea is one of the countries with the strongest preference for a thin physique. In a society where slim bodies are rated as desirable and overweight bodies as unattractive, weight stigma is socially accepted, and weight bias is internalized [1]. Negative attitudes toward overweight people develop from an early age. Parents play a crucial role in conveying weight-related social norms to their children and shaping their children’s weight perception. Ra et al. [2] reported that parental weight-related teasing was associated with anti-fat attitudes among Korean girls aged 5–7. Internalized weight bias from childhood contributes to the adolescent overestimation of body weight. Adolescents with weight misperception are at a higher risk of poor mental health. Lee et al. [3] showed that Korean adolescents who overestimated their body weight had lower subjective happiness and were more likely to experience subjective stress, sadness/despair, suicidal ideation, and suicide planning.
Media is known to be a major source of stigma and weight bias. Weight-biased content is prevalent across various media, including the news, entertainment, advertising, and social media. In the media, overweight people are not only underrepresented, they are also portrayed as lazy, greedy, gluttonous, stupid, and lacking willpower. The media disseminates, reinforces, and perpetuates the inaccurate view that being overweight is attributed to individual responsibility while ignoring the genetic, biological, and environmental causes of being overweight [4]. Excessive exposure to weight-biased media content can lead to body dissatisfaction, body image distortion, and disordered eating behaviors [5].
Smartphones are major screen devices used by Korean adolescents to access various types of media content, including social media, games, videos, webtoons, and music. Korea has one of the highest smartphone penetration rates worldwide, with 98% of Korean teenagers owning smartphones. In a national survey conducted in 2023, the prevalence of smartphone dependence among Korean adolescents was 40.1%. In this survey, adolescents were at the highest risk of smartphone dependency among all age groups [6]. There is growing evidence that excessive smartphone use and smartphone dependency negatively impact adolescents’ mental health [7,8]. Although excessive smartphone use among Korean adolescents has been reported to be associated with body image distortion and inappropriate weight loss strategies [9], the association between smartphone dependency and body image distortion among Korean adolescents has not yet been studied among Korean adolescents.
In the present issue, Cho et al. [10] investigated whether excessive smartphone use and smartphone dependency are associated with body image distortion (overperception of body weight) among Korean adolescents using data from the 16th Korea Youth Risk Behavior Survey, 2020. The study participants consisted of 42,981 students (20,683 boys and 22,298 girls) from middle and high schools in Korea. Those who had missing values for height, weight, or smartphone usage time and those who underestimated their body weight were excluded. In their study, both moderate and high levels of smartphone dependency were associated with body image distortion among both boys (moderate: odds ratio [OR], 1.11; 95% confidence interval [CI], 1.01–1.22; high: OR, 1.18; 95% CI, 1.05–1.32) and girls (moderate: OR, 1.14; 95% CI, 1.05–1.23; high: OR, 1.30; 95% CI, 1.18–1.42) compared to low level of smartphone dependency. However, after adjusting for covariates, including smartphone dependency, excessive smartphone use was not associated with body image distortion in either boys or girls. In other words, although excessive smartphone use increased the risk of smartphone dependency [8], excessive smartphone use without smartphone dependency did not increase the risk of body image distortion. Adolescents use smartphones for a variety of purposes, including habitual use, pleasure, communication, games, multitasking, stress relief, learning, ubiquitous traits, and not being left out. Lee et al. [11] reported that learning was a protective factor against smartphone addiction among Korean adolescents. Excessive exposure to weight-biased media content through smartphones rather than excessive smartphone use increases the risk of body image distortion [5].
Smartphones are becoming a central part of adolescents’ lives. Adolescents can easily and quickly use smartphones to access the internet, engage in learning, share information, interact with peers, obtain pleasure, and deal with stress. Although Korean psychiatrists recommend limiting smartphone usage time during adolescence to prevent the harmful effects of excessive smartphone use [12], simply limiting smartphone use is not the solution. School-based interventions to enhance media literacy are significantly effective in reducing body dissatisfaction, body image concerns, eating concerns, and thin internalization attitudes among adolescents [13,14]. Sung et al. [15] presented that the BodyThink program-based body image education improved attitudes toward cosmetic surgery among Korean adolescents. They stated that the positive effects of the BodyThinking program on body image satisfaction may be attributable to the cultivation of media literacy in adolescents, which allows them to view media images critically. Media literacy education should be widely implemented to protect adolescents from the negative effects of excessive exposure to weight-biased media content through smartphones.
Article Information
Conflict of interest
Young Gyu Cho is an Associate Editor of the journal but was not involved in the peer reviewer selection, evaluation, or decision process of this article. No other potential conflicts of interest relevant to this article were reported.
Funding
None.
Data availability
Not applicable.
Author contribution
All the work was done by Young Gyu Cho.
References
1. Cho YG. Why does weight gain put more stress on women? Korean J Fam Med 2020;41:363-4.
2. Ra JS, Cho KS, Cho YH. Gender differences regarding parental teasing of Korean children’s weight and anti-fat attitudes. J Korean Public Health Nurs 2020;34:289-300.
3. Lee KH, Bong SH, Kang DH, Choi TY, Kim JW. Association between weight misperception and some mental health-related characteristics in Korean adolescents. Neuropsychiatr Dis Treat 2020;16:3053-62.
4. Kite J, Huang BH, Laird Y, Grunseit A, McGill B, Williams K, et al. Influence and effects of weight stigmatisation in media: a systematic review. EClinicalMedicine 2022;48:101464.
5. Sanzari CM, Gorrell S, Anderson LM, Reilly EE, Niemiec MA, Orloff NC, et al. The impact of social media use on body image and disordered eating behaviors: content matters more than duration of exposure. Eat Behav 2023;49:101722.
7. Kim H, Cho MK, Ko H, Yoo JE, Song YM. Association between smartphone usage and mental health in South Korean adolescents: the 2017 Korea Youth Risk Behavior Web-Based Survey. Korean J Fam Med 2020;41:98-104.
8. Yun H, Choi EK. Association between smartphone overdependence and mental health in South Korean adolescents: a secondary data analysis. Child Health Nurs Res 2024;30:87-96.
9. Kwon S, Kim R, Lee JT, Kim J, Song S, Kim S, et al. Association of smartphone use with body image distortion and weight loss behaviors in Korean adolescents. JAMA Netw Open 2022;5:e2213237.
10. Cho H, Park J, Lee D, Shin DW. Association of body image distortion with smartphone dependency and usage time in adolescents: a cross-sectional Korean youth study. Korean J Fam Med 2025;46:98-106.
12. Lee YJ, Lee SI, Lee AR, Bahn GH, Choi TY, Kim JY, et al. Attitudes of psychiatrists towards smartphone usage of children and adolescents. J Korean Neuropsychiatr Assoc 2015;54:556-63.
13. Kurz M, Rosendahl J, Rodeck J, Muehleck J, Berger U. School-based interventions improve body image and media literacy in youth: a systematic review and meta-analysis. J Prev (2022) 2022;43:5-23.
14. Zuair AA, Sopory P. Effects of media health literacy school-based interventions on adolescents’ body image concerns, eating concerns, and thin-internalization attitudes: a systematic review and meta-analysis. Health Commun 2022;37:20-8.
