. . .

David: So, Lauren, cosmetic surgery. What role might Latter-day Saint theology or culture - that's not necessarily the same thing, of course, play in the decision to have cosmetic surgery, especially since your research shows that it appears that Latter-day Saints are above the national average.

Lauren: Yeah, so, this is really interesting, and I was checking these stats, um, this morning, so um, when we published this, Pew research has said 4% of people have undergone elective cosmetic surgery. The rates have actually gone up in the last couple years. So the Latter-day Saint population is about even - about 20%. I think it's 24% of individuals in the United States have undergone cosmetic surgery. We don't know if that's elective or not, but that was kind of interesting to see. And I do know just from being in this field that rates continue to go up.

. . .

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Mormon Land Podcast - Body Image in LDS Culture

Peggy Fletcher Stack: Welcome to Mormon Land, where we explore news in and about the Church of Jesus Christ of Latter-day Saints. I'm senior religion reporter Peggy Fletcher Stack. Joining me is senior managing editor David Noyce, who oversees our faith coverage.

David Noyce: Hi, Dave.

Peggy: Hello, Peggy. Before we start, we remind you about another way to support Mormon Land. Just go to patreon.com, or with a donation as small as $3 a month, you can access transcripts to our podcasts, our complete newsletter, and all of our religion coverage. Again, that's patreon, P-A-T-R-E-O-N.com/MormonLand. And if you haven't already, follow us on Instagram at mormon.land.

Now for today's episode. Religion, in general, has prompted believers to have a more positive view of their bodies and Mormonism specific teachers that heavenly parents are embodied, that humans are created in their divine image, and that the body is a temple. Why then does some members of the Church of Jesus Christ of Latter-day Saints struggle with their body image? Why do many turned to cosmetic surgery to, quote, improve their bodies? Two researchers from Brigham Young University have just completed what they say is the largest study ever done regarding the potential connections between Latter-day Saints doctrine and culture.

Lauren Barnes: Thanks so much for having me.

Peggy: Thank you.

Lauren: Yeah. So, there is some research about eating disorders, and as a marriage and family therapist, I try to take a systemic lens, right? We don't just exist in our bubble as an individual. We have context that informs us and tells us messages or encourages us to do some things, might discourage us from other things.

So especially in graduate school, I started looking at how to eat in families and other influences contribute to eating disorder behaviors or positive body image or negative body image, and really came to study to eating disorders. Our mental illness is not just about eat more food or eat less food or do this behavior. We know that eating disorders for years were the number one killer of all mental illnesses. That's recently been bypassed by drug dependence.

But that was really concerning for me. What's happening to these girls and what can we do here? And I would say in the 15 years I've been practicing, I will tend to talk about girls and women more just because that's what I've worked with. But the rates of eating disorders in men have gone up about 10 times in just the last 15 years. And even statistics from like three years ago, it used to be a 3-8% rate of prevalence of eating disorder. It's now closer to 10%, and maybe even higher than that, in just the last five years. So it's something that's happening around us, and I'm just so curious about that.

I've seen a wide variety of things with body image from body dysmorphic disorder, a diagnosable mental illness.

Peggy: Yeah, great question.

Lauren: Okay, so body dysmorphic disorder, we would diagnose that using the diagnostic statistical manual, our lovely DSM. It means that you're having a discrepancy between reality and perception. And probably all of us have that part of it at some point in our life. My hair's awful today, or oh, my face looks so much bigger than it did yesterday. Reality of that, really small. But our perception is off. So it constitutes that to point that it's interfering with daily life, right? Like clinical distress and impairment.

And then also people who have body dysmorphic disorder in what we would call body checking or kind of repetitive behaviors, where they're trying to soothe that a little bit. At first, I thought, oh, my gosh, this is just, this is my really naive, young therapist, mind. I'm just gonna own that. Oh, my gosh, we have all these beautiful girls who just complaining that they feel when they look that all the time. And I think that's a pretty common myth. But really, your brain is struggling from nutrients, keep you alive, and your actual perception, what you see in the mirror is legitimately different than what is reality. So that's a more severe case, body dysmorphic disorder. But I would say body image struggles, probably most people can relate to in some way or the other.

David: So you talked about family members or family of people outside the person. Just a quick question. Do you think the social media and influencers and all that, especially LDS ones, have an impact, have had an impact in the past, say, five years?

Lauren: Yeah, I would say, yeah, social media has really been on the rise, right? I didn't grow up with Instagram or things like that. And a lot of the teenagers today are growing up with access to that. So Dr. Coins, Sarah, who I worked with, a lot of her initial research was looking at media. And that's kind of where this started. We just started to talk about our similar interests and where they converged. So there are some studies that look at social media use and impacts on perceptions of oneself, comparing, feeling less than, things like that. So does it have an influence? Probably. Absolutely. Does it have all of the influence and power? No, I wish we could just be like, this is the one thing. And so let's fix that. But really it's so many messages from all over the place.

Peggy: Let's talk about the study itself now, the one that just came out. How did you get involved in a research? How did you decide to go about devising it?

Lauren: Yeah. So I gave you a little bit of history about Dr. Coins. So Sarah is probably one of the best and most diligent researchers I know. She has been fabulous and she's a great mentor to graduate students and also younger people in the field. So I joined the faculty at BYU about 11 years ago. And we just started talking and we became good friends. And I think she's raising two girls. I'm raising one. I'm also raising a boy. And I think as moms, as parents, right, individuals in this world, we kind of start to wonder, what can we do? How can we protect these kids and help them?

So Sarah did most of the footwork for this. I'm just going to give that all to her. She got a grant for this. She did the IRB approval. We had all of the data analyzed and coded. And we really wanted to know, like you mentioned at the beginning, Peggy, religion and religiosity and spirituality are often protective factors. What does this look like within a Latter-day Saint population?

And for me, I attended an international training for clinicians and eating disorders a couple of years ago. And one of the presentations there looked at eating disorder prevalence within a Jewish community and varying levels of whether it's orthodox. I don't know all the different levels. And I apologize, I should. But it was so fascinating that they were quoting research that said within their religion, their religion had the highest prevalence of eating disorders when compared to other religions. But also some of the things from that I thought, oh, my gosh, this probably applies to a Latter-day Saint population. We have a word of wisdom. We have other things that give us guidelines on food to eat and maybe how to dress and how to act. I wonder how this could apply. So it was helpful for me. And I was really invested in doing this research just to know what's helpful and what can we do a little better? What can I do better as a clinician, as a mom, as a professor, as a person in this world that wants to make it better?

Peggy: So we're going to dive into some of these. But just quickly, what were some of the important conclusions or takeaways that you discovered?

Lauren: Like takeaway was spirituality and religiosity even for a Latter-day Saint population does contribute to better body esteem. That is awesome. And I like to, in your introduction, had you talked about LDS theology is kind of distinct because we believe in the face doctrine and the nature of a God and importance of physical body, right? That is kind of distinct to this. So it was fun and it was fun. I think that's fun to find that finding. Awesome. This is helping people.

And to find some of the core doctrine of the theology, like the plan of salvation, the atonement of belief and heavenly parents being the most important and impactful, at least in our sample. That's what the participants said. Those were really protective and had the highest relation to positive body image. And I thought it was interesting to get through some of the more qualitative studies to break out some themes.

Between what people said. So, okay, let's focus on principles instead of like the do's and the don'ts. And for me, that was exciting to see that found in the research and also to know that's kind of a direction that LDS Church has been taking lately, focusing more on principle guided instead of the do's and don'ts.

I would say one of the things that surprised me or that saddened me if this is that kind of surprise. I was really saddened to see this perception and the prevalence of what's called costly grace, right? The thought that people within the Latter-day Saint community still believe that at least this portion of them, right? Still believe that they really need to earn God's love and approval, right? So, like, I'm only good enough if I do X, Y, and Z. And as a clinician, I think we're hearing about this more just day to day life and screw velocity, right? Religious OCD.

So, for me, that's kind of what my brain put together. Like, oh, okay, this is still happening and it's happening maybe more. Maybe it's just being talked about, but we need to be aware of that within a Latter-day Saint community. Some people are still going to believe I've got to earn God's love and approval. It's not just given. And so then as a clinician, as a researcher, as a person, what do I do with that information? How can I help?

I think I felt maybe surprised in a good way like, oh, this can be celebrated. One of the things that I really liked that came up was how people were talking about seeing diversity in their congregation that they worshiped with on Sunday. So, most people talked about how they didn't have a very diverse congregation, especially the 30% that were from Utah. But I really liked how they said that it's nice when we see even artwork or when we see other people or when we see people at general conference that represent different skin tones, body shapes, sizes, hair, color, things like that. That was all really helpful for them.

And I loved that because this is going to be a podcast. So, this is my own personal thing probably that I was excited. I am a Cuban American girl with big curly red hair. I do not look like what you think the typical Mormon woman is. And that's just who I am. Right? So, it's always exciting for me to find ways to celebrate diversity and to be able to recognize how that's pretty incredible. Like, God put us here looking different ways and we can celebrate all of that. And that's a really helpful thing in helping people develop body of scene.

David: Lauren, previous studies have been undertaken about how, for instance, Latter-day Saint temple garments, especially can...

Lauren: Okay. So, I'm going to pull this up just so I can make sure I'm telling you the correct numbers here. So, most of the people said that garments were either neutral, was about 30%. And then about 45% said that it was positive or extremely positive. This was really interesting to me. And when we kind of dug into that on some of the themes, it had to do, if it was going to be positive, it was because the individual linked that to their personal covenants and beliefs in that church. If it was more negative, it tended to come from kind of messages of, well, you have to do this. This is necessary because I think this is also where we started to get a lot of those comments of, well, I've just been told to cover my shoulders and my knees to not let men have bad thoughts. And that was like across the board negative. So, if people link garment wearing to like protecting men's thoughts, that's bad. That's not going to be helpful. But if they could link garment wearing to personal covenants and doctrine and beliefs, it was actually found to help their body of scene.

Peggy: So, how many of your participants or your responses were women versus men? And yes, did you ask the same questions of all of them?

Lauren: Yeah, so yes, we asked the same questions. And I can tell you what some of those were. So, this is a mixed method study, which means part of it was qualitative or interviews, right, where we ask open ended questions and people can respond. And then about 1300 of them did a quantitative or just kind of a survey, right? So, out of about 1500 people, 200 were men. So, keep that in mind. Like most of these were women. And we tried to go ahead and make men in the quantitative, the answering questions or the personal total total.

Peggy: Okay.

Lauren: Yeah. So, I think 23, somewhere, yeah, 23 of the qualitative were men and a bit over 80, 90 were women. And then 175 ish in the survey, the quantitative were men.

Peggy: And did you ask the same questions, though?

Lauren: Yeah. So, this is probably especially relevant around cosmetic surgery. We all want to know that, right? Yeah. It's kind of it's like one of those topics. I'm like, I want to touch that with a 10-foot pole and offend somebody. And it's just like so interesting. Let's talk about it. What's happening here?

So, I think it was in the qualitative, is only one man had reported having a cosmetic surgery. And there's a difference here between surgeries and procedures is how we did them. So, there's a cosmetic procedure, which could be like laser hair removal, things like that. And then there's a surgery, which go under cut with a knife, restructure something.

So, some of the questions were things like, how do you feel about cosmetic surgery and other physical alterations, like microblading or permanent lashes? And then we want to hear about your experiences with cosmetic surgery. Tell us your story, right? And then we just like record and transcribe and code. And then we ask them, how does your religiosity, your beliefs and culture impact your decision to get cosmetic surgery or not?

David: So, Lauren, cosmetic surgery. What role might Latter-day Saint theology or culture - that's not necessarily the same thing, of course, play in the decision to have cosmetic surgery, especially since your research shows that it appears that Latter-day Saints are above the national average.

Lauren: Yeah, so, this is really interesting, and I was checking these stats, um, this morning, so um, when we published this, Pew research has said 4% of people have undergone elective cosmetic surgery. The rates have actually gone up in the last couple years. So the Latter-day Saint population is about even - about 20%. I think it's 24% of individuals in the United States have undergone cosmetic surgery. We don't know if that's elective or not, but that was kind of interesting to see. And I do know just from being in this field that rates continue to go up.

So, this is a tricky question. Like LDS theology, do I think like the plan of salvation or core doctrine and things like that play into like, perfect your body by doing these procedures and spending tens of thousands of dollars? No, I don't personally think that. And I would actually add to that by saying about 60% of the participants who had undergone some kind of surgery, they were like, this has zero. My religiosity and my spirituality had zero impact on my decision to have a surgery.

And I like what you said there too, like the difference between doctrine and culture, Dave, because I, you know, I grew up in the Pacific Northwest coming to Utah was a very different culture, right? So just like Jell-O and carrot shavings, that's like a cultural thing. That's nowhere in the doctrine that I found. I don't even know if people actually do that or if that's just like myth here.

So I think there might be some context issues here, contributors. I know like when we drive on the interstate, we're seeing the billboard after billboard that something cosmetic it seems. And what are those messages telling us? And my guess is Utah and some parts of Utah and maybe some parts of being in this religion. Maybe people want to look different or they, I don't know, or like they think it will give them a sense of pride or it will be status back.

Yeah. Satisfying for them. I'm really curious why people get cosmetic surgery. That's what I want to know more about. Um, my guess as a therapist, I bring a lot of things back to like attachment, wanting, um, secure love, wanting to have affection, attention. And I wonder what's at the root of that. Where's that desire? Are people like, well, if I do this, then I can achieve that. If I do this, and I think things are often marketed that way.

Um, the one that was up for like two or three days before it got a really big outcry, the God's remodeling his temple. You remodel yours too. I think most of us in Utah have heard about that one. Like, the message there too, right? Like, okay, this is what we do here. I'm like, that is nowhere in the doctrine, but it is fascinating to see.

David: Can I ask the inverse question? And you may not have studied this obviously, but some Latter-day Saints not have cosmetic surgery because of a theology that says God gave you this body. So you shouldn't change it in some way. I'm, I'm just curious if that has any effect.

Lauren: So there were definitely some things that came out, especially in the qualitative research where people would talk about like exactly exactly what you said. God gave me this body. It is mine to take care of. It is beautiful as it is. And because I know that it's from God, I'm going to respect it. And to me, respecting it looks like not doing X, Y and Z. Um, so it is kind of interesting. Something with the culture and the messages there.

David: I want to go back a little bit, uh, just to clarify for our listeners. So you divided, as you said, you divided it into cosmetic surgery or something might be cut or it's you go under. Versus these procedures, uh, um, microblading, Botox, et cetera. And from the report I read, it said that 14% had cosmetic surgery, but I couldn't tell how many actually had those procedures. 14% was higher than the national average was about 4% at the time. You did your study.

Lauren: Yes.

David: How, how was, were the procedures or someone told me that the procedures are actually less than the national average. Is that true? Do you have stats on that?

Lauren: Um, so I do know this morning when I looked at the cosmetic surgery, it was somewhere in the 20% for the United States. Um, I'm really curious about cosmetic procedures and if they're higher or lower. It is so interesting.

David: So that's not part of your conclusions. So now what you're saying is now the 14% or 20 overall, is that right? Is more like the national average? Is that correct?

Lauren: So in, in our study, so this was done in 2022. We had 14% or about 160 people had undergone a cosmetic surgery and I was looking at the types of this. So this was anything from like nose surgery to ear surgery to breast augmentation, anything like that. And then about 190 out of this 1300 ish had undergone a cosmetic procedure.

David: That's where you came up with 20%.

Lauren: Mm hmm.

Peggy: Um, okay. What, what were the conclusions about the word of wisdom?

Lauren: Oh, yeah. Okay. So the word of wisdom tended to be pretty positive. So about 60% said it is positive or extremely positive. And then 26% said it was neutral. So that was kind of like, I don't know if I was surprised by, yeah, maybe surprised would be a good word because I work with a lot of teenagers and young adults and I often hear, Oh, the word of wisdom is so limiting. I don't like it. This, right?

Um, there is a quote that I think we put in there. Um, one young man. So like young adult age, he said, "I want to keep a healthy body and I know that my body is a gift from God. It's a good motivator to exercise and eat well. It makes me feel more grateful for my body and makes me respect it more." And that was kind of the general theme that we found there with the word of wisdom.

Um, and previous research has looked at word of wisdom and it's influenced on health outcomes and found a positive effect there. So it seems like people who are focusing on the principles of health, they're able to respect their bodies and then therefore care for their bodies and have better body image.

Peggy: So what additional research would you like to pursue? What's, what's next in this body image study research?

Lauren: Yeah, I think I would like to do more research, especially there seems to have been a shift in the last five years around bodies. It seemed like during COVID, there was a lot of body positivity, body neutrality, take care of your body. And now I was so excited, right? It was really nice and I was making good progress in my clients and they had good support. And now it seems like we've moved to another, um, round of everything again. So it's like, get this procedure, get this shot, take this supplement, um, fix your body. It's not good enough. And that's really hard.

So I would like to kind of replicate this and I would like to include more men because all of the eating disorder literature is saying that more men are struggling. Um, and I'm curious in what ways they're impacted by this. And I'll also add in this study that IRB wouldn't let us include anybody who had eating disorder, um, and eating disorder diagnosed, right? So all of those people were automatically not allowed to participate just to, um, make sure vulnerable population populations are protected. Um, so part of me wants to dig a little deeper there. Um, if we could do some research looking at eating disorders themselves, that would be fascinating to me.

Peggy: And individuals in the church can do to improve positivity about bodies, uh, for, for women, obviously, and others. But what, what were some of those? So our listeners can know.

Lauren: Yeah. So, um, some of those, but let me pull them up here. I should just know them off the top. One of them was the grace. One of them was the grace thing you mentioned, I believe. Yeah. The last one. Yeah. Teach the real meaning of grace.

Um, so some of these included focus on the doctrine. Um, the nature of the role of the body and the plan of salvation have open conversations about how church practices are related to body image. So that includes the word of wisdom, garments, focus on principles, teaching about modesty, create a church culture that emphasizes acceptance, celebrate and encourage diversity, focus on attachment to God. So all of those are good things that people can implement and can be fairly beneficial.

Peggy: And we have, say, a lesson about perfection. Um, the people need to be aware how they teach perfection, correct?

Lauren: So yeah, right. We could have a conversation like, what's the perfect body look like? And we could all say, okay, now your homework is to go out there and create the perfect body. I want you all to come back looking perfect, right? Or do we talk about perfectionism as this kind of like, what is this whole, right? And do we allow for diversity within that, right? You're perfect. Your wholeness is going to be different than mine.

And I love that we're encouraging youth and individuals to form their own relationship with deity, right? That's one of the coolest things that I love and admire about this religion, right? You can have a direct relationship with your God. You can have a direct relationship with your Savior. So what does that mean to you? And what does that do for you? How are you going to care for this if you're made in the image of your God? What does that mean? I would love to see more conversations like that.

Peggy: Lauren Barnes, thanks for joining us today.

Lauren: Thank you so much for having me.

Peggy: And thanks to Dave Noyce. Always a pleasure. And to our producer, Chris Samuels, we remind our listeners that they can keep up on all the happenings in and about the church by subscribing to the Salt Lake Tribune's free Mormon land newsletter. Just go to sltrib.com to sign up and we'll talk again next time on Mormon land.