Body image in Australians compared to women with breast hypertrophy and US norms

**Background**: The Multidimensional Body-Self Relations Questionnaire (MBSRQ) is a widely used instrument to assess body image. This study aimed to assess MBSRQ Australian norms and test the hypotheses that these would be different to United States norms and to women with breast hypertrophy. Secondary aims were to understand socio-demographic determinants of scores and the change in body image satisfaction associated with breast reduction surgery. **Methods**: Australians ≥18 years were recruited according to the 2016 Census age and sex distribution. Participants completed MBSRQ-Appearance Scales (MBSRQ-AS) and provided socio-demographic information. A comparison was made to previously published US normative scores, to scores of women who had prospectively completed the MBSRQ before and after breast reduction surgery and to women with untreated breast hypertrophy. **Results**: Data for 1016 normative, 209 surgical and 161 breast hypertrophy control participants were analysed. MBSRQ-AS scores for Appearance evaluation and Body areas satisfaction were significantly lower for women than for men. Body mass index (BMI) was a significant predictor across all five scales, with a higher BMI associated with lower scores for appearance and satisfaction. Age and marital status were significant predictors for Body areas satisfaction and Overweight preoccupation. Differences between Australian MBSRQ-AS scale scores and US general population values were significant, with Australian values lower for both sexes. Women with breast hypertrophy had lower scores than population norms but this corrected with breast reduction surgery, with women having scores equivalent to the general population at 12 months post-surgery. **Conclusion**: The Australian population is a distinct population in terms of body image, as measured by the MBSRQ-AS. This normative dataset provides a useful reference for future health-related research in Australian cohorts. Women with breast hypertrophy have a body image that is lower than that of the normal population and this improves with surgery.