The relevance of appearance-related social pressure as a crucial factor for low self-esteem and depression as well as body dissatisfaction and unhealthy body change efforts has been proven repeatedly [e.g.[44–46]. Up to now, knowledge of gender, weight, and age-related variations in social pressure has either been incomplete or controversial because very few studies have explicitly investigated these aspects together. Moreover, most of the existing studies have permitted only limited conclusions, because they either focused on single aspects of social pressure or were limited in their assessment.
The current study thus contributes to a better understanding of the occurrence of social pressure by explicitly addressing gender, grade-level, and weight variations in a large sample of German adolescent girls and boys. Furthermore, we applied a new measure (FASD), whose psychometric quality and applicability for both girls and boys has been proven before [17, 43] and which allows a broad assessment of aspects of appearance pressure from both peers and parents. In doing so, the results may help to identify adolescents who are particularly at risk of suffering from appearance-related social pressure and thus provide concrete advice for preventive approaches.
Following the overall effects of the current study, the findings suggest that social pressure is more prevalent during mid-adolescence compared to early adolescence and girls and adolescents with higher weight are particularly affected. A comparison of the effect sizes indicated that gender differences were particularly pronounced in the current sample.
Our hypotheses regarding gender differences in peer and parental pressure were only partly supported. While we found the expected gender differences on all peer pressure scales, gender effects were only found for parental teasing. Thus, our results support previous findings on negative verbal commentary that found a higher prevalence among girls [6, 14]. Nevertheless, the conclusion often drawn in previous research that the parental impact is generally higher for girls was probably premature. Because the effect size for parental teasing was rather low and no effects emerged on the other scales, levels of parental pressure among girls and boys seem to be more similar than previously assumed. This finding also resembles the results of Rodgers et al. . Even though they found gender differences for a few aspects of parental pressure, a closer look at the scores and effect sizes reveals that only the difference regarding negative maternal comments is noteworthy. Maybe no effects were revealed because of the extreme floor effect and the restricted variance of these FASD scales, which is also known for instruments assessing similar constructs in population-based samples .
Gender effects for peer pressure are in line with current research, indicating that girls are more strongly affected by peer influences and the impact of friends is especially important [7, 46]. Gender effects with regard to teasing experiences have been controversial because of limitations in the measurement of teasing. Our results obtained with a gender-neutral, reliable peer teasing scale support the findings of the American EAT-Project  and can serve as further evidence that girls experience more peer teasing. Summing up, the results support the assumption that girls are particularly embedded in an appearance culture [1, 46]. In detail, the findings suggest that girls perceive more pressure from appearance norms and modeling and are more often subject to proximate forms of peer pressure such as teasing or exclusion. Because the current study applied a measure of social pressure that is not biased by female ideals and has proven to be suitable for both girls and boys alike, we conclude that the higher extent of appearance pressure among females is not just a result of inappropriate measurement but in fact a result of the greater societal emphasis on beauty and appearance for females .
The prevalence of appearance-related social pressure especially by peers underlies age-related trends whereas grade-level effects in parental pressure only emerged for encouragement to control weight and shape and were also rather minor.
In contrast to Chen and Jackson , these effects proved to be comparable for girls and boys in this German sample. Based on previous results, comparing male body image in Western and Asian cultures, we assume that the divergent results might point to a cultural difference. As Yang, Grey, and Pope  revealed, Asian males were less preoccupied with body image than Western males and they discussed interesting reasons why in Western cultures more emphasis is placed on male appearance (e.g. media exposure, decline in traditional male roles).
In accordance with the literature [7, 32], differences in our sample were particularly evident comparing early (grade 7) and middle adolescents (grades 8 and 9). Although conclusions must be drawn cautiously due to the cross-sectional design, it seems as if the transition from grade 7 to grade 8 is particularly relevant. Interestingly, differences were mainly reflected by an increase of perceived school and class norms. This effect might be a result of the local school system. In this region of Germany, students change schools between grades 6 and 7. Hence, the adolescents in grade 7 have just joined a new school context and their new schoolmates. This new school context constitutes an important developmental transition, which is associated with changes in social roles and a substantial reorganization of attitudes and beliefs and has been considered a period of risk for problematic behavior . Thus, we believe that among grade 7 students the establishment of norms and group processes has presumably just started. Consequently, we assume that the results probably reflect both – on the one hand, individual changes and transitions throughout adolescence, and on the other hand, the development of the class as a group of shared attitudes and values. It might be an interesting issue for future studies to distinguish between these two processes and figure out which role age per se or the attainment of a certain grade-level plays in this issue. Furthermore, the findings suggest that early adolescence as well as school transitions are crucial periods for establishing prevention programs that counteracts the development of an appearance culture within a class. Again, we have to emphasize that the findings can only lead to cautious conclusions because of the cross-sectional design of the study. Longitudinal studies are needed to confirm these findings.
Body mass variations
Our results suggest that mainly high-average and overweight adolescents experience more appearance pressure from peers and parents, whereas teasing and exclusion are particularly prevalent. We could not replicate the interaction of weight and gender reported by Jones and Crawford , who hypothesized that girls experience teasing for higher weight whereas boys are teased for being underweight. In line with stigmatization research  and our expectations, the results suggest that overweight adolescents are generally faced with more appearance pressure regardless of their gender. A possible explanation for this is methodological, for we could also find slight similar tendencies in the univariate but not in the multivariate analysis. Jones and Crawford  also used univariate analyses. However, due to the intercorrelations between the aspects of pressure, we decided to use a multivariate and thus, more conservative approach, which reveals that the interactive effects are not strong enough and that only the main effect of BMI is relevant. Thus, our findings indicate that girls and boys with higher weight are equally at risk of being faced with appearance pressure.
Body mass variations in the perception of more subtle, norm-related aspects of pressure have rarely been investigated and could only be observed to a lesser extent in our sample. However, small effects for school and class norms indicated that high-average students show the highest levels. Possibly, adolescents who barely fail to fit the slim norm are more likely to internalize appearance ideals  and are thus more sensible to subtle appearance-related messages.
Regarding parental pressure the body mass effect is primarily reflected in higher levels of parental encouragement to control weight and shape especially among overweight participants. Hence, overweight adolescents perceive their parents as more demanding regarding weight or shape control. This result is not surprising, because parents are often concerned about the overweight of their child and feel responsible . So, they probably try to support weight control and dieting efforts with comments designed to act as reminders. In accordance with previous studies [13, 15, 25] our findings can serve as further evidence that these encouraging messages are more problematic than previously assumed. The results indicate that the line is fine between support and pressure and future research must keep track of possible consequences. Beyond this, the findings appear to be particularly relevant for the field of obesity prevention and treatment of children and adolescents. Approaches including parents should address these processes and negotiate the balancing act in teaching parents to support their children without putting them under pressure.
The results of our study are limited to a certain extent first due to the sample. Unfortunately, we could not use the data collected on SES and ethnicity of the sample, because plausibility checks revealed that some adolescents misunderstood these items. Hence, we had to consult data from the Federal Statistical Office, which show that Potsdam is a city with a low percentage of inhabitants with foreign backgrounds and a high percentage of inhabitants with academic and higher social background. Because we only included students from schools with higher educational levels generalizations are restricted and future research might extend these findings to larger, more representative samples. Furthermore, the use of self-reported weight remains a limitation when investigating body mass variations. However, self-reported weight has repeatedly proven to be a valid measure in epidemiological studies with adolescents [12, 36]. In addition, BMI confounds lean mass with fat mass, which might lead to a screwed picture when studying males. Therefore future research should also include fat-free mass, body fat indices or girth measurements in order to confirm these findings. Finally, the results are based on cross-sectional data and thus do not permit developmental conclusions. The age-related variations can only point to possible trends that require further confirmation in longitudinal studies.