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"Only When I’m Idle Do I Pay Attention to Myself in the Mirror"：
The Underlying Concern behind Appearance Anxiety among Chinese
Female College Students
Lili Liu1,2, Haslinda binti Abdullah1*, Zatul Himmah Adnan3
1Institute for Social Science Studies, University Putra Malaysia, Serdang, Malaysia
2Yancheng Teachers University, Yancheng, China
3Department of Government and Civilisation Studies, Faculty of Human Ecology, University Putra
Malaysia, Serdang, Malaysia
*Correspondence Author
DOI: https://dx.doi.org/10.47772/IJRISS.2025.910000241
Received: 12 October 2025; Accepted: 18 October 2025; Published: 08 November 2025
ABSTRACT
Appearance anxiety has become a widespread sociocultural phenomenon among contemporary Chinese young
women, yet the deeper developmental concerns that underlie this anxiety remain under‑examined. This study
investigates what appearance anxiety is really about for Chinese female college students and how identity work
may attenuate such anxiety. This study conducted semi‑structured one‑on‑one interviews with 14 Chinese female
college students and analyzed transcripts using reflexive thematic analysis. Interviewees often equated others’
approval with self‑realization, and uncritical adherence to narrow beauty ideals intensified anxiety. They
recognized that their excessive focus on appearance sometimes served as a refuge for feelings of worthlessness
and idleness. Through ongoing self‑exploration, they gradually abandoned the pursuit of “perfection” defined
by others, embraced authentic self‑presentation, and built confidence by developing “acquired abilities” beyond
appearance. Body‑image journeys were experienced as developmental processes of self‑acceptance,
self‑exploration, and self‑improvement—the underlying concern of “appearance anxiety” was frequently
confusion about self‑identity rather than appearance per se. Psychological practitioners and youth workers should
promote holistic capability development and cultivate multiple sources of self‑worth to help young people move
from externally‑driven appearance concerns toward stable self‑identity.
Keywords: Appearance Anxiety; Body Image; Chinese Female College Students; Self-Identity; Qualitative
Research
INTRODUCTION
The rise of new media has amplified "appearance culture." Digital retouching technology, an extension of
makeup and plastic surgery, immerses individuals in unrealistic body ideals (Murnen & Seabrook, 2012).
"Appearance culture" actively interacts with and reinforces media ideals, peer conversations, and other
sociocultural influences related to appearance (Jones et al., 2004). For contemporary Chinese women, the
prevailing beauty ideal is "fair-skinned, young-looking, and slim," with specific and stringent criteria: a girlish
appearance, a weight under 100 jin (50 kilograms), fair skin, a palm-sized face, a high cranial vault, double
eyelids, a high nose bridge, "smiling lips," white teeth, a pointed chin, a "swan neck," right-angle shoulders,
collarbones that can hold coins, an "A4 waist," and "comic legs" (Liu, 2022; Liu, 2023).
Due to these rigid and homogenous beauty standards prevalent in the culture, "appearance anxiety" has become
a buzzword among Chinese young people since 2021. Initially recognized as a pathological symptom in
psychology, appearance anxiety is now becoming a widespread sociocultural phenomenon among young people.
The 2022 Chinese Youth Internet Users' Social Mindset Report surveyed the anxious status of 5,492 young
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people across different regions, age groups, and education levels, revealing that appearance anxiety was the third
most common concern, following study/work and health anxiety (CCSGR, 2023). College-aged women are
particularly vulnerable to body image disorders due to the significant physical, psychological, and environmental
changes they experience (Neighbors & Sobal, 2007; Snapp et al., 2012). Cross-cultural research indicates that
Chinese college women report higher levels of appearance anxiety compared to their American counterparts
(Jung et al., 2009). A survey conducted by China Youth Daily among 2,063 college students nationwide found
that approximately 59% reported experiencing appearance anxiety, with moderate anxiety being more prevalent
among female students (nearly 60%) than male students (37%) (China Youth Daily, 2021).
Over a century, basic and applied research on negative body image has developed considerably. This body of
work has expanded its scope from initial investigations of clinical populations to include nonclinical populations,
shifting its focus from pathology towards public health. However, much of this literature treats appearance
anxiety as exclusively appearance‑focused and pays insufficient attention to its underlying developmental
concerns (e.g., identity work) among emerging adults. Qualitative, context‑sensitive examinations of what lies
beneath appearance anxiety in everyday life remain limited.
This study explores the deeper concern that underlies appearance anxiety among Chinese female college students
and examines how identity exploration and capability development may alleviate such anxiety. It contributes to
a conceptual clarification that reframes appearance anxiety as frequently rooted in self‑identity confusion and
practical implications for capability‑oriented interventions in higher‑education and youth‑work settings.
LITERATURE REVIEW
Negative Body Image
Body image is a multidimensional construct encompassing subjective perceptions and attitudes toward one's
body, especially physical appearance (Cash, 2012). Negative body image, an aspect of body image, refers to an
individual’s negative perceptions, emotions, attitudes, and behaviors about specific body parts (Cook-Cottone
& Phelps, 2003). It exists on a continuum, ranging from widespread "benign dissatisfaction" to intense
disturbances and pathologic distress (Cash, 2002), occurring when a discrepancy arises between the desired ideal
self-image and the perceived actual self-image. Certainly, the degree of satisfaction with one's appearance often
depends on the importance one places on achieving the ideal image (Cash & Szymanski, 1995; Kong & Harris,
2015).
Adolescence is consistently identified as a high-risk period for negative body image (Mahon et al., 2023; Wu et
al., 2022). For many, the body image concerns of adolescence persist into emerging adulthood (Frisén et al.,
2015; Grogan, 2017). Zhang et al. (2018) found that over 57% of surveyed Chinese female college students
desired thinness despite many being underweight. However, emerging adulthood also offers potential for
positive change (Gattario & Frisén, 2019; Piran & Teall, 2012; Wood-Barcalow et al., 2010). A survey of
positive body image among Chinese college students showed that 67.8% had a positive body image (Yan, 2025).
According to the holistic model proposed by Wood-Barcalow (2010), despite the protective filter of positive
body image, negative body messages may sometimes bypass the filter and be internalized in certain situations.
Having a positive body image does not exclude the occasional “bad days.” These findings suggest that women
may experience appearance anxiety all the time.
Emerging Adult，Self-identity and Body Image
Erikson (1950) posited that identity formation is the central task of adolescence. However, with the subsequent
development of industrial society, young people experienced an "extended adolescence," a period during which
they could explore and find their appropriate roles in society through free role experimentation (Erikson, 1968,
p. 156). Today's emerging adults possess unprecedented freedom, and identity formation extends beyond high
school graduation and continues into "emerging adulthood" (Arnett, 2015, pp. 7, 10).
Self-identity involves a deep exploration of one's living conditions and the meaning of life. It addresses questions
like "Who am I?", "Where do I come from?", and "Where am I going?". The body self is an important component
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of one's self-concept (Bermúdez et al., 1995). Webster and Tiggemann (2003) found that self-esteem and self-
concept were more significantly related to body satisfaction in a young female population. An individual's
appearance holds significant meaning: firstly, it has substantive meaning, as appearance can be a component of
self-identity; secondly, it has symbolic meaning, as appearance can be a symbol expressing self-identity (Wang,
2001). Therefore, the external image is not only a physiological existence but also a carrier of self-identity and
a symbol of social interaction.
Method
This study utilized a generic qualitative research method. By asking participants to recount their experiences
struggling with their bodies, we aimed to gain rich, contextualized insights into when they experience appearance
anxiety, what are they truly anxious about.
Purposeful sampling guided participant selection. A recruitment poster was disseminated via popular Chinese
social media platforms among young women (e.g., Xiaohongshu, Douban, WeChat Moments). Eligibility
criteria included: (a) being female Chinese citizens enrolled in mainland Chinese colleges; and (b) having a
history of negative body image coupled with a current generally positive body image, which may provide them
with richer body image experiences and stronger reflective abilities. Following the initial online recruitment,
snowball sampling was employed. Saturation was achieved after interviewing 14 participants.
Data were gathered through semi-structured interviews conducted by researcher. Interviews were conducted
both offline and online according to participants' preferences. Interviews ranged from 60 to 90 minutes. An
interview guide, informed by the research questions and literature, was used. All interviews were audio-recorded
with participants' permission and transcribed verbatim shortly after completion. Data analysis followed Braun
and Clarke's (2012) six-phase thematic analysis. NVivo 14.0 software aided data management, coding, and
theme development.
Credibility was addressed through reflexivity and member checking. Researcher maintained a reflexive journal
throughout the research. Preliminary findings were shared with participants to ensure alignment between
identified themes and their lived experiences. Transferability was enhanced through thick description, and the
use of maximum variation sampling further contributed by capturing diverse experiences within the target
population. Ethical approval was obtained from Ethics Committee for Research Involving Human Subjects,
Universiti Putra Malaysia (JKEUPM-2024-051).
FINDINGS AND DISCUSSIONS
Across participants' narratives, what was labelled as "appearance anxiety" often indexed identity work during
emerging adulthood rather than a purely appearance-centered problem. The developmental movement described
by participants ran from externally driven perfectionism to authenticity and capability-anchored confidence.
There are three interlinked themes: (1) underlying anxieties beyond appearance; (2) accepting imperfections and
presenting the authentic self; and (3) building confidence through efforts beyond appearance. Throughout, we
interpret the data with reference to classic and contemporary perspectives on the looking-glass self, the
“true/false self,” positive body image, and youth development. The anxiety associated with a negative body
image appears to be about appearance but fundamentally stems from confusion about self-identity. To alleviate
their anxiety, apart from making adaptive investments in their appearance, the girls further establish self-identity
through "efforts beyond appearance." Their self-identity is continuously constructed, deconstructed, and
reconstructed along the journey of body image, becoming increasingly solid over time.
"What Are My Real Life Issues? " — Underlying Anxiety Beyond Appearance
This subtheme is reflected by three progressive codes: "Continuous Mental Burnout," "Continuous Self-
Discovery," and "Self-Identification as Deep Anxiety." Appearance anxiety is not necessarily triggered by a
specific appearance-related event. The interviewees believe that, often, appearance anxiety is not just about
appearance itself. It is frequently accompanied by anxiety in other areas. Appearance anxiety is often
accompanied by mental drain or overthinking. Han Yu used to spend a lot of time watching beauty videos on
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Douyin (one of the most popular Chinese social media platforms) or browsing clothes on Taobao (the most
popular Chinese shopping website). "…I couldn't stop until I felt nauseous. It seemed like appearance anxiety,
but it was essentially an unfillable void and an inescapable tension inside me." This was because she felt stagnant
and unproductive, keeping herself in a state of endless anxiety. Siwen believed that appearance anxiety is actually
caused by constant self-examination.
It's like there's always another voice inside you, and it's completely negative. Then you really start to believe
you're not good enough. Actually, no one has even called you fat! Some people may have experienced verbal
attacks from others, but many people are just fighting with themselves, engaging in mental burnout. It's about
constantly finding fault with yourself, like finding bones in an egg. (Siwen)
Therefore, appearance anxiety was just an external manifestation of deeper anxiety. Zhou Lu believed that
cognitive efforts are key to alleviating anxiety. She used to be an anxious, sensitive, and insecure person with
very unstable emotions. Now, when facing appearance anxiety, she no longer confines herself to superficial
matters but instead asks, "What are my real life issues? I don't avoid them; I solve them!"
My current good mental state is the result of long-term efforts. I don't like to stay on the surface; I discover the
essence of things bit by bit. Only by understanding the nature of things can I truly solve my problems. Later, I
really felt that I was getting better bit by bit. My current state is increasingly relaxed because I have gradually
figured out my past confusions. (Zhou Lu)
Wang Huan mistakenly thought that her persistent anxiety just came from our appearance at first. However, with
each fluctuation in body image, her self-exploration deepens continuously. The essence of appearance anxiety
lies not in appearance itself, but in self-worth and self-identity.
Larson (2000) observes that boredom, worthlessness, and a lack of motivation are pervasive among
contemporary youth, producing “an ennui of being trapped in the present, waiting for someone to prove to them
that life is worth living.” The sample of this study consists of a group of college women who are in the stage of
"emerging adulthood," exploring and struggling amidst uncertainties by their bodies. Arnett (2015) proposed
emerging adults experience "both excitement and uneasiness, wide-open possibility and confusion, new
freedoms and new fears." It is "an extended period of exploration and instability" (p.1-2). Therefore, the primary
characteristic of emerging adulthood is "identity explorations: answering the question 'who am I?' and trying out
various life options, especially in love and work" (p. 9). Consistent with those opinions, our participants—after
navigating changes and fluctuations in body image—gradually recognized that what appears as appearance
anxiety is often the surface expression of a deeper, more persistent concern about self-identity. For most non-
clinical female college students, appearance-related anxiety is best understood as a developmental form of
anxiety rather than a purely aesthetic problem.
"I'm Now Starting to Accept My Imperfections" — From Perfectionism to Authenticity
In the early stages of pursuing beauty, the interviewees were accustomed to viewing themselves from others'
perspectives, equating others' approval with self-fulfillment. They dressed not to please themselves but to chase
the "perfection" in others' eyes. They took photos not to authentically record themselves but to create a beautiful
yet deceptive image through filters. After exploring themselves from appearance to their inner self, the
interviewees not only began to accept their appearance but also eventually came to embrace their entire selves,
which allowed them to present their true selves. This theme is generated through the following two codes:
"Acceptance of Imperfections" and " presentation of True Self."
When beauty has a unified standard, people tend to think that failing to meet this standard is imperfect and
flawed. Han Yu believed that every instance of negative body image is accompanied by intense self-denial. She
further explained: "I don't think that chubby body, that unattractive face belongs to me. I despise my big face,
freckles, double chin, waist fat, thick legs... I internally reject them. It feels as if the body is not my own." After
entering college, Weiwei also realized that appearance was just the initial stage of self-identity. After
experiencing negative body images and repeated fluctuations, she embarked on a path of self-acceptance that
began with appearance anxiety:
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I'm now starting to accept my imperfections: I have some belly fat, freckles, high cheekbones, and a receding
hairline. This journey began with appearance anxiety. Then, I started to ponder many other aspects of myself. I
began to accept all my imperfections, starting with my appearance and gradually moving towards my inner self.
It's been a progressive process. (Weiwei)
Xinxin used to strive to maintain a perfect image in front of the boy she liked. "I didn't even dare to blow my
nose in front of him, fearing he would see my imperfections. Now, I don't care about these things anymore. I
just want to present my true self. I don't accept anyone's judgment." When discussing girls liking to use filters
in photos, Song Jia shared her perspective: "I used to enjoy editing my photos to make myself look better, but
now I prefer uploading the original images. I now appreciate the natural and authentic look." After experiencing
repeated fluctuations and breakthroughs in her body image, Siwen can now confidently show herself. She
believed, "Those who truly accept themselves can exude charming confidence and grace from the inside out."
Initially, respondents simply believed that if they look in line with societal beauty standards, they can expect to
gain others' approval. When beauty is defined by a singular standard, girls come to believe that anything
deviating from it is unacceptable. As a result, they habitually express dissatisfaction or even disgust with their
bodies. "I have excess fat on my belly; I have freckles; my cheekbones are high; my hairline is receding..."
(Weiwei). Society imposes idealized beauty standards on women, leading many to devote significant time and
effort to chasing an unattainable vision of perfection. Since it is impossible to fully achieve the societal standards
of female beauty, which demand a near-transcendence of natural limitations. "A woman may live much of her
life with a pervasive feeling of bodily deficiency. Hence, a tighter control of the body has gained a new kind of
hold over the mind" (Bartky, 1988).
The essence of body image fluctuations is the inability to accept the real self at this moment, because one's self-
worth is attached to external aspects and others' recognition. Viewing others as extensions of their self-
perception, they rely on others' comments to support an increasingly fragile self. Negative evaluations or social
neglect can significantly undermine their self-worth, making it even more difficult to accept their authentic selves
and ultimately leading to a negative body image. According to the "Looking-Glass Self" theory, others act like
a mirror, allowing people to form self-awareness by observing others' reactions to themselves (Cooley, 1998).
We equate others' recognition with self-realization.
However, an identity shaped by others' perceptions and expectations is inherently false and fragile. Donald W.
Winnicott proposed the concepts of the true self and the false self. The true self is constructed around one's own
feelings; "Only the true self can be creative and only the true self can feel real" (Winnicott, 1960, p. 148).
Individuals with a false self are constantly concerned with others' words and actions, unaware of their own
suffering. Their mind and body are separated. They have "managed to put on a successful 'show of being real.'
Such patients suffered inwardly from a sense of being empty, dead, or 'phony'" (p. 146). Only by learning to
accept and appreciate the real self can one create a positive cycle in various aspects of life. Positive interpersonal
interactions, embodied activities, and significant life events help interviewees gain perception, acceptance,
appreciation, and gratitude for their bodies. Xuanxuan eventually overcame appearance anxiety and boldly
showcased her body and personality through different styles of dress. Han Yu achieved a connection between
body and mind through yoga practice. Traditional Chinese medicine not only improved Weiwei's health and skin
condition but also changed her attitude towards appearance, body, and even life. They abandoned the pursuit of
"perfection" in others' eyes, accepting and appreciating their real selves. Increasingly, voices on Chinese social
media advocate for "turning off filters" and "making peace with bare faces." Beauty is not about catering to
others' eyes; it is a free expression of the true self. "Only by truly accepting oneself can a woman radiate charming
confidence and style from the inside out" (Jingwen).
"Exploring Multiple Aspects of Yourself and the World"— Capability Building and Confidence
The interviewees asserted that "there are many things in this world worth your attention," suggesting that girls
should build confidence beyond their appearance. "When there are many sources of confidence, appearance will
not cause too much anxiety" (Wang Huan). They also believed that growth in other areas brings a state of
confidence from the inside out. When a person's overall sense of value is enhanced, their body is upright and
relaxed, and their eyes and face have a "glow," making them look even more attractive. This theme is generated
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through the following three codes: "Experiencing Appearance Anxiety When Lacking a Sense of Achievement,"
"Becoming Confident When Gaining a Sense of Achievement," and "Exploring Multiple Aspects of Yourself
and the World."
The respondents thought girls should gain a sense of control over their lives through their own efforts. Remaining
in a state of "lying flat" only leads to focusing on a static external self. As they gradually gain a sense of control
over their lives, their appearance anxiety will also be alleviated. In high school, Shanshan had poor grades and
was overweight, which led her to give up on herself, believing that her life would always remain the same. After
entering university, she became the class monitor and participated in many activities.
I felt capable again. At that point, I thought, I need to change quickly and cannot remain stuck in the past. So, I
researched healthy recipes online and started going to the gym. Soon, I not only lost weight and looked better,
but I also became more confident. (Shanshan)
When an individual's abilities are demonstrated or recognized, they become more confident. Zhou Lu asserted
that inner confidence can make her appear more attractive. Her friends often remarked that when she was on
stage articulating her views, her eyes and face exude a “glow” that makes her particularly attractive. Han Yu
posited that a beautiful face can eventually lead to aesthetic fatigue. "My mother always says, 'Confidence is a
woman's best cosmetic.' Confidence stems from one's capabilities. Confident individuals tend to look more
attractive. This can indeed create a positive feedback loop."
Wang Huan believed that if individuals do not make efforts, do not "explore other aspects of life," and do not
gain recognition from themselves or others through their efforts, they will only see a static external self. At this
point, they will focus heavily on appearance and are likely to develop appearance anxiety. "Because you have
not made efforts to explore other aspects of your life, it is essential to develop acquired abilities; this is the
foundation of confidence. People only care about themselves in the mirror when they are idle."
Self-identity are crucial developmental tasks during their emerging adulthood, and pursuing a better self is the
fundamental way for them to address overall anxiety. "Growth has not only rewards and pleasure, but also many
intrinsic pains and always will have. Each step forward is a step into the unfamiliar and is thought of as possibly
dangerous" (Friedan, 1963, p. 305). When reviewing her experiences with negative body image, Han Yu often
finds herself in a state of endless anxiety. She describes the essence of appearance anxiety as "an unfillable void
inside me, an inescapable tension." As Wang Huan analyzed, "If you don't make an effort, have nothing to do,
and don't explore more aspects of yourself inwardly, you can only see a static external self. The only thing you
can focus on is your appearance." It is evident that appearance anxiety is not necessarily triggered by specific
appearance-related events. Sometimes, it may be caused by an individual's overall anxiety, which then
generalizes to their appearance.
Facing the fluctuations in body image, the interviewees believe that "anxiety is not necessarily a bad
thing"(Siwen). Anxiety reflects dissatisfaction with one's current state and the desire of a better self. In our
culture, women's development is hindered on a physiological level. However, like men, women also aspire to
achieve secular accomplishments, gain others' respect, and attain independence and freedom through their efforts
and abilities (Friedan, 1963, p. 303-304). This aligns with Maslow's hierarchy of needs theory: after basic
survival needs are met, humans develop higher-level needs for belonging and love, esteem, and ultimately self-
actualization. Moreover, self-actualization is not an end state but a process of realizing personal potential at any
moment and to any degree (Maslow, 1954). The surface of anxiety is appearance, but the deeper issue is self-
identity. Recognizing this essence, the interviewees actively alleviate their anxiety through efforts beyond
appearance. Zhou Lu no longer confines herself to superficial matters but instead "thinks about what her real life
issues are and faces and solves them!" Wang Huan also suggests developing "acquired abilities beyond
appearance," stating that "only by exploring other aspects of life" can one avoid being preoccupied with
appearance.
Implications
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This study reconceptualizes "appearance anxiety" as a developmental identity phenomenon rather than a purely
appearance-bound disturbance. Drawing on participants’ narratives, what is experienced as anxiety “about
looks” often operates as an index of identity confusion, especially salient during emerging adulthood, when
commitments and self-definitions are in flux. This ontological re-specification shifts the analytical and
intervention focus to constructing the self (e.g., values clarification, role exploration, capability building). It also
explains the common coexistence of generally positive body image with episodic "bad days" in non-clinical
populations: fluctuations are expected features of ongoing identity work and are often self-correcting as
developmental resources strengthen. In doing so, the study extends body-image scholarship to dynamic
processes of identity formation and regulation.
Gattario and Frisén (2019) suggested that addressing young people's overall sense of belonging, competence,
and empowerment is crucial for developing a positive body image. Success in work and study can foster a sense
of agency and empowerment, which is vital for the positive transformation of body image. Accordingly, to help
young people overcome negative body image, it is crucial for the practitioners and policymakers to foster their
positive development and ignite their inner passion.
CONCLUSION
This study reframes "appearance anxiety" among Chinese female college students as a developmental identity
phenomenon rather than a purely appearance-bound disturbance. The participants in this study are in the
developmental stage of "emerging adulthood," a period primarily characterized by identity exploration. They are
exploring and struggling amidst uncertainties by their bodies, with each fluctuation in body image reflecting a
process of self-exploration and discovery. They viewed appearance anxiety as "not necessarily a bad thing," but
as a sign of striving toward self-improvement. Consequently, the participants believed that only through "efforts
beyond appearance" can they truly accept their authentic selves, achieve better selves, and ultimately establish a
sense of self-identity.
ACKNOWLEDGEMENTS
We express our sincerest gratitude to the participants who unreservedly volunteered to share their stories about
their body image.
Ethical Approval
This study is approved by the Ethics Committee for Research Involving Human Subjects of Universiti Putra
Malaysia (Reference No.: JKEUPM-2024-051).
Disclosure statement
The authors report there are no competing interests to declare.
Data availability statement
Considering the privacy of the participants, the data is confidential and used only for this study.
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