An international study published in the scientific journal Body Image indicates that a majority of women are dissatisfied with their breast size. The research, which is the largest to date to examine breast size satisfaction, indicates that being unhappy with one’s breast size is associated with detrimental psychological outcomes.

“One of my research interests is on the way people in different cultural and national settings experience and think or feel about their bodies,” said lead researcher Viren Swami, a professor of social psychology at Anglia Ruskin University and Perdana University.

“My colleagues and I had previously conducted some cross-national research on body dissatisfaction and there were a handful of studies examining breast size dissatisfaction specifically, but nothing on breast size dissatisfaction across nations. So, this seemed like a good opportunity to bring together some of the best minds working on the topic of body image to work together to fill a gap in the research.”

In the study, 18,541 women from 40 nations were shown computer-generated images of 14 female figures with increasing breast size. The women were asked to indicate which image most closely corresponded to their own breast size and then indicate which image they would most like to resemble. The participants also completed assessments of weight dissatisfaction, personality, media exposure, and several other factors.

Overall, 47.5% of participants wanted larger breasts than they currently had, 23.2% wanted smaller breasts, and 29.3% were content with their breast size. Women who were younger, less financially secure, less conscientious, and more neurotic tended to have higher levels of breast size dissatisfaction.

“Women who are dissatisfied with their breast size were more likely to experience poor psychological well-being and had poorer breast awareness — these relationships were stable across all the nations we examined. Taking steps to develop better breast satisfaction – perhaps by focusing on the functionality rather than aesthetics of the breasts — is important,” Swami told PsyPost.

In particular, breast size dissatisfaction was associated with lower breast self-examination frequency, greater dissatisfaction with one’s appearance and weight, and lower happiness and self-esteem.

“Breast cancer is the leading cause of female cancer-related deaths worldwide and poor survival rates are associated with poorer breast awareness. Breast size dissatisfaction may result in avoidance behaviours that reduce breast awareness, particularly if a woman’s breasts trigger feelings of anxiety, shame, or embarrassment,” Swami said in a news release.

“Our study found a direct link between greater breast size dissatisfaction and poorer breast awareness, as seen through lower frequency of breast self-examination and lower confidence in detecting changes in the breasts, and this requires urgent public health intervention.”

Women from India, Pakistan, Egypt, Lebanon, and the United Kingdom desired the largest breasts on average, while women from Japan, the Philippines, Germany, Austria, and Malaysia desired the smallest. But the researchers found that these differences were small and that the desired breast size was “relatively homogeneous across nations,” with most women desiring medium-to-large breasts.

“Another key finding is that breast size dissatisfaction decreases with age. It is possible that older women experience less pressure to attain breast size ideals or that motherhood and breastfeeding encourages women to focus on the functional purposes of breasts rather than seeing them purely in aesthetic terms,” Swami said.

“Our data came primarily from socioeconomically developed settings, so it will be important to examine whether our findings hold in more diverse populations globally. There are also many other outcomes of breast size dissatisfaction that we weren’t able to examine, such as participation in physical activity,” she told PsyPost.