Americans spend billions of dollars each year trying to change their weight with diets, gym memberships and plastic surgery.

    Trying to live up to the images of “perfect” models and movie heroes has a dark side: anxiety, depression, as well as unhealthy strategies for weight loss or muscle gain. It also has a financial cost. Having an eating disorder boosts annual health care costs by nearly US$2,000 per person.

    Why is there both external and internal pressure to look “perfect”? One reason is that society rewards people who are thin and healthy-looking. Researchers have shown that body mass index is related to wages and income. Especially for women, there is a clear penalty at work for being overweight or obese. Some studies have also found an impact for men, though a less noticeable one.

    While the research literature is clear that labor market success is partly based on how employers and customers perceive your body image, no one had explored the other side of the question. Does a person’s own perception of body image matter to earnings and other indicators of success in the workplace?

    Our recently published study answered this question by tracking a large national random sample of Americans over a critical time period when bodies change from teenage shape into adult form and when people build their identities.

    As in other research, women in our sample tend to over-perceive weight—they think they’re heavier than they are—while men tend to under-perceive theirs.

    We found no relationship between the average person’s self-perception of weight and labor market outcomes, although self-perceived weight can influence self-esteem (自尊心), mental health and health behaviors. 

    While the continued gender penalty in the labor market is frustrating, our finding that misperceived weight does not harm workers is more heartening.

    Since employers’ perception of weight is what matters in the labor market, changing discrimination laws to include body type as a category would help. Michigan is the only state that prohibits discrimination on the basis of weight and height. We believe expanding such protections would make the labor market more fair and efficient.

解析：D。题目中问的是可能会对人们产生不利影响的因素，根据题目中的adverse impact定位至原文第二段，adverse impact（不利影响）与第二段第一句中的dark side（阴暗的一面）相对应。原文第二段第一句前半部分指出，试图拥有如同“完美”模特和电影主角那样的形象，这样做也有其阴暗的一面。D项与此内容相符，D项中的Attempting to meet对应定位句中的Trying to live up to（试图迎合），而society’s expectation of appearance是对定位句中images of...movie heroes的概括总结，故D项为正确答案。

错项排除：A项利用原文第一段中出现过的plastic surgery（整容手术）设置干扰，但这里只是说人们会通过各种方式改变自己的体重，而整容手术只是方式之一，原文中并没有提到整容手术是否存在危害，故A项排除。B项利用在原文第二段第一句中出现过的heroes和models设置干扰，但原文中并没有提到模仿这些人的生活方式（Imitating the lifestyles），只是说人们试图拥有像他们一样的形象，故B项排除。C项利用在原文第二段第二句中的financial cost（金钱花销）设置干扰，但金钱花销只是人们在迎合社会期望这一现象时所要付出的代价之一，原文中并没有讨论人们为了追求完美而不惜重金是否存在不利影响，故C项排除。