Aesthetic Conflict and Eating Behaviour in Adolescent Girls of an Urban Slum- A Community Based Mixed Method Design

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Introduction: Body image is correlated to self-esteem and eating behaviour and is often skewed in adolescence. The social pressure to be thin and the stigma of obesity lead to unhealthy eating practices. Dieting could be a corollary to body dissatisfaction reflecting skewed perception. Aim: To study the perception of body image among the adolescent girls of our study area and to explore if it affected their eating behaviour. Materials and Methods: An explanatory mixed method design (Quantitative Descriptive - Qualitative) was conducted in a sample of 250 adolescent girls after obtaining ethical clearance. The adolescents’ ‘Self perceptions of body shape’ (compared with their actual body weight, Body Mass Index (BMI), World Health Organisation (WHO) Asian standards), their ‘perceptions of a healthy body shape’ and their practices were collected quantitatively. Qualitative exploration {Focus Group Discussions (FGD)} of their beliefs and practices pertaining to their perceptions of body image were summarised and the data was analysed by Statistical Package for the Social Sciences (SPSS) (version 13.0) and N Vivo 8 (Demo version). Results: The ‘self-perception of body shape’ in adolescent girls was compared with their BMI. Of those who felt that they were normal, 57.3% were underweight (BMI ≤18.5) and among those who perceived their self-image as fat, about 29.4% were normal and even about 33.3% were underweight (kappa 0.116, p<0.001). About 7% of the adolescent girls did dieting for maintaining body shape. The respondent’s various perspectives of a fatty body shape were related to dietary factors and few beliefs predominant in their community. Those who were ‘very thin’ wanted to be ‘normal’ but never ‘fat’ at any cost (Qualitative). Additionally, those who perceived themselves as ‘thin’ did not diet. For those who were on diet, being ‘thin’ was considered healthy (91%) but for none (0%), being ‘fat’ was healthy. Conclusion: Body image dissatisfaction and negative self-perception is observed in adolescent girls and impacts their eating behaviour. They should be positively counselled and their food habits must be shaped with sustained motivation as these tend to persist till adulthood.