BMI, Body image, and self-esteem in psychiatric patients

Abstract

Objective: Epidemiological studies call attention to risks associated with obesity. We evaluated the relationships of body mass index (BMI) and waist size to the patients’ present and ideal body image and to self-esteem. Materials and Method:Thirty five psychiatric patients (17 men, 18 women; mean age = 42.8, SD=15.9) participated. They were diagnosed with major depression, bipolar disorder, schizophrenia, or with schizoaffective disorder. They were all stabilized on antipsychotics. Patients with eating disorders and body dysmorphic disorder were not included. The mean BMI was 28.3 (SD=4.9, range 19.4 to 42.9). All patients were administered Thompson and Gray’s visual scale to obtain ratings of their own perception of their present body size/shape, and also of an ideal body size for self, and also of the most attractive body shape in general. All patients also completed Rosenberg self-esteem scale. Their ratings and scores were compared to 15 normal controls (4 men, 11 women; mean age 31.7, SD=12.5; mean BMI 26.8, SD=5.2, range 21.1 to 37.8). Results and Discussion: Larger patients (as determined by BMI and waist size) were also rating themselves as more voluminous on Thompson and Gray scale. Discrepancy between the actual and ideal body size in these 35 psychiatric patients significantly correlated with their BMIs and waist size: those more dissatisfied with their bodies (perceiving them as too wide) had indeed larger BMI and waist circumference. Neither their self-ratings of present or ideal body size, nor the discrepancy between their ideal and their present body shape, nor their actual BMI and waist size correlated with their scores on Rosenberg self-esteem scale. Self-esteem scores of normal controls were significantly higher than those of the patients. Conclusions: Although the patients’ self-esteem was lower than in normal controls, these patients’ self-esteem appeared not significantly affected by their BMI, their waist size, and their body image, their ideal body image, or by the discrepancy between their ideal body image and present body image. Research on larger samples with a separate analysis of data for males and females is needed.