Abstract
This study investigated the associations between underweight, obesity and body image (BI) among 15+ year-old South Africans with diverse socio-demographic backgrounds. A cross-sectional survey and the analyses of data for 6411 15+ year-old participants in the first South African National Health and Nutrition Examination Survey was undertaken. Body image was compared to body mass index (BMI) and socio-demography. Data were analyzed using SPSS versions 25. Results are in percentages, means, 95% confidence intervals, p-values, and odds ratios. Overall, participants who were obese of which majority: were females, earned ZAR 9601+, completed grade 6, were non-Black men, were married and resided in urban formal areas, were more likely to underestimate their BMI and desire to be lighter. Participants who were underweight of which majority: were males, had no form of income or education, were black men, were not married, resided in less urban and farm areas, were younger than 25 years, were more likely to overestimate their BMI and desire to be heavier. While underweight and obesity were strong determinants of BI, BI was differentiated by socio-demography. These findings have a public health implication that requires special attention to curb the irrepressible underweight and obesity in South Africa.
Highlights
Underweight and obesity co-exist in the same households in South Africa [1,2]
Shisana et al [1] and Mchiza et al [5] have shown that the majority of South Africans who present with negative body image (BI) tend to present with unhealthy body size
This research managed to magnify the nexus between body mass index (BMI), BI and different socio-demographic variables in a representative sample of South Africans
Summary
Underweight and obesity co-exist in the same households in South Africa [1,2]. While the prevalence of underweight in men is 4 times that of women, the prevalence of obesity in women is almost 4 times that of men [2]. Body image seems to be one of the important factors that can explain the stable underweight prevalence in men and the escalating prevalence of obesity especially in women and those individuals who fall below the poverty index line (PIL) in South Africa [1,2,3,4]. Shisana et al [1] and Mchiza et al [5] have shown that the majority of South Africans who present with negative body image (BI) tend to present with unhealthy body size (underweight and obesity). In the “Western” affluent world, there are persistent pressures that promote the idea that being lighter in body size is attractive [7]
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