Abstract
This study aims to examine the associations between BMI, disordered eating attitude, body dissatisfaction in female adolescents, and descriptive attributes assigned to silhouettes of varying sizes in male and female adolescents, aged 11 to 15, in rural South Africa. Height and weight were measured to determine BMI. Age and sex-specific cut-offs for underweight and overweight/obesity were determined using the International Obesity Task Force cut-offs. Body image satisfaction using Feel-Ideal Discrepancy (FID) scores, Eating Attitudes Test-26 (EAT-26), and perceptual female silhouettes were collected through self-administered questionnaires in 385 adolescents from the Agincourt Health and Socio-Demographic Surveillance System (HSDSS). Participants self-reported their Tanner pubertal stage and were classified as early pubertal (< = Tanner stage 2), and mid to post pubertal (Tanner stage > 2). Mid to post pubertal boys and girls were significantly heavier, taller, and had higher BMI values than their early pubertal counterparts (all p<0.001). The prevalence of overweight and obesity was higher in the girls than the boys in both pubertal stages. The majority (83.5%) of the girls demonstrated body dissatisfaction (a desire to be thinner or fatter). The girls who wanted to be fatter had a significantly higher BMI than the girls who wanted to be thinner (p<0.001). There were no differences in EAT-26 scores between pubertal groups, within the same sex, and between boys and girls within the two pubertal groups. The majority of the boys and the girls in both pubertal groups perceived the underweight silhouettes to be “unhappy” and “weak” and the majority of girls in both pubertal groups perceived the normal silhouettes to be the “best”. These findings suggest a need for policy intervention that will address a healthy body size among South African adolescents.
Highlights
Adolescence, a period of transition from childhood to adulthood, is characterised by psychological, physical and social changes [1]
Within the early pubertal group, boys were significantly older than the girls in the same pubertal group, but there were no significant differences in weight, height or body mass index (BMI) between boys and girls in the early pubertal stage
Within the mid to post pubertal group, there was no significant difference in age, the girls were significantly heavier and shorter and had a higher BMI than the boys
Summary
Adolescence, a period of transition from childhood to adulthood, is characterised by psychological, physical and social changes [1]. Considerable research has been conducted on body image, eating disorders and other weight-related behaviours among adolescent girls and young women living in developed countries [2,3,4], with few research studies being done in low-tomiddle income countries [5,6,7,8]. The decreasing age at which body image dissatisfaction and disordered eating attitudes occur in adolescence is of public health concern globally [9,10,11], due to physiological and psychological health problems [12]. It is widely accepted that girls are at greater risk of body dissatisfaction and eating disorders [2], and that both a low and a high body mass index (BMI) have been shown to influence weight control behaviours [5, 13, 14]. Increasing globalisation and exposure to a ‘Western’ ideal of thinness through the media [2, 10], which often differs from traditional beliefs, creates even greater conflict within the adolescent
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