Abstract
In this mixed-methods study, we explored how gender and cultural factors, including social status were linked with children’s immigrant backgrounds and their body image dissatisfaction and weight management strategies in Australia. Cross-sectional data analysis of 10-11-year-old children from the Birth cohort of the “Longitudinal Study of Australian Children” showed that approximately half of the children were dissatisfied with their body images. A higher proportion of these were children of immigrants from low-and-middle-income-countries. Additionally, about three-quarters children were actively managing their weights. Children of immigrants from low-and-middle-income-countries constituted a higher proportion of these also. Among boys, desiring a heavier body was highest for those with immigrant mothers from low-and-middle-income-countries, while the desire to be thinner was highest among girls of immigrants from low-and-middle-income-countries. Although the percentage of children who adopted strategies to gain weight was very small, boys of immigrants from low-and-middle-income-countries, in particular, were almost three times as likely as non-immigrant boys, to try to gain weight (18% vs 5.9%, respectively).
 
 Qualitative face-to-face interviews with immigrant mothers and their 8-11-year-old children revealed intergenerational variations in body image standards. Maternal body image standards were drawn from their origin countries, but children followed Australian norms. Despite increased obesity awareness amongst mothers, they desired higher body weight for their children, due to an association with high status and health in origin countries. However, children were aware of the stigma, unpopularity, and low status associated with high body weights in Australia. To reduce cultural and status-based obesity inequalities, Australian obesity prevention plans must include culturally responsive health promotion strategies for immigrant parents and their children to improve their knowledge about healthy weights and weight management strategies.
Highlights
In Australia, where a quarter of children are either overweight or obese, childhood overweight/obesity is a major public health threat (Australian Bureau of statistics, 2015)
The decision to combine overweight/obesity as a single category was due to small numbers of children of immigrants from LMICs and because of our previous analysis where we found that these two groups shared similar risk-factors at every age (Zulfiqar et al, 2018)
At 10-11 years, a slightly higher percentage of boys (34%) and girls (29%) from LMICs were overweight/obese compared to boys (23%) and girls (22%) from HICs, and boys and girls from Australian backgrounds (25% and 24% respectively)
Summary
In Australia, where a quarter of children are either overweight or obese ( referred to as overweight/obese), childhood overweight/obesity is a major public health threat (Australian Bureau of statistics, 2015). The risk of overweight/obesity is even higher in Australian-born children of immigrants from low-and-middle-Income-countries (LMICs) compared to children of Australian-born parents (Zulfiqar, Strazdins, Banwell, Dinh, & D'Este, 2018; Zulfiqar, Strazdins, Dinh, Banwell, & D’Este, 2018). These children of immigrants experience higher body image dissatisfaction (BID), weight stigma, lower self-esteem and poorer mental health (Gualdi-Russo et al, 2012; Toselli, Brasili, & Spiga, 2014), compared to children of the host population with dissimilar linguistic, culinary and cultural norms.
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