The association between body image, self-esteem, and body mass index in patients with schizophrenia at a tertiary care unit: A case–control study

Abstract

Abstract Background: When compared to the general population, patients with schizophrenia are more likely to have a higher body mass index (BMI). As a result, they are more likely to have low self-esteem, poor quality of life, and poor drug adherence. Aims and Objectives: The aims and objectives of the study are to compare the body image and self-esteem in patients on treatment for schizophrenia with healthy controls and study the association of BMI with body image and self-esteem in them. Setting and Design: This was a case–control study, comprising 50 patients with schizophrenia who attended the outpatient clinic of our tertiary health-care unit’s department of psychiatry and 50 healthy controls. Materials and Methods: Sociodemographic data were obtained, and BMI was computed. Body image was assessed using the Body Weight, Image, and Self-Esteem Evaluation Questionnaire (B-WISE), and global self-worth was measured using the Rosenberg Self-Esteem Scale for all participants. Statistical Analysis: Chi-square test/Fisher’s exact test was used to assess independent variables and their distribution across the study groups. Mann–Whitney U-test was used to compare the means of continuous variables across the study groups. Pearson and Spearman correlation tests were done to study the association between clinical variables. It was done using IBM SPSS 22 Program on the windows operating system. Results: The schizophrenia group differed from the control group in marital status (P = 0.012) and educational level (P = 0.001) calculated using the Chi-square test. They also differed significantly in terms of BMI (P < 0.001) and self-esteem (P < 0 .001) assessed using the Mann–Whitney U-test. There was no significant difference in B-WISE scores between the groups (P = 0.0451). Spearman correlation revealed a positive correlation between B-WISE scores and self-esteem scores, a negative correlation between BMI and self-esteem scores, and between BMI and B-WISE scores among the cases. Conclusion: Patients with schizophrenia had lower self-esteem and increased BMI compared to controls. Patients with a better body image had more self-esteem. Patients with greater BMI had poorer body image and lower self-esteem.