What are the determinants of body image distortion and dissatisfaction among Tunisian teenagers?

Abstract

Abstract Background Body image (BI) is considered as central to many aspects of human functioning including emotions, thoughts, behaviors and relationships. This study aimed to investigate the prevalence and the main determinants of distortion and dissatisfaction among teenagers. Methods This was a cross-sectional school-based study using a self-administered questionnaire, conducted among a randomized sample of 1300 school-adolescents in Southern Tunisia, 2018. BI perception was assessed by the Stunkard Figure Rating Scale. Results Among 1210 respondents (93%), BI distortion and dissatisfaction prevalence were 44.8% and 42.4%, respectively. Multivariate analysis showed that 16-18 years age group (Adjusted Odds Ratio (AOR)=1.28; p = 0.046), low family financial situation (AOR=1.88; p = 0.014), as well as high frequency of eating pasta (AOR=1.3;p=0.04) and fast-food consumption (AOR=1.7;p=0.042) were independently associated with under-estimated BI. Skipping breakfast (AOR=1.9; p = 0.017) and having one obese parent (AOR=1.9;p=0.01) were independently associated with higher frequency of over-estimated BI. For BI dissatisfaction, independent factors associated with desire to lose weight were female gender (AOR=1.53; p = 0.007), high family financial situation (AOR= 2.1,p=0.008) and having one parent obese (AOR=2.21,p<0.001). Frequent fast-food consumption (AOR=1.9, p = 0.038) and eating between meals (AOR=1.57,p=0.01) were associated with higher desire to gain weight. Conclusions Our study highlighted a substantially high prevalence of BI distortion and dissatisfaction among adolescents. Their determinants included socio-demographic factors and lifestyle behaviors. Increased awareness among parents and public health planners may help adolescents improve accuracy of BI attitudes. Key messages BI distortion and dissatisfaction are pervasive problems that increased negative affect in adolescents. Promotion of healthy lifestyle including balanced diet and physical activity is warranted.