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Description
Introduction: The prevalence of overweight and obese children continues to rise in developed and developing countries. This poses an increasing threat worldwide as the standards of living rise. Body perceptions is linked to weight management and Sub-Sahran Africans tend to prefer a larger “overweight” body size which is perceived as being wealthy and healthy. Inaccurate perception of the adolescents’ body weight could lead to lack of physical activity, long-term consequences such as obesity related diseases and unhealthy practices to maintain what they wrongly perceive as healthy.
This study compared rural and urban body perceptions of Malawian adolescents, and the overall ideal body size amongst males and females. Actual body weight was compared to the adolescents’ perceived own body size.
Methods: This was a cross-sectional observational study which took place in rural and urban Malawi. Weights and heights of the adolescents were measured in order to determine their Body Mass Index for age (BMI-for-age). A survey questionnaire which explored various body perceptions was filled out electronically. Seven images of various body sizes from “severely thin” to “extremely obese” were used. Own perceived body size was compared to actual weight to investigate adolescents who over-perceived, under perceived and those who correctly perceived their own body size.
Results: Adolescents aged 10-18 years took part in the study (152 rural, 176 urban). The adolescents were categorized using the BMI for age criteria as per World Health Organisation (WHO) growth standards for children between 5 and 19 years, 1.8% of the subjects were found to be severely thin, 4.2% thin, 80.2% normal, 10.1% overweight and 3.7% obese.
Actual Body Mass Index (BMI) was significantly different in rural and urban adolescents (χ2 = 13.65, P=0.01). More adolescents were overweight in the urban area (13.6%) than in the rural area (5.9%).
There was no significant difference between rural and urban own perceived body sizes (χ2=0.52, P = 0.77) and ideal body size (χ2=0.59, P= 0.90). In comparison to the actual body weight, 34.8% of adolescents over-perceived their body size, 32% under-perceived and 33.2% had accurate own body perceptions.
The “overweight” body image was selected by 48.5% of the adolescents as their ideal body size.
There was a significant relationship between sex and perceived body size (χ2=128.89, P<0.001). More males over-perceived their body size than females.
Conclusion: The findings of this study demonstrate that a larger ‘overweight’ body size is preferred amongst Malawian adolescents. The potential implications include increased risk of non-communicable diseases and the double burden of malnutrition. Adolescence is an important growth period for the development of body image and various psychological, social and cultural changes. Understanding the complex relationship between actual weight and body perceptions requires internalization of factors such as social influences, body ideals and other weight related concerns. These findings could inform future interventions on body perceptions of adolescents in Malawi.
| Institution | London School of Hygiene and Tropical Medicine |
|---|---|
| Country | United Kingdom |
