Original ResearchBody size ideals, beliefs and dissatisfaction in Ghanaian adolescents: sociodemographic determinants and intercorrelations
Introduction
Obesity is increasingly prevalent in African countries due to many factors including the nutrition transition.1 An overweight prevalence of 11.7% has been reported in Ghanaian adolescents.2 Further, one's awareness of being overweight is an essential factor for successful weight management.3 A research gap that exists in most of Africa's obesity research is the sociocultural perception of obesity. These perceptions as well as the sociodemographic determinants are important in understanding the aetiology of obesity in these societies and its implications on obesity interventions and policies. In most African societies, including Ghana, the preference has been for the obese body size, and being overweight has been perceived as attractive, associated with good health, beauty, dignity, respect and happiness in marriage.4, 5, 6, 7, 8 These traditional body and beauty ideals have been challenged by exposure and acceptance of Western fashion and beauty ideals.9 However, few studies carried out in Africa have determined whether this ideal body size (IBS) has changed in the face of continuing globalization and its possible impact on the rising trend of obesity.
Factors that affect body image perception and dissatisfaction include beliefs and attitudes about body size, socio-economic status, ethnicity, gender and acceptance in social groups.10, 11 Existing literature in both Western and African countries reports contrasting relationships between these determinants depending on the context.10, 12, 13, 14, 15 As such, understanding these determinants and their intercorrelations within the adolescent Ghanaian population will inform the formulation of socioculturally friendly policies and interventions to combat the rise in obesity and its associated chronic diseases.
Several theories including the social comparison and self-discrepancy theories explain body dissatisfaction as resulting from body comparison.16, 17 Perceiving a discrepancy between one's current self and one's ideal self would stimulate dejection-related emotions, such as dissatisfaction and depression.18 Body weight perception and dissatisfaction during adolescence are correlates of weight-control practices, strong predictors of disordered eating and they could thus be linked to the risk of obesity.19, 20 In a formative stage of life, adolescents are more vulnerable to societal influences as they try to establish their personalities; as such, body size perception plays an important role in the management of their body weight.21, 22
This paper examines body size ideals, body size beliefs and body size dissatisfaction in Ghanaian adolescents. The first aim was to determine the IBS and its sociodemographic determinants in this population. In doing this, participants' and their peers' IBS, as well as the healthiest and Ghana's preferred IBS, were examined. As a second aim, beliefs on causal factors of weight status (e.g. lifestyle and genetics) were explored as IBS determinants since they might be modifiable predictors and thus useful targets in interventions. As a final aim, the association of this IBS with dissatisfaction and actual measured body size was tested to know whether an extreme IBS might induce decreased well-being and weight problems.
Section snippets
Study design and population
The study was conducted in the Greater Accra Metropolitan Area. Accra, the capital city of Ghana, has a population of 1,848,614 million people (2010 National Population Census, Ghana Statistical Service, 2012); it is one of the most populated and fastest growing cities in Africa. Accra's population is, like in most urban centres, very youthful with 56% of the population under the age of 24 years. As a result, we consider it representative of an urban African region highly exposed to Western
Sociodemographic characteristics of participants
Table 1 shows the background characteristics of the 370 adolescents (53% girls) who participated. Based on the measured weight and height, 19% of the adolescents were overweight. No gender differences were found in these sociodemographic characteristics, only in anthropometrics.
IBS, body size beliefs and body size dissatisfaction are described in Table 2 and sociodemographic differences were tested. Most participants perceived their current body size, IBS, healthiest body size and IBS among
Discussion
Apart from being a risk factor for developing obesity, body dissatisfaction could lead to psychosocial health problems especially in adolescence. Since dissatisfaction is precipitated by comparison of one's self to the societal ideal, it is imperative to recognize existing IBS in the population in order to promote a healthy IBS. In our study, most adolescents preferred the normal body size. Some body size-related beliefs (attractiveness for the other sex and health relevance) could predict IBS
Acknowledgements
The authors want to thank the participating adolescents, their teachers and Dr Irene Ayi of the Noguchi Memorial Institute of Medical Research, Ghana.
Ethical declaration
Approval to conduct the studies was sought from the ethical clearance committee of the Ghent University Hospital and the institutional review board of the Noguchi Memorial Institute of Medical Research. In addition, verbal and written consent of the participants and their parents were sought prior to data collection.
Funding
No funding was received for
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