Elsevier

Public Health

Volume 139, October 2016, Pages 112-120
Public Health

Original Research
Body size ideals, beliefs and dissatisfaction in Ghanaian adolescents: sociodemographic determinants and intercorrelations

https://doi.org/10.1016/j.puhe.2016.05.012Get rights and content

Highlights

  • Body dissatisfaction existed at both extremes of body weight (i.e. underweight and overweight).

  • Sexual attractiveness and health beliefs predicted body size ideals.

  • Weight-related teasing was common and could affect body esteem negatively.

Abstract

Background

Understanding the sociocultural perception of body size and its relation to body weight management is essential for policy and intervention planning. Herein, African adolescents deserve special interest because of a possible shift in body size ideals due to globalization and because of adolescence as a vulnerable stage of life. Therefore, the objective of this study was to explore body size beliefs and its determinants (sociodemographic and beliefs) in Ghanaian adolescents. Furthermore, the association of these ideals with body size dissatisfaction and measured body size was examined to detect the link with well-being and overweight.

Methods

A cross-sectional study involving 370 adolescents (53% girls, 11–18y) from the Greater Accra Metropolitan Area in Ghana was conducted. Questionnaires on body size beliefs were administered and anthropometric measurements were obtained. Body size ideals and dissatisfaction were based on the Stunkard figure rating scale. Multinomial, ordinal and linear regressions were adjusted for gender, age and parental education.

Results

Though 64% preferred the normal-weight ideal, the traditional preference for the overweight ideal was still present. Body size dissatisfaction was higher in adolescents who preferred the overweight or underweight ideal. Both underweight and overweight adolescents reported teasing. Sexual attractiveness and health beliefs were predictors of body ideals, but beliefs on the role of lifestyle were not.

Conclusions

The associations of the ideal body size with beliefs show that promoting the normal-sized body as healthy might be a good way to influence ideals in this population. Interventions should stimulate body esteem and a healthy lifestyle without extremes.

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

References (43)

  • C.A. Appiah et al.

    Predictors of overweight/obesity in urban Ghanaian women

    Int J Clin Nutr

    (2014)
  • T. Puoane et al.

    'Big is beautiful'-an exploration with urban black community health workers in a South African township

    South Afr J Clin Nutr

    (2005)
  • Z. Mvo

    Perceptions of overweight African women about acceptable body size of women and children

    Curationis

    (1999)
  • D.A. Frederick et al.

    Female body dissatisfaction and perceptions of the attractive female body in Ghana, the Ukraine, and the United States

    Psychol Top

    (2008)
  • H. Alwan et al.

    Association between weight perception and socioeconomic status among adults in the Seychelles

    BMC Public Health

    (2010)
  • G. Mintem et al.

    Body size dissatisfaction among young adults from the 1982 Pelotas birth cohort

    Eur J Clin Nutr

    (2014)
  • J.A. O'Dea et al.

    Socio-cognitive and nutritional factors associated with body mass index in children and adolescents: possibilities for childhood obesity prevention

    Health Educ Res

    (2006)
  • E. Lynch et al.

    The relation between body size perception and change in body mass index over 13 years: the Coronary Artery Risk Development in Young Adults (CARDIA) study

    Am J Epidemiol

    (2009)
  • L. Zaccagni et al.

    Body image and weight perceptions in relation to actual measurements by means of a new index and level of physical activity in Italian university students

    J Transl Med

    (2014)
  • N.A. Jumah et al.

    Comparison of the perception of ideal body images of Ghanaian men and women

    Afr J Health Sci

    (2008)
  • L. Festinger

    A theory of social comparison processes

    Hum Relat

    (1954)
  • View full text