Body Image Perception among Adolescent students in a private School in Thrissur, Kerala

Body Image Perception among Adolescent students in a private School in Thrissur, Kerala K Kartha G.1, Navya C J.2*, Aswathy M.3, M Joshy V.4 DOI: https://doi.org/10.17511/ijphr.2019.i2.04 1 Gauri K Kartha, Medical Student, Amala Institute of Medical Sciences, Thrissur, Kerala, India. 2* Navya C J, Associate Professor, Amala Institute of Medical Sciences, Thrissur, Kerala, India. 3 M.G Aswathy, Post Graduate Student, Amala Institute of Medical Sciences, Thrissur, Kerala, India. 4 Vidhu M Joshy, Statistician, Amala Institute of Medical Sciences, Thrissur, Kerala, India.


Introduction
The World Health Organization (WHO) defines adolescents as individuals aged between 10 to 19 years [1]. The term adolescent is derived from the Latin word 'adolescere' meaning 'to grow up' [2,3].
This group of young individuals, who are often thought to be healthy, are sadly the most neglected, as they are neither children nor adults [4].
Adolescents experience a variety of health and social problems like anxiety, depression, eating disorders, drug abuse, tobacco and alcohol abuse, learning disabilities and malnutrition.
There is growing literature that shows girls as young as 8 years old already show higher concern towards body image perception and weight [5,6]. If left unchecked these problems might have a potentially devastating effect on their health as adults tomorrow [4].
Body image is considered a multi-dimensional concept that includes perceptual, attitudinal, affective, and behavioural dimensions [7]. It is the mentalpicture we have in our minds of the size, shape and form of our bodies and our feelings concerning these characteristics [8].
Body image perception is the way a person feels about his/her body and these feelings can be positive, negative or both. It is ever changing, and is influenced by individual and environmental factors. It can be both self-perceived or as perceived by others like family, friends, peer group, teachers etc.
Positive body image occurs when a person is able to accept, appreciate and respect their body and is one of the protective factors which can make them resilient to eating disorders, depression and anxiety of the participants had a negative body image perception [11]. All the students of 9th, 10th, 11th, and 12th classes who gave consent to participate in the study were included in the study.
After obtaining prior permission from the school authorities, four divisions from classes 9, 10, 11 and 12 were randomly selected for the study. The purpose of the study was explained in detail to all students of these 4 classes.
They were assured of anonymity and confidentiality was strictly maintained during all stages of the study. Questionnaires in English language were distributed among students and were collected back after completion. Operational definition: Body image is a mental picture we have in our minds of the size, shape and form of our bodies and our feelings concerning these characteristics and one's body parts [12].

Results
Majority of the study subjects were in the middle adolescence.    The above ten item scale was used to assess the presence or absence of a negative body image perception.
Each item were scored Yes= 1 and No=0. A total score of 0 indicates no negative image perception and, and a score of 10 indicates a strong negative body image perception   On univariate analysis using independent samples ttest, it was found out that the mean BMI was Significantly higher in those who were not satisfied with their body size and those who had tried to lose weight in their past.  [18]. It was seen that urban subjects were more dissatisfied than their rural and slum counterparts. Almost similar proportions of adolescents were found to be satisfied in the present study.
Dissatisfaction rates were seen to be 71.4% in a Brazilian study, 51% among girls and 60% among boys in a Spanish study [11,19]. Rates of dissatisfaction were seen to be much higher in our study. The ethnic-socio-cultural background of adolescents and their exposure to media and internet probably have a profound bearing on body image dissatisfaction.
An Asian study involving 13-and 14-year-olds found that 78.1% were dissatisfied with their current body size, even though 50% of the students had normal BMI, and those with high body image discrepancy scores were reported to be more likely to have higher BMI [20].
In another study using the Figure  Prevention of Adult Noncommunicable disease) study [22].
The CASPIAN-IV survey, done among 13,486 Iranian adolescents with the mean age of 12.5 years, showed that 53.5% were dissatisfied with their weight [22]. This discrepancy could be due to the vast difference in the sample population of both Studies.
On the other hand, our prevalence is lower than that found by Pallan et al., who showed that more than 80% of South Asian children aged 5e7 years old were not satisfied with their body image [23].
Similarly, another study using the figure rating scale and involving 1530 children aged 7e10 also showed higher prevalence in body image dissatisfaction, at 82.9% among their students,of whom 59.9% desired a smaller body size and 23.0% desired a larger body size [24].
These findings indicate that the problem of body image dissatisfaction is not isolated to certain ethnicities or regions but has become a global phenomenon, and the fact that it is also high among younger adolescents may indicate that interventions should be undertaken seriously to curb its spread.
In a study conducted in Malaysia, more than half of the students were dissatisfied with their body image (60.1%). Overweight and obese students had higher body image dissatisfaction (79.6%) compared to students with normal weight (51.7%) or underweight students (57.6%).
Among the students with normal BMI, only 48.3% were satisfied with their current body image. Female students had higher body image dissatisfaction (66.1%) compared to male students (52.0%).
The proportion of body image dissatisfaction was higher than satisfaction for all students, regardless of their academic performance, parental education level or their family income [25]. But in our study a negative correlation was obtained between body image perception and academic performance.

Conclusion
Varying degrees of negative body image perception was seen among the subjects with a larger proportion of females with body size dissatisfaction.

Contribution by authors
Assessing body image in young children-a preliminary study of racial and developmental differences. SAGE Open. 2013;3(1)32-34. [Crossref] 06. Damiano SR, Gregg KJ, Spiel EC, et al. Relationships between body size attitudes and body image of 4-year-old boys and girls, and attitudes of their fathers and mothers. J Eat Disord. 2015;Apr;10;3;16.