The association of body image distortion with weight control behaviors, diet behaviors, physical activity, sadness, and suicidal ideation among Korean high school students: a cross-sectional study

Jan 17, 2016BMC public health

Body image distortion linked to weight control, diet, exercise, sadness, and suicidal thoughts in Korean high school students

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Abstract

Among 20,264 normal weight high school students, body image distortion is prevalent and significantly linked to mental health issues.

Students who overestimate their body weight are more likely to be female and employ unhealthy weight control behaviors.
Overestimating body weight is associated with increased feelings of sadness and suicidal thoughts.
Students who underestimate their body weight are less likely to be female and to engage in unhealthy weight control behaviors.
Underestimating body weight is associated with feelings of sadness and suicidal ideation, though to a lesser extent.

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BACKGROUND: The identification of predictors for body image distortion would be an especially important first step in targeting a vulnerable population and developing a nutrition intervention program. We aimed to investigate the prevalence of body image distortion and the factors associated with body image distortion among Korean high school students.

METHODS: We selected 20,264 normal weight high school students from the 10(th) Korea Youth Risk Behavior Web-based Survey using nationally representative data in 2014. With multivariate logistic regression, we assessed the association of body image distortion with individual demographic and socio-economic factors, weight control behaviors, and mental health characteristics.

RESULTS: The over-estimation group of body weight status, compared with the correct estimation group, was significantly more likely to be a 3(rd) year high school student [adjusted odds ratio (AOR): 1.27, 95% confidence interval (CI): 1.16-1.39], to be female [AOR: 3.52, 95% CI: 3.25-3.81], to employ unhealthy weight control behaviors [AOR: 1.54, 95% CI: 1.37-1.72], and to have a sadness [AOR: 1.25, 95% CI: 1.16-1.35] and suicidal ideation [AOR: 1.20, 95% CI: 1.08-1.33]. The under-estimation group, compared with the correct estimation group, was significantly less likely to be female [AOR: 0.23, 95% CI: 0.21-0.25] and to employ unhealthy weight control behaviors [AOR: 0.50, 95% CI: 0.43-0.59] but were more likely to have a sadness [AOR: 1.12, 95% CI: 1.03-1.21] and suicidal ideation [AOR: 1.12, 95% CI: 1.00-1.25].

CONCLUSIONS: Not only the over-estimation but also the under-estimation of body weight is prevalent among high school students in South Korea. Body image distortion was significantly associated with sadness and suicidal ideation.

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