Influence of Body Weight and Image Perception on the Nutritional Status of 8-19-Year-Olds Attending Schools in Kampala, Uganda

Catherine Tamale Ndagire; Dorothy Nakimbugwe; John Muyonga

doi:10.70851/jfines.2025.2(2).01.12

Authors

Ndagire Tamale Catherine Department of Food Innovation and Nutrition, Faculty of Agriculture and Environmental Sciences, Mountains of the Moon University, Fort Portal, Uganda Author https://orcid.org/0000-0002-2695-8466 (unauthenticated)
Nakimbugwe Dorothy School of Food Technology, Nutrition & Bio-Engineering, Makerere University, Kampala, Uganda Author
Muyonga John H. School of Food Technology, Nutrition & Bio-Engineering, Makerere University, Kampala, Uganda Author

DOI:

https://doi.org/10.70851/jfines.2025.2(2).01.12

Keywords:

Weight perception, Weight preference, Body image distortion, Body image dissatisfaction

Abstract

Inaccurate weight perceptions (body image distortion) and body image dissatisfaction among children and adolescents may lead to unhealthy weight control practices, increasing the risk of adult obesity and related health issues. This study aimed to assess weight perception, body image distortion, dissatisfaction, their associated factors, and how these influences affect the nutritional status of children and adolescents attending schools in Kampala District, Uganda. The cross-sectional survey included 1,043 children and adolescents (aged 8–19 years) attending primary and secondary schools in Kampala. Semi-structured questionnaires were used to collect data on self-reported weight perception and preference. Overall, 17.74% of participants underestimated, 67.98% accurately estimated, and 14.28% overestimated their weight status. There was only fair agreement between participants’ actual and perceived weight status, as indicated by a kappa coefficient of 0.21. A significant proportion of participants (32.02%) exhibited body image distortion. The highest levels of dissatisfaction were found among: individuals classified as grade 3 thinness based on BMI, perception, and preference; children aged 10–14 attending primary schools; and females. Normal weight status was the most preferred, while grade 3 thinness was the least preferred weight category. More children (14.46%) than adolescents (9.95%) preferred being obese, and more females (15.29%) than males (8.06%) preferred being thin. Factors such as actual, perceived, and preferred weight status, age, gender, and education level were found to influence weight perception, weight preference, and body image distortion and dissatisfaction. These factors should be considered when designing interventions to prevent and manage childhood and adolescent overweight and obesity.

References

Afriyie-Adjimi, H., & Nkyi, A. K. (2024). Impact of body image and perceived stigmatization on the psychological wellbeing of obese women in Kumasi metropolis, Ghana. PloS one, 19(4), e0296061.

Al-Rasheed, Amal, Eatedal Alabdulkreem, Mai Alduailij, Mona Alduailij, Wadee Alhalabi, Seham Alharbi, and Miltiadis D. Lytras. 2022. “Virtual Reality in the Treatment of Patients with Overweight and Obesity: A Systematic Review.” Sustainability 2022, Vol. 14, Page 3324 14(6):3324.

Anamika, Neetu S. 2014. “The Relationship Between Eating Behaviors , Body.” E-Library Science Research Journal 2(9):1–4.

Apopei, Daria, Jennifer Coe, and Sebastian Cordoba. 2024. “Examining the Role of Family, Media, Peers in Young Caucasian Men’s Understandings of Body Dissatisfaction: A Thematic Analysis Using the Tripartite Influential Model and Social Comparison Theory.” Gender Issues 41(4):1–25.

Van den Berg, Patricia, Susan J. Paxton, Helene Keery, Melanie Wall, Jia Guo, and Dianne Neumark-Sztainer. 2007. “Body Dissatisfaction and Body Comparison with Media Images in Males and Females.” Body Image 4(3):257–68.

Bhurtun, Darshini Devi, and Rajesh Jeewon. 2013. “Body Weight Perception and Weight Control Practices among Teenagers.” ISRN Nutrition 2013:1–6.

Blashill, Aaron J., and Sabine Wilhelm. 2014. “Body Image Distortions, Weight, and Depression in Adolescent Boys: Longitudinal Trajectories into Adulthood.” Psychology of Men & Masculinity 15(4):445–51.

Bodde, Amy E., Timothy J. Beebe, Laura P. Chen, Sarah Jenkins, Kelly Perez-Vergara, Lila J. Finney Rutten, and Jeanette Y. Ziegenfuss. 2014. “Misperceptions of Weight Status among Adolescents: Sociodemographic and Behavioral Correlates.” Patient Related Outcome Measures 5:163–71.

Brener, Nancy D., Danice K. Eaton, Richard Lowry, and Tim McManus. 2004. “The Association between Weight Perception and BMI among High School Students.” Obesity Research 12(11):1866–74.

Bruzas, Maija B., and Kelly C. Allison. 2023. “Nutrition and Eating Disorders.” Nutrition and Health (United Kingdom) Part F3942:141–55.

Datar, Ashlesha, and Paul J. Chung. 2016. “Accuracy of Weight Perceptions in a Nationally Representative Cohort of US 8th Grade Adolescents.” Academic Pediatrics 16(3):267–74.

Dietz, William H. 2006. “What Constitutes Successful Weight Management in Adolescents?” Annals of Internal Medicine 145(2):145.

Escrivá, Dolores, Esther Moreno-Latorre, Jordi Caplliure-Llopis, Inmaculada Benet, and Carlos Barrios. 2021. “Relationship of Overweight and Obesity with Body Self-Image Dissatisfaction in Urban Mediterranean Adolescents.” International Journal of Environmental Research and Public Health 2021, Vol. 18, Page 7770 18(15):7770.

Gonsalves, Diane, Helen Hawk, and Carol Goodenow. 2014. “Unhealthy Weight Control Behaviors and Related Risk Factors in Massachusetts Middle and High School Students.” Maternal and Child Health Journal 18(8):1803–13.

Grogan, Sarah. 2021. “Body Image: Understanding Body Dissatisfaction in Men, Women and Children, Fourth Edition.” Body Image: Understanding Body Dissatisfaction in Men, Women and Children, Fourth Edition 1–250.

Gualdi-Russo, Emanuela, Vanessa Samantha Manzon, Sabrina Masotti, Stefania Toselli, Augusta Albertini, Francesca Celenza, and Luciana Zaccagni. 2012. “Weight Status and Perception of Body Image in Children: The Effect of Maternal Immigrant Status.” Nutrition Journal 11(1):85.

Gualdi‐russo, Emanuela, Natascia Rinaldo, Sabrina Masotti, Barbara Bramanti, and Luciana Zaccagni. 2022. “Sex Differences in Body Image Perception and Ideals: Analysis of Possible Determinants.” International Journal of Environmental Research and Public Health 2022, Vol. 19, Page 2745 19(5):2745.

Held, Martina, Mario Sestan, and Marija Jelusic. 2023. “Obesity as a Comorbidity in Children and Adolescents with Autoimmune Rheumatic Diseases.” Rheumatology International 43(2):209–19.

Horesh, Adi, Avishai M. Tsur, Aya Bardugo, and Gilad Twig. 2021. “Adolescent and Childhood Obesity and Excess Morbidity and Mortality in Young Adulthood—a Systematic Review.” Current Obesity Reports 10(3):301–10.

Hrabosky, Joshua I., and Carlos M. Grilo. 2007. “Body Image and Eating Disordered Behavior in a Community Sample of Black and Hispanic Women.” Eating Behaviors 8(1):106–14.

İNCE PALAMUTOĞLU, Merve, and Meltem İNCE YENİLMEZ. 2021. “Relation Between Eating Behaviours and Personal Body Image Perception of Yasar University Students.” International Journal of Contemporary Economics & Administrative Sciences 11(2):339–53.

Jackson, Todd, and Hong Chen. 2008. “Sociocultural Influences on Body Image Concerns of Young Chinese Males.” Journal of Adolescent Research 23(2):154–71.

Manneville, Florian, Karine Legrand, Abdou Y. Omorou, Jenny Ann Rydberg, Johanne Langlois, Philip Böhme, Laura Saez, Edith Lecomte, and Serge Briançon. 2024. “Lifestyle Behaviors and Psychological Health in Adolescents with Overweight or Obesity: Cross-Sectional Associations with Weight Underestimation.” International Journal of Behavioral Medicine 1–12.

Markland, David, and David K. Ingledew. 2007. “The Relationships between Body Mass and Body Image and Relative Autonomy for Exercise among Adolescent Males and Females.” Psychology of Sport and Exercise 8(5):836–53.

Maximova, K., J. J. McGrath, T. Barnett, J. O’Loughlin, G. Paradis, and M. Lambert. 2008. “Do You See What I See? Weight Status Misperception and Exposure to Obesity among Children and Adolescents.” International Journal of Obesity 32(6):1008–15.

Mbogori T, Arthur TM. Perception of Body Weight Status Is Associated With the Health and Food Intake Behaviors of Adolescents in the United States. American Journal of Lifestyle Medicine. 2019;15(3):347-355.

McCreary, Donald R., and Stanley W. Sadava. 2001. “Gender Differences in Relationships among Perceived Attractiveness, Life Satisfaction, and Health in Adults as a Function of Body Mass Index and Perceived Weight.” Psychology of Men & Masculinity 2(2):108–16.

McHugh, Mary L. 2012. “Lessons in Biostatistics Interrater Reliability : The Kappa Statistic.” Biochemica Medica 22(3):276–82.

Mendonça, Karla L., Ana L. L. Sousa, Carolina S. Carneiro, Flávia M. N. Nascente, Thaís I. R. Póvoa, Weimar K. S. B. Souza, Thiago S. V. Jardim, and Paulo C. B. V. Jardim. 2014. “Does Nutritional Status Interfere with Adolescents’ Body Image Perception?” Eating Behaviors 15(3):509–12.

Mohamed, Balqees Abdeen Ahmed, and Malaz Hassan Dafaalla Idrees. 2023. “Body Image Dissatisfaction and Its Relation to Body Mass Index among Female Medical Students in Sudan: Across-Sectional Study 2020-2021.” BMC Women’s Health 23(1):1–8.

Moradi, Maedeh, Hadis Mozaffari, Mohammadreza Askari, and Leila Azadbakht. 2021. “Association between Overweight/Obesity with Depression, Anxiety, Low Self-Esteem, and Body Dissatisfaction in Children and Adolescents: A Systematic Review and Meta-Analysis of Observational Studies.” Critical Reviews in Food Science and Nutrition 62(2):555–70.

Mvo, Z., J. Dick, and K. Steyn. 1999. “Perceptions of Overweight African Women about Acceptable Body Size of Women and Children.” Curationis 22(2):27–31.

Olivardia, Roberto, Harrison G. Pope, John J. Borowiecki, and Geoffrey H. Cohane. 2004. “Biceps and Body Image: The Relationship Between Muscularity and Self-Esteem, Depression, and Eating Disorder Symptoms.” Psychology of Men & Masculinity 5(2):112–20.

de Onis, Mercedes. 2007. “Development of a WHO Growth Reference for School-Aged Children and Adolescents.” Bulletin of the World Health Organization 85(09):660–67.

Pelegrini, Andreia, Raildo da Silva Coqueiro, Carmem Cristina Beck, Karoliny Debiasi Ghedin, Adair da Silva Lopes, and Edio Luiz Petroski. 2014. “Dissatisfaction with Body Image among Adolescent Students: Association with Socio-Demographic Factors and Nutritional Status.” Ciência & Saúde Coletiva 19(4):1201–8.

Petroski, Edio Luiz, Andreia Pelegrini, and Maria Fátima Glaner. 2012. “Motivos e Prevalência de Insatisfação Com a Imagem Corporal Em Adolescentes.” Ciência & Saúde Coletiva 17(4):1071–77.

Polivy, Janet, David M. Garner, and Paul E. Garfinkel. 2022. “Causes and Consequences of the Current Preference for Thin Female Physiques.” Physical Appearance, Stigma, and Social Behavior 89–112.

Potgieter, Cheryl Ann, and Gadija Khan. 2005. “Sexual Self-Esteem and Body Image of South African Spinal Cord Injured Adolescents.” Sexuality and Disability 23(1):1–20.

Prnjak, Katarina, Phillipa Hay, Jonathan Mond, Kay Bussey, Nora Trompeter, Alexandra Lonergan, and Deborah Mitchison. 2021. “The Distinct Role of Body Image Aspects in Predicting Eating Disorder Onset in Adolescents after One Year.” Journal of Abnormal Psychology 130(3):236–47.

Santana, Mônica L. P., Rita De Cássia R. Silva, Ana M. O. Assis, Rosa M. Raich, Maria Ester P. C. Machado, Elizabete de J Pinto, Lia T. L. P. de Moraes, and Hugo Da C. Ribeiro Júnior. 2013. “Factors Associated with Body Image Dissatisfaction among Adolescents in Public Schools Students in Salvador, Brazil.” Nutrición Hospitalaria 28(3):747–55.

Singh, Aditi, and Abhishek Nandy. 2024. “Lifestyle Diseases in Adolescents: Addressing Physical, Emotional, and Behavioral Issues.” Lifestyle Diseases in Adolescents: Addressing Physical, Emotional, and Behavioral Issues 1–203.

Thompson, J. Kevin, and Eric Stice. 2001. “Thin-Ideal Internalization: Mounting Evidence for a New Risk Factor for Body-Image Disturbance and Eating Pathology.” Current Directions in Psychological Science 10(5):181–83.

Wacker-Gussmann, Annette, and Renate Oberhoffer-Fritz. 2022. “Cardiovascular Risk Factors in Childhood and Adolescence.” Journal of Clinical Medicine 11(4):1136.

Wilson, Michael L., Bharathi Viswanathan, Valentin Rousson, and Pascal Bovet. 2013. “Weight Status, Body Image and Bullying among Adolescents in the Seychelles.” International Journal of Environmental Research and Public Health 10(5):1763–74.

Yost, Jennifer, Barbara Krainovich-Miller, Wendy Budin, and Robert Norman. 2010. “Assessing Weight Perception Accuracy to Promote Weight Loss among U.S. Female Adolescents: A Secondary Analysis.” BMC Public Health 10:465.

Zu, Ping, Shao Jun Xu, Cheng Ying Shi, Yu Qiu Zhao, Zhao Hui Huang, and Fang Biao Tao. 2023. “Perceived Rather than Objective Weight Status Is Associated with Suicidal Behaviors among Chinese Adolescents: A School-Based Study.” Journal of Public Health 45(1):75–83.