Influence of body weight and image perception on the nutritional status of 8-19-year-olds attending schools in Kampala, Uganda

Abstract

Inaccurate weight perceptions (body image distortion) and body image dissatisfaction among children and adolescents, may lead to unhealthy weight control practices, greater risk for adult obesity and obesity-related morbidities. This study aimed at assessing weight perception, body image distortion and dissatisfaction, their related factors and how all these influences the nutritional status of children and adolescents attending schools in Kampala district in Uganda. The cross-sectional survey constituted 1043 children and adolescents (aged 8–19 years) attending primary and secondary schools in Kampala district, Uganda. Semi-structured questionnaires were used to collect the data on self-reported weight perception and preference. Overall, 17.74%, 67.98% and 14.28% of participants under-, correctly and over-estimated their weight status. There was only fair agreement between participants’ actual and perceived weight status, denoted by an overall kappa coefficient of 0.21. A significant proportion of participants (32.02%) had body image distortion. Highest proportions of dissatisfaction were among: those who belonged to grade 3 thinness based on BMI, perception and preference; 10-14-year-olds attending primary schools and; females. Normal weight status was the most preferred while grade 3 thinness was the least preferred weight status category. More children (14.46%) than adolescents (9.95%), preferred being obese. More females (15.29%) than males (8.06%) preferred being thin. Factors including actual, perceived and preferred weight status, age category, gender and education level were identified to influence weight perception, weight preference and body image distortion and dissatisfaction. These should be considered when designing interventions for prevention and management of childhood and adolescence overweight and obesity.