|Year : 2018 | Volume
| Issue : 1 | Page : 6-9
Body image perception: An early predictor of weight change among medical students
Bhawana Pant, Sartaj Ahmad, Arvind Kumar Shukla, Chhavi Kiran
Department of Community Medicine, Subharti Medical College, Swami Vivekanand Subharti University, Meerut, Uttar Pradesh, India
|Date of Web Publication||2-Nov-2018|
Dr. Arvind Kumar Shukla
Department of Community Medicine, Subharti Medical College, Swami Vivekanand Subharti University, Meerut, Uttar Pradesh
Source of Support: None, Conflict of Interest: None
Body image is a multidimensional dynamic construct that involves internal biological and psychological factors as well as external cultural and social determinants. Individuals who perceive their bodies negatively with regard to culturally valued features may have low self-esteem, low satisfaction in life, and feeling of inferiority and pose themselves at higher risk for depression, anxiety, or eating disorders. With the change in epidemiological shift, India is witnessing simultaneous manifestation of double burden of communicable and noncommunicable disease with a challenging and daunting task for stakeholders to identify issues, resolve conflict, mobilize resources, and overcome situation with innovative solution and strategies. The presence of psychological and psychiatric morbidities among medical students has been reported in various studies conducted across the world.
Keywords: Body dysmorphic disorders, body weight, features appearance, medical students
|How to cite this article:|
Pant B, Ahmad S, Shukla AK, Kiran C. Body image perception: An early predictor of weight change among medical students. Int J Soc Rehabil 2018;3:6-9
|How to cite this URL:|
Pant B, Ahmad S, Shukla AK, Kiran C. Body image perception: An early predictor of weight change among medical students. Int J Soc Rehabil [serial online] 2018 [cited 2020 Aug 5];3:6-9. Available from: http://www.ijsocialrehab.com/text.asp?2018/3/1/6/244545
| Introduction|| |
Body dysmorphic disorder (BDD) is a psychiatric disorder characterized by a preoccupation with an imagined or slight defect which causes significant distress or impairment in functioning. It is an underrecognized yet relatively common and severe mental disorder that occurs globally.
The term BDD has been formerly attributed to wide array of nomenclatures in medical literature as dysmorphophobia, dysmorphic syndrome, dermatologic hypochondriasis, or dermatologic nondisease in different contexts.
Body image can be described as a way person thinks regarding his/her body and how it appears to the others. Although many people have concerns about unattractive body parts, only a few of them fulfill the criteria for BDD.
The main component of BDD is a fixation with an imaginary flaw in appearance or exaggerated concern with a trivial physical abnormality. This obsession most frequently involves the skin, facial features, obesity, and hair-related issues. Changing sociocultural values and excessive exposure to mass media targeting the young people have crafted an imaginary body image that inculcates the insecurity among ordinary people regarding self-image. Individuals with BDD have a poor quality of life, are socially isolated, depressed, and at a high rate of committing suicide. It is well recognized that in some communities being physically unattractive is considered more of a social liability for women than for men. Studies and surveys have shown that dysmorphic concerns and body image dissatisfaction are increasing in the population.
BDD has been found to be more prevalent in medical student populations as compared to community samples. It is important to discern whether doctors have any element of body image disturbance because this may have some impact on their practice and specifically, their perception of a patient's physical defects. Given the chronic nature of BDD and the early age of onset (adolescence), it is highly likely that medical students with body image disturbance will retain it when they start their professional career.
Aims and objectives
The aim of this study was to assess the prevalence of body image disorders among medical students.
| Materials and Methods|| |
This interventional study was conducted among 150 medical students of Subharti Medical College, Meerut. The aim of this study was to know the response regarding body image disorders among medical students. The study was done during September and October 2015, after taking informed consent of participants ensuring complete confidentiality. Data collection was carried through personal interview by the investigator using predesigned, pretested semi-structured interview schedules. The questionnaire included perception of image, image satisfaction, diet, and physical activities.
After 1 week, a power point presentation on disorder was shown to the students; the same questionnaire was refilled by students as a posttest assessment. Their responses were collected, tabulated, analyzed, and interpreted. Prevalence of body image disorders, effects on health, and intervention was expressed as percentage. Pre- and post-test assessments were compiled and analyzed using Microsoft Excel (2010) software statistical package (SPSS version. 21.0). Association between variables was assessed with Chi-square test. Variables showing statistically significant association with the outcome variables (P < 0.05) were considered.
| Results|| |
[Table 1] shows that after educational intervention, a significant change of behavior was seen in seeking medical treatment 75%, and least change was seen in not going into party because of personal looks.
[Table 2] shows that health education has a good impact about 50% on behavior change among all parameters of body weight-related disorders.
[Graph 1] depicts that minimum changes found in the awareness regarding party or social gathering (33.3%) while maximum changes in posture of sitting on the floor among the medical students. Hence, there were 33%–77% changes in awareness regarding body image disorder.
| Discussion|| |
The present study revealed tha an educational intervention has role in changing knowledge and attitude for body image perception. The results did not come as sharp as expected but one possibility of low dissatisfaction could be that the 1st year students have just emerged from the protected environment of their family and may throw surprising results if the study is repeated after few years when they are exposed to more competitive situations later in life. Our study reports a relatively lower proportion of body image dissatisfaction among college students in comparison with other selected studies done at international platform.
A study conducted by Priya et al. revealed that among all resident medical students in South India reported image dissatisfaction to the tune of 33.3%. An another study conducted by Dixit et al., in Lucknow, suggested that 73.4% adolescent girls were satisfied with their body image, while 26.6% were dissatisfied.
In our study, after intervention, 44.7% medical students had changes in opinion regarding food restriction to improve body shape which was found to be statistically significant. Educational intervention is a helpful instrument for exploring ideal body image and objective image, particularly among overweight and obese individuals or those struggling to maintain their weight and control their eating behaviors.
A study done by Miranda and Karlis revealed that eating disorders (ED) – anorexia nervosa, bulimia nervosa, and binge ED – are behavioral syndromes whose diagnostic criteria have been widely studied over the past thirty years. An another study done by Laws revealed that overweight students preferred skipping of meals as a means of losing weight. The relationship between EDs and body image self-perception is well documented in the literature. However, Leonhard and Barry note that studies on body image distortion and dissatisfaction have mostly focused on individuals with specific EDs (bulimia, anorexia, nervosa, and morbid obesity). It has recently been described a similar body image distortion in normal weight individuals without any specific EDs.
In a study conducted Priya et al., a total of 61.5% of the females and 21.5% of the males reported trying to lose weight; 6.8% of the females and 36.3% of the males were trying to gain weight. There was a strong correlation (r = 0.62, P < 0.0001) between attempting to gain weight and self-perception of underweight for both genders. Females changed their intake of several foods for attempting change in weight. The failure to accurately recognize their own overweight status before becoming obese may prevent them from changing behaviors that might contribute to additional weight gain. Therefore, it is important to understand the magnitude of weight status distortions within persons with BMI scores within the overweight range.
In our study, doing regular exercises to alter their body shape or weight was found in 50.8% changes. A study carried by Sinhababu among nursing students in West Bengal revealed double burden of nutritional disorder with prevalence of faulty weight perception of 38.6% and was found to be weighted toward feeling higher weight. In a study conducted in Delhi, half of overweight/obese youth had low body satisfaction, while one-quarter of the nonoverweight youth felt the same; among overweight/obese youth, girls were more likely than boys to perceive themselves as overweight.
An Austrian psychiatrist Paul Ferdinand Schilder (1886–1940) said that the mental images that individuals have of their own bodies explain the way their bodies are introduced to them. According to the psychiatrist, one's mental body image is established by senses, ideas, and feelings that, most of the time, are unconscious. This representation is built and rebuilt throughout life. Linde et al. assessed intake of specific foods, dietary fat or fiber and behaviours attempted to control weight. Most of the underweight and all overweight females were not satisfied with their body image. Overweight students preferred skipping of meals as a means of losing weight. The relationship between EDs and body image self-perception is well documented in the literature. A study by Hassapidou and Papadopoulou on food choice criteria according to body image satisfaction among adolescents showed that around 39% (45% females and 26.6% males) wanted to lose weight, while 14% wished to gain weight after perception of their body image. The remaining 50% wanted to maintain their same body weight. Another study done by Sinead McElroy et al. reported that 39% of the respondents in the European Union and about 29% Finnish were content with their weight. The highest percentage of individuals who were content with their body weight was among the females who were underweight (58%) and males who were normal weight (66%).
| Conclusion|| |
Our study reflected that BDD is fairly common among the medical students. Our survey confirmed that many medical students have concerns about unattractive body parts although only a few of them fulfill the criteria for BDD.
When comparing with normal population, medical student population were significantly more concerned about their features and body weight. We have addressed that need and demonstrated the influence of sociocultural norms on body image concerns.
Body image was perceived correctly by the medical students after educational intervention. Proactive preventive measures could be initiated in institutions on personality development, acceptance of self, and individual differences while maintaining optimum weight and active lifestyle.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Phillips KA. Body dysmorphic disorder: Recognizing and treating imagined ugliness. World Psychiatry 2004;3:12-7.
McElroy SL, Phillips KA, Keck PE Jr., Hudson JI, Pope HG Jr. Body dysmorphic disorder: Does it have a psychotic subtype? J Clin Psychiatry 1993;54:389-95.
Sterling JC. Warts. In: Burns T, Breathnach SM, Cox N, Griffiths CE, editors. Rook's Textbook of Dermatology. 7th
ed. Oxford, England: Wiley-Blackwell; 2010. p. 64.17-8.
Hollander E, Cohen L, Simeon D. Body dysmorphic disorder. Psychiatr Ann 1993;23:359-64.
Veale D. Body dysmorphic disorder. Postgrad Med J 2004;80:67-71.
Perugi G, Akiskal HS, Giannotti D, Frare F, Di Vaio S, Cassano GB, et al
. Gender-related differences in body dysmorphic disorder (dysmorphophobia). J Nerv Ment Dis 1997;185:578-82.
Priya D, Prasanna KS, Sucharitha S, Vaz NC. Body image perception and attempts to change weight among female medical students at Mangalore. Indian J Community Med 2010;35:316-20.
] [Full text]
Dixit S, Agarwal G, Singh J, Kant S, Singh N. A study on consciousness of adolescent girls about their body image. Indian J Community Med 2011;36:197-202.
] [Full text]
Miranda GT, Karlis V. Eating disorders in the female patient: Pathophysiology and treatment strategies. Oral Maxillofac Surg Clin North Am 2007;19:173-85, vi.
Laws R, Counterweight Project Team. Current approaches to obesity management in UK primary care: The counterweight programme. J Hum Nutr Diet 2004;17:183-90.
Leonhard ML, Barry NJ. Body image and obesity: Effects of gender and weight on perceptual measures of body image. Addict Behav 1998;23:31-4.
Johnson-Taylor WL, Fisher RA, Hubbard VS, Starke-Reed P, Eggers PS. The change in weight perception of weight status among the overweight: Comparison of NHANES III (1988-1994) and 1999-2004 NHANES. Int J Behav Nutr Phys Act 2008;5:9.
Sinhababu A. A study on weight status and weight perception of GNM students of a nursing training centre, Bankura, West Bengal. J Indian Med Assoc 2007;105:85-7.
Stigler MH, Arora M, Dhavan P, Shrivastav R, Reddy KS, Perry CL, et al.
Weight-related concerns and weight-control behaviors among overweight adolescents in Delhi, India: A cross-sectional study. Int J Behav Nutr Phys Act 2011;8:9.
Slade PD. What is body image? Behav Res Ther 1994;32:497-502.
Linde JA, Utter J, Jeffery RW, Sherwood NE, Pronk NP, Boyle RG, et al.
Specific food intake, fat and fiber intake, and behavioral correlates of BMI among overweight and obese members of a managed care organization. Int J Behav Nutr Phys Act 2006;3:42.
Hassapidou M, Papadopoulou SK. Food choice criteria in adolescents according to body image. J Sci Technol 2006;28:165-9.
Kakeshita IS, de Sousa Almeida S. Relationship between body mass index and self-perception among university students. Rev Saude Publica 2006;40:497-504.
[Table 1], [Table 2]