Body image dissatisfaction and its determinants in urban Sri Lankan adolescents

Background: Body image dissatisfaction is a significant public health issue, particularly among adolescents. We investigated the prevalence of body image dissatisfaction in urban Sri Lankan adolescents and its determinants. Methods: A descriptive cross-sectional study examined the body image dissatisfaction among urban adolescents of 15-16 years old in one educational zone in the Colombo district. Perceived current body size and body size ideals were assessed based on the Stunkard Figure Rating Scale (SFRS). Body mass index (BMI) was categorized according to WHO 2007 growth references. Univariate and multivariate analysis was performed to examine the correlates of body image dissatisfaction. Independent variables were BMI, waist to height ratio, gender, socioeconomic status, and ethnicity. Results: Overall, most (73.5%) were not satisfied with their body image. More males (79%) than female (69%) adolescents were dissatisfied. Among the dissatisfied, 66% of males desired larger body size, and 57% of females preferred a thinner size. Overweight/obese adolescents had four times greater body image dissatisfaction, and underweight adolescents had three times greater dissatisfaction when compared to students with normal BMI when adjusted for gender. (OR: 4.18, CI: 1.209,14.416, p=0.02 and OR: 3.2, CI: 1.073,9.852, p=0.04). Males had higher odds of dissatisfaction than females (OR: 1.9. CI: 1.020,3.407, p=0.04). Conclusions: Most adolescents were dissatisfied with their body image. Overweight/obesity and underweight were significant determinants of dissatisfaction when adjusted for gender. Also, males had a greater risk of having dissatisfaction than females. It informs that further research is required using more rigorous scientific methods to clarify these findings further.