Body size ideals and dissatisfaction in Ghanaian adolescents: role of media, lifestyle and well-being

Objectives: To inspire effective health promotion campaigns, we tested the relationship of ideal body size and body size dissatisfaction with (1) the potential resulting health-influencing factors diet, physical activity and well-being; and (2) with media as a potential influencer of body ideals. Study design: This is a cross-sectional study in 370 Ghanaian adolescents (aged 11e18 years). Methods: Questionnaires included disordered eating (EAT26), diet quality (FFQ), physical activity (IPAQ), well-being (KINDL) and media influence on appearance (SATAQ: pressure, internalisation and information). Ideal body size and body size dissatisfaction were assessed using the Stunkard figure rating scale. Body mass index (BMI), skinfolds and waist were measured. Linear regressions were adjusted for gender, age and parental education. Also, mediation was tested: can perceived media influence play a role in the effects of actual body size on body size dissatisfaction?'. Results: Body size dissatisfaction was associated with lower well-being and more media influence (pressure and internalisation) but not with physical activity, diet quality or disordered eating. An underweight body size ideal might worsen disordered eating but was not significantly related to the other predictors of interest. Only a partial mediation effect by media pressure was found: especially overweight adolescents felt media pressure, and this media pressure was associated with more body size dissatisfaction. Conclusions: To prevent disordered eating and low well-being, health messages should include strategies that reduce body size dissatisfaction and increase body esteem by not focussing on the thin body ideal. Changing body size ideals in the media might be an appropriate way since media pressure was a mediator in the BMI-dissatisfaction relation. (C) 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.