Body mass index, body image and possible factors related to weight loss practices of female undergraduate students on the Pietermaritzburg campus, University of Kwazulu-Natal.

Abstract

South Africa is undergoing epidemiological transition, characterized by an increasing prevalence of obesity, especially among women. Among those 15 to 24 years of age, the prevalence of overweight and obesity at 40.9% is cause for concern, as it is associated with the development of non-communicable diseases of lifestyle. However, 18.1% of women in the above age category, indicated that they are unhappy with their current weight. Body image is related to an individual’s perception of the attractiveness of their own body, and has an impact on actual weight and weight management practices. Body image dissatisfaction refers to the negative perceptions and feelings a person has about their body and can be affected by factors such as body shape and appearance, body weight gain attitudes, and cultural norms regarding an ideal body size. In this respect, university students are of particular interest, as they are known to experience a number of stressors during the transition from secondary- to tertiary education that contributes to unhealthy eating habits, a decreased level of physical activity and subsequent weight gain. Objectives To determine the Body Mass Index (BMI), body image and factors related to weight loss practices among female undergraduate students on the Pietermaritzburg (PMB) campus of the University of KwaZulu-Natal (UKZN). Methods A cross sectional descriptive survey of conveniently sampled female undergraduate students on the PMB campus (N=316), UKZN was conducted. Weight and height were measured by trained fieldworkers for the calculation of BMI. Data was collected by means of a self-administered questionnaire to determine the socio-demographic characteristics, physical activity level, nutrition knowledge, body perceptions, weight management practices and dietary diversity of study participants. Results The majority of participants (86.7%), were black African and registered for study within the College of Agriculture, Engineering and Science (45.6 %). The mean age of the study sample was 20 ± 2 years. Participants mainly resided in private accommodation (44.3%), followed by 38.6% living in university residences. The majority (72.7%) were funded by the National Student Financial Aid Scheme (NSFAS). Participants who prepared their own meals, did so 3.7 ± 2.3 times per week, with 84.3% reporting that they prepared their own meals most days of the week. Most consumed take-aways (91.1%), with 61.2% doing so on a weekly basis. Nearly half (48.1%) of the participants had a normal BMI, followed by 19% being overweight. Furthermore, 13.3% were classified as obese class I, while 12.6% were classified as obese class II. Only 4.4% were underweight, while 2.5% were classified as obese class III. The majority (46.8%) could be classified as being moderately physically active, followed by those with a low level of physical activity at 38.6%. Only 14.6% were classified as having a high level of physical activity. A nutrition knowledge score of ≥ 50% was achieved by 63.8% of participants, followed by a third (34.3%) who had a score of less than 50%. The most noteworthy findings were that participants were not aware that starchy foods should form the basis of most meals, and that drinking boiled water does not facilitate weight loss. An assessment of participant weight management practices, revealed that 59.1% weighed themselves, with 61.0% reporting that they do so monthly. Despite the fact that the majority of participants (70.0%) classified their current body weight as normal, 56.4% had attempted weight loss. Of those who had not attempted weight loss, the majority (37.5%) indicated that the reason for not attempting weight loss, was that they were satisfied with their body weight, followed by 35% indicating that they perceived their body weight as normal. The majority of participants who attempted weight loss, resorted to healthy weight loss practices (50.9%), followed by 42.0% who made use of a combination of healthy and unhealthy weight loss practices. In terms of body image perceptions, the difference between perceived (“feel”) and ideal body size was calculated, rendering a Feel Ideal Index (FID) score of 0.4 ± 1.33, indicating that participants desired to be thinner. The majority of participants (45.0%) had a medium dietary diversity as was indicated by the consumption of 6 to 11 food groups, followed by more than a third of participants (35.6%) having a high dietary diversity score due to the consumption of more than 11 food groups. One out of five participants (19.4%) consumed diets that lacked diversity. Conclusion Body image perception and level of body image satisfaction were the most important determinants of whether participants engaged in weight management practices. This was illustrated by participants who had never attempted weight loss, indicating that the reason why they have never attempted weight loss was because they “perceived their current body weight to be normal” and that they are “satisfied with current weight”. An increase in BMI was positively associated with an increase in body image dissatisfaction (BID), resulting in overweight and obese participants attempting to lose weight. It was also noted that a larger proportion of participants indicated that they have attempted weight loss, and did so using healthy weight loss practices such as exercise, diet and reduced portion sizes. Participants desired body sizes that were thinner than their perceived current body size. This was illustrated by a positive mean FID index score of 0.4 ± 1.33. Although those with a high BMI desired a large body size, it was thinner than what they perceived themselves to be. Furthermore, participants living in university residences and private accommodation, had a higher BMI than those who lived at home. Those with a higher physical activity level (PAL), weighed themselves more often when compared to those who were less active. This may suggests that participants were engaged in physical activity to improve appearance. However, it could also be an indicator that participants were physically active for the promotion of health, general wellbeing and for social reasons. Significant relationships between nutrition knowledge score and BMI, as well as dietary diversity score were not documented. However, participants with a good nutrition knowledge score perceived their current weight to be lower than those with a poor nutrition knowledge score.