Do different groups have different risk factors for dieting and exercise as body management strategies?

Introduction

While concerns about one’s body and degree of physical attractiveness have been a part of history, these concerns have become more intense in recent decades. Body image has been defined as the perception of overall physic cal appearance .It consider a multidimensional issue that includes perception, attitude, feeling and the effects of these perceptions on the individual’s behaviors [1]

Body size estimation, attractiveness and one’s feelings about these  are among the aspects of body image [1]. Body image is the mental representation about   own body. Body satisfaction and its related problems were, in the past, known as a western culture phenomenon; however, recent studies are finding that it is now a worldwide matter. Despite previous beliefs, body concerns and eating disorders are increasing in Asian countries, and in some of these societies, their prevalence is similar to that of western cultures [2, 3]. In recent decades, the emphasis for the ideal women has been on thinness, while the emphasis for the ideal man has been on muscledevelopment/masculinity [4]. These body characteristics are considered symbols of success, self control and sexual attractiveness in women and empowerment in men [1, 4].

There are multiple differences between Asian cultures that can affect an individual’s perceptions, attitudes and behaviors [5]. For example, in east Asia, Japanese women suffer more from eating disorders and body dissatisfaction than Taiwanese women [6]. Researchers contend that there are many cultural differences within east Asian countries [7] as well as significant differences between eastern and western Asian cultures.

Body image and body satisfaction can be affected by many socio-cultural factors [8, 9]. Culture plays a significant role in the conceptualization of beauty and attractiveness [8]. Desire for achieving of Ideal body, could be cause some of health consequences ,such as  eating disorders and unhealthy behaviors for body change. Body dissatisfaction is correlated with various attempts to change  one’s body, and these efforts can begin in children as young as 5-years-old [10, 11]. The most accepted method is dieting, a method that can result inanorexia, if successful and encouraged by others,orbulimia, which hascompensatory activities such as induced vomiting and theuse of laxatives [12]. As previously stated, females wish to be thinner, and males wish to be more masculine [10]. These desires can cause males to exercise excessively and engage in steroid use,whilefemalesprefer dieting strategies or surgery. In somestudies,however,body image dissatisfaction negatively correlated with physical activity, especially among adolescent girls [10]. The aim of this  identifying of  body change strategies  that were chosen by different groups in one Iranian sample.

Material and Methods

This population-based study was carried out in Kerman, the capital of the largest province in Iran. The main outcomes of the study include body change strategies. We focused on two main methods: diet (restricted food, induced vomiting) and exercise (heavy exercise for masculinity or weight reduction). In this study, was done in three different group, general population, university students and body building (gym) users. These participants were selected) by multistage sampling.

Self-administrated questionnaire include below parts:

Demographic variables: Age (>20, <20 years), gender (male, female), economical status (fair to medium and good to excellent), marital status (married, single), place of birth (big cities, small cities and village), BMI (cut-offs at 18.5, 24.9, and 29.9, subjects were categorised into four groups: BMI<18.5 (thin), BMI=18.5-24.9 (normal), BMI=25-29.9 (overweight), BMI>30 (obese), use of media (TV, fashion magazine).

Socio-cultural variables: This parts evaluated comparison of body with others {Physical Appearance Comparison Scale (PACS)}, that had acceptable reliability and validity in Persian [13], perceived pressure from relatives {Perceived Socio-cultural Pressure Scale (PSPS)}, Body Satisfaction (Figure Rating Scale ) that subjects were classified into three groups: no body dissatisfaction their current and ideal shapes were the same), mild dissatisfaction (BD score of 1), and severe dissatisfaction (the difference was greater than 1), and Self Steam {Rosenberg self steam scale (RES)}. This study was approved by Ethical Committee of Kerman Medical Sciences University.

Statistical analysis

Descriptive statistics were used to summarise the data. A series of multifactorial logistic regression models were applied to identify the factors that influence each of the outcomes or body management methods (i.e., diet, exercise). The results are presented in terms of the odds ratio (OR), associated 95%-confidence intervals (CI), and P-value.

In addition, the probability of outcomes was estimated from developed logistic models. The estimated probabilities were then compared with the observed individual’s status to calculate the correct classification proportion. P<0.05 was considered as significant.

Results

About 48.5% (149) of 400 respondents were female. The mean (SD) for age in three groups (general population, university students, gym users) were 27.6 (8.36), 23.13 (3.29), 22.09 (2.19) years, respectively. Some of demographic characteristics of respondents were shown in Table 1. Mean of BMI in three groups were 23.75 (4.12), 49 (3.5), 22.90 (2.96) kg/m² inprevious groups (Table 1). Frequencies of Body Dissatisfaction categories in participants were listed in Table 2.

Table 1. Demographic characteristics of respondents

Table 2. Distribution of body dissatisfaction

BD=Body Dissatisfaction

Regarding the factors that encourage people to manage their body shape through dieting, we find that pressure from relatives (PSPS) (CI 95%: 0.83-0.95, P=0.01, own comparison with others (PACS) (CI 95%: 1.01-1.16, P=0.029), self steam (CI 95%: 1.01-1.38, P=0.029) where are all influencing variables (Table 3). Belonging to specific group, and gender, there were no effect for decision regarding choose of body image strategies.

Table 3. Identification of factors that encourage people to diet as a way to manage their body shape through a multi factorial logistic regression

With respect to exercise, we find that gender (CI 95%: 0.19-0.68, P<0.001) and use of western TV (CI 95%: 1.16-3.92, P=0.014), were important factors. It shows that other factors such as scores of PACS, and PSPS or other socio-cultural variables, there were not influencing factors. Choosing of body management strategies had not affect by belonging to special groups.

Place of birth had significant effect on dieting (CI 95%: 1.35-13.01, P=0.013) and exercise (CI 95%: 0.12-0.80, P=0.016). Participants who were born in big cities were 4.1 times more likely to manage their body shape through dieting. Born in big cities was increased chance of using exercise as a body change strategies about 30% (Table 4).

Table 4. Identification of factors that encourage people to exercise as a way to manage their body shape through a multi factorial logistic regression

Discussion

Among contributing factors that could be affect decision about body change activities, body dissatisfaction is considered as an important factors. Body dissatisfaction is known significant predictors of body change activities for women [14]. The desire for thinness as an appearance-related reason for exercise is associated with body dissatisfaction and low self-esteem. In some studies, however, body image dissatisfaction negatively correlated with physical activity, especially among adolescent girls [15]. Some studies found that body satisfaction in women has a greater effect on self-esteem than in men. Chronic dieters have increased body dissatisfaction and lower self-esteem [16]. It was surprising that in recent study, body dissatisfaction had no effect on body management strategies. Body image and body satisfaction can be affected by many socio-cultural factors [8], that may be a greater role in body change activities. Although this effect on dieting was evident in both genders, dieting was more prominent in males [17]. However, according previous studies, we found that self-esteem had contributing effect on body change activities especially in dieting.

Socio-cultural variables are important factors that contribute to body dissatisfaction and related problems such as desire for body management strategies. One of the socio-cultural factors that may affect an individual’s desire to be thin or masculine and a person’s decision regarding body change strategies is perceived pressure from family, friends and/or the media [8]. One of the social groups for comparison is the peer group. Peer groups have a significant effect on body satisfaction and body change activities. The effect of peers with ideal body types was associated with longer periods of exercise, especially for women. Although this comparison appears higher in females, peer effect on body satisfaction and decisions about body changes are found in both genders [4]. In our study, dieting was influenced by comparison with others and family and peer pressures.

Body image is affected by environment and cultural issues. In big cities, individuals are more prone to media or social pressure such as fashion, magazines, beauty contest. In addition, in big cities, social situations and marriage could be related to attractive appearance [18]. Ideal body image is promoted through the media that suggests thinness is the sign of attractiveness. Despite the desire to increase muscle mass, weight concerns and dieting are also important for males [19]. Although heavy exercise was done for weight loss achievement of masculinity especially for male adolescents. Effects of born in big cities and western TV. On body management strategies were shown in recent study.  Such as previous researches, gender could be an important factor for decision about body management. Belonging to specific group, there was no effect on body management activity. The reason of this finding may be due to greater power of other contributing factors such as pressure from relatives, friends and media. Based on this studies` results, body management strategies in different cultures were different.

Conclusion

Body image and related consequences such as body change activities  are new issues in Iran. It seem socio-cultural factors are  important predictive factors for body change activities .White considering  differences between Asian culture ,in planning for  harm reduction   of unhealthy behavior   in dieting or exercise , culture must be consider seriously. Future Asian transcultural  studies  about these differences  are advised.

Acknowledgement: This research was financially supported by Neurosciences Research Center of Kerman University of Medical Sciences.

Conflict of interest: none declared.