Differential perceptions of body image and body weight among adults of different socioeconomic status in a sub-urban population

Abstract

This study explored the association of socioeconomic status with individuals' perception of their body image (BI) and body weight (BW) among adults in a sub-urban Nigerian population. The cross-sectional sample comprised 1521 residents (775 males and 746 females) of the town of Nnewi. Perceived BI was assessed using figural representations of different sizes for males and females. Perceived BW was determined by presenting participants with BW category options to choose from. Body mass index (BMI) was calculated from objectively measured BW and height using standardized procedures. Actual BW categories were derived from participants' BMIs using WHO criteria. Perceived BI and BW differed from actual BW among unskilled and non-tertiary males (p<0.001) and female (p<0.001 to p<0.04) in all BW categories whereas these variables differed (p<0.001) among skilled and tertiary males and females in normal weight, overweight and obese categories. Perceived BW differed (p<0.001) from actual BW among unskilled and non-tertiary males in underweight, overweight and obese categories whereas these variables differed (p<0.001) among unskilled and non-tertiary females, skilled and tertiary males and females in overweight and obese categories. Underweight 'unskilled' and 'non-tertiary' males perceived their BI to be different from their actual BW (p<0.001). Overweight and obese 'skilled' and 'unskilled', and 'tertiary' and 'non-tertiary', males and females perceived their BI and BW to be different from their actual BW (p<0.001). Significant differences in perceived BI existed between 'skilled' and 'unskilled' (p<0.001), and 'tertiary' and 'non-tertiary' (p=0.005), overweight males, and between 'skilled' and 'unskilled' (p<0.001), and 'tertiary' and 'non-tertiary' (p=0.008), normal-weight females. The 'skilled' participants had a lower risk of perceiving a larger BI (OR 0.51, 95% CI 0.41-0.64; p<0.001) and larger BW (OR 0.71, 95% CI 0.53-0.96; p=0.03) than the 'unskilled' participants. The 'tertiary' participants had a lower risk of perceiving a larger BI (OR 0.51, 95% CI 0.40-0.63; p<0.001) and larger BW (OR 0.71, 95% CI 0.53-0.95; p=0.02) than the 'non-tertiary' participants. After adjusting for possible confounders, all the risks became insignificant except for perception of BI by the 'skilled' participants (OR 0.70, 95% CI 0.50-0.99; p=0.04). Individuals in the different occupational and educational categories perceived their BI differently but their BW similarly. Given the same BMI, age, perceived ideal BI and sex, only occupation is found to be associated with perception of BI.