Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Body image and weight control in young adults: international comparisons in university students from 22 countries

Abstract

Objective:

Young women in the United States and Western Europe are notoriously concerned about weight but less is known about attitudes to weight in other regions of the world. This study explores the associations between body mass index (BMI), weight perceptions, and attempts to lose weight in male and female university students from 22 countries.

Methods:

Data were collected from 18 512 university students, using standardised methods, as part of the International Health Behaviour Survey. Measures included weight, height, perception of overweight, and weight loss status. BMI was calculated from weight and height, but was categorised into gender and country-standardised deciles rather than the conventional weight categories in response to the inaccuracy of self-reports. Perceived overweight and weight loss status were plotted against country-standardised BMI deciles. The 22 countries were grouped into five geopolitical/economic areas for regional analyses: North-Western Europe and the USA, Central and Eastern Europe, the Mediterranean, Pacific Asia, South America. Perceived overweight compared across the five regions.

Results:

Perceived overweight increased systematically across BMI deciles in all countries. More women than men felt overweight at any decile. Women had low levels of perceived overweight in the lowest decile but rates rapidly increased to 50% by the 5th decile. Men, even in the highest deciles, were less aware that they are overweight and few of them were trying to lose weight. Women had a faster rise of weight loss attempts over the BMI deciles but nevertheless the proportion trying to lose in the highest decile did not exceed 75%. Perceived overweight profiles across BMI deciles were similar across all regions, suggesting that perceptions of overweight derive from local comparisons. The patterning for trying to lose weight was more diverse, with men and women from Asian countries showing higher levels of trying to lose weight at all deciles.

Conclusions:

This study shows the international consistency in perceptions of overweight in educated young men and women across diverse regions of the world. It confirms the patterning of women's overestimation of weight at lower BMI deciles and men's underestimation of weight at the higher deciles. Perceptions of overweight and attempts to lose weight were highest in the group of Asian countries where body weights are generally low, suggesting that local culture and norms could moderate attitudes to weight.

This is a preview of subscription content, access via your institution

Relevant articles

Open Access articles citing this article.

Access options

Buy article

Get time limited or full article access on ReadCube.

$32.00

All prices are NET prices.

Figure 1
Figure 2
Figure 3
Figure 4

References

  1. Flegal KM, Carroll MD, Kuczmarski RJ, Johnson CL . Overweight and obesity in the United States: prevalence and trends, 1960–1994. Int J Obes Relat Metab Disord 1998; 22: 39–47.

    Article  CAS  Google Scholar 

  2. World Health Organisation. Obesity: preventing and managing the global epidemic. WHO Technical Report Series, No. 894, Geneva, 1997.

  3. James PT, Leach R, Kalamara E, Shayeghi M . The worldwide obesity epidemic. Obes Res 2001; 9 (Suppl 4): 228S–233S.

    Article  Google Scholar 

  4. Finkelstein EA, Ruhm CJ, Kosa KM . Economic causes and consequences of obesity. Ann Rev Public Health 2004, Nov 1, E-pub.

  5. Jeffrey RW, Utter J . The changing environment and population obesity in the United States. Obes Rev 2003; 11: 12S–22S.

    Article  Google Scholar 

  6. Mercer SL, Green LW, Rosenthal AC, Husten CG, Khan LK, Dietz WH . Possible lessons from the tobacco experience for obesity control. Am J Clin Nutr 2003; 77 (Suppl): 1073S–1082S.

    Article  CAS  Google Scholar 

  7. Hoare P, Cosgrove L . Eating habits, body-esteem and self-esteem in Scottish children and adolescents. J Psychosom Res 1998; 45: 425–431.

    Article  CAS  Google Scholar 

  8. Crawford D, Owen N . The behavioral epidemiology of weight control. Aust J Public Health 1994; 18: 143–148.

    Article  CAS  Google Scholar 

  9. Patton GC, Carlin JB, Shao Q, Hibbert ME, Rosier M, Selzer R et al. Adolescent dieting: Healthy weight control or borderline eating disorder? J Child Psychol Psychiatry 1997; 38: 299–306.

    Article  CAS  Google Scholar 

  10. Pritchard ME, King SL, Czajka-Narins DM . Adolescent body mass indices and self-perceptions. Adolescence 1997; 32: 863–880.

    CAS  PubMed  Google Scholar 

  11. Wardle J, Johnson F . Weight and dieting: examining levels of weight concern in British adults. Int J Obes Relat Metab Disord 2002; 26: 1144–1149.

    Article  CAS  Google Scholar 

  12. Chang VW, Christakis NA . Self-perception of weight appropriateness in the United States. Am J Prev Med 2003; 24: 332–339.

    Article  Google Scholar 

  13. Wardle J, Griffith J . Socioeconomic status and weight control practices in British adults. J Epidemiol Commun Health 2001; 55: 185–190.

    Article  CAS  Google Scholar 

  14. Wardle J, Steptoe A . The European health and behaviour survey: rationale, methods and results from the United Kingdom. Soc Sci Med 1991; 33: 925–936.

    Article  CAS  Google Scholar 

  15. Steptoe A, Wardle J . The European Health and Behaviour Survey: the development of an international study in health psychology. Psychol Health 1996; 11: 49–73.

    Article  Google Scholar 

  16. Steptoe A, Sanderman R, Wardle J . Stability and changes in health behaviours in young adults over a one year period. Psychol Health 1995; 10: 155–169.

    Article  Google Scholar 

  17. Health Survey for England; www.dh.gov.uk/PublicationsandStatistics/PublishedSurvey/HealthSurveyforEngland.

  18. Brener ND, Mcmanus T, Galuska DA, Lowry R, Wechsler H . Reliability and validity of self-reported height and weight among high school students. J Adolesc Health 2003; 32: 281–287.

    Article  Google Scholar 

  19. Frankenfield DC, Rowe WA, Cooney RN, Smith JS, Becker D . Limits of body mass index to detect obesity and predict body composition. Nutrition 2000; 17: 26–30.

    Article  Google Scholar 

  20. Schlichting P, Hoilund-Carlsen PF, Quaade F . Comparison of self-reported height and weight with controlled height and weight in women and men. Int J Obes Relat Metab Disord 1981; 5: 67–76.

    CAS  Google Scholar 

  21. French SA, Jeffrey RW, Murray D . Is dieting good for you? Prevalence, duration and associated weight and behavior changes for specific weight loss strategies over four years in US adults. Int J Obes Relat Metab Disord 1999; 23: 320–327.

    Article  CAS  Google Scholar 

  22. Gorin AA, Phelan S, Wing RR, Hill JO . Promoting long-term weight control: does dieting consistency matter? Int J Obes Relat Metab Disord 2004; 28: 278–281.

    Article  CAS  Google Scholar 

  23. Wardle J, Robb KA, Johnson F, Griffith J, Brunner E, Power C et al. Socioeconomic variation in attitudes to eating and weight in female adolescents. Health Psychol 2004; 23: 275–282.

    Article  Google Scholar 

  24. Kaneko K, Kiriike N, Ikenaga K, Miyawaki D, Yamagami S . Weight and shape concerns and dieting behaviours among pre-adolescents and adolescents in Japan. Psychiat Clin Neurosci 1999; 53: 365–371.

    Article  CAS  Google Scholar 

  25. Yoshiike N, Seino F, Tajima S, Arai Y, Kawano M, Furuhata T et al. Twenty-year changes in the prevalence of overweight in Japanese adults: the National Nutrition Survey 1976–1995. Obes Rev 2002; 3: 183–190.

    Article  CAS  Google Scholar 

  26. Choo V . WHO reassesses appropriate body-mass index for Asian populations. Lancet 2002; 20: 235.

    Article  Google Scholar 

  27. Pan WH, Flegal KM, Chang HY, Yeh WT, Yeh CJ, Lee WC . Body mass index and obesity-related metabolic disorders in Taiwanese and US whites and blacks: implications for definitions of overweight and obesity for Asians. Am J Clin Nutr 2004; 79: 31–39.

    Article  CAS  Google Scholar 

  28. Crawford D, Campbell K . Lay definitions of ideal weight and overweight. Int J Obes Relat Metab Disord 1999; 23: 738–745.

    Article  CAS  Google Scholar 

  29. Blokstra A, Burns CM, Seidell JC . Perception of weight status and dieting behaviour in Dutch men and women. Int J Obes Relat Metab Disord 1999; 23: 7–17.

    Article  CAS  Google Scholar 

  30. Bennett EM . Weight-loss practices of overweight adults. Am J Clin Nutr 1991; 53 (Suppl): 1519S–1521S.

    Article  CAS  Google Scholar 

  31. Wardle J, Haase AM, Steptoe A, Nillapun M, Jonwutiwes K, Bellisle F . Gender differences in food choice: the contribution of health beliefs and dieting. Ann Behav Med 2004; 27: 107–116.

    Article  Google Scholar 

  32. Courtenay WH . Engendering health: a social constructionist examination of men's health beliefs and behaviors. Psych Men Mascul 2000; 1: 4–15.

    Article  Google Scholar 

  33. Trichopoulou A, Costacou T, Bamia C, Trichopoulos D . Adherence to a mediterranean diet and survival in a Greek population. N Eng J Med 2003; 348: 2599–2608.

    Article  Google Scholar 

  34. Beer-Borst S, Hercberg S, Morabia A et al. Dietary patterns in six European populations: results from EURALIM, a collaborative European data harmonization and information campaign. Eur J Clin Nutr 2000; 54: 253–262.

    Article  CAS  Google Scholar 

  35. Bellisle F, Monneuse MO, Steptoe A et al. Weight concerns and eating patterns: a survey of university students in Europe. Int J Obes Relat Metab Disord 1995; 19: 723–730.

    CAS  PubMed  Google Scholar 

Download references

Acknowledgements

This research was supported by Cancer Research UK and the Economic and Social Research Council.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to J Wardle.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Wardle, J., Haase, A. & Steptoe, A. Body image and weight control in young adults: international comparisons in university students from 22 countries. Int J Obes 30, 644–651 (2006). https://doi.org/10.1038/sj.ijo.0803050

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.ijo.0803050

Keywords

  • perceived overweight
  • weight loss
  • epidemiology

This article is cited by

Search

Quick links