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 Table of Contents  
ORIGINAL ARTICLES
Year : 2019  |  Volume : 7  |  Issue : 1  |  Page : 8-14

Perception of body image and weight status in Algerian adult population: A wrong self-evaluation


1 Department of Nutrition, Institute of Nutrition, Food and Agro-Food Technologies (INATAA), University of Brother’s Mentouri Constantine 1 (UFMC1), Constantine, Algeria; Laboratory of Food, Nutrition and Health (ALNUTS), University Salah Boubnider Constantine 3, Constantine, Algeria
2 Department of Psychology, Faculty of Psychology and Educational Sciences, Abdelhamid Mehri, University Constantine 2, Constantine, Algeria

Date of Submission03-Jan-2022
Date of Decision15-Jun-2022
Date of Acceptance22-Jun-2022
Date of Web Publication02-Aug-2022

Correspondence Address:
Chaima Boudaoud
Department of Nutrition, Institute of Nutrition, Food and Agro-Food Technologies (INATAA), University of Brother’s Mentouri Constantine 1, Aïn El Bey Road, 25 000 Constantine
Algeria
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/sjo.SJO_1_22

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  Abstract 

Background: Overweight and obesity is increasing among Algerian adults with a prevalence of 55.6% in 2017. Numerous studies demonstrate that obesity is associated with the misperception of body weight. The latter causes in the individual dissatisfaction with his or her body, which could affect his or her behavior with regard to weight control and self-esteem. Aim: The objective of this study is to describe the body image perception of Algerian adults according to their body size. Settings and Design: A cross-sectional survey by a questionnaire was conducted at the city of Constantine (Eastern Algeria) from January 13 to July 31, 2019. Materials and Methods: A survey was carried among 405 adults (25–65 years old). Body mass index has been classified according to the World Health Organization references (2000). The Figure Rating Scale of Stunkard et al. (1983) was used to evaluate the body image. Statistical Analysis: Data were analyzed using Epi-Info 7 software. We used the Student’s t test, the chi-squared test, and the analysis of variance for, respectively, the comparison between two means, the comparison between two percentages, and the comparison of several means. Statistical significance was set at 0.05. Results: Between all adults, 25.9% were (n = 105) obese, and they were the most likely to underestimate their weight. About 70.5% of them (n = 74) chose an ideal overweight body, and 88.6% (n = 93) had a wrong perception of their body weight. Among the participants, 60.6% of men (n = 175) and 68.1% of women (n = 79) were dissatisfied with their body image. Conclusion: The ideal body image for the majority of women and men was represented by a large figure. The wrong self-evaluation of adults’ current figure could significantly influence their eating behavior. The evaluation of body image and self-esteem of Algerians seems necessary to develop effective strategies for obesity prevention.

Keywords: Adult, Algeria, body dissatisfaction, figure rating, obesity


How to cite this article:
Boudaoud C, Karoune R, Adjali W, Dahel CC. Perception of body image and weight status in Algerian adult population: A wrong self-evaluation. Saudi J Obesity 2019;7:8-14

How to cite this URL:
Boudaoud C, Karoune R, Adjali W, Dahel CC. Perception of body image and weight status in Algerian adult population: A wrong self-evaluation. Saudi J Obesity [serial online] 2019 [cited 2022 Aug 14];7:8-14. Available from: https://www.saudijobesity.com/text.asp?2019/7/1/8/353152




  Key Message Top


  • – Almost 67.0% of Algerian adult had an excess weight.


  • – The body figure assessment showed that 60.0% of participants chose an ideal overweight silhouette.


  • – The misperception of body weight was prevalent among 60.3% of women and 36.0% of men. The underestimation concerned women, and overestimation concerned men.


  • – Both women and men were dissatisfied of their body image (62.7%), and they wanted to lose or gain weight.



  Introduction Top


Globally, the incidence of obesity continues to rise.[1] It has reached epidemic proportions worldwide with at least 2.8 million deaths per year. Previously associated with high-income countries, obesity is now also widespread in low- and middle-income countries.[2] Algeria, an emerging country, has been undergoing a nutritional transition over the past 20 years, which has resulted in an increase in the prevalence of noncommunicable diseases, particularly obesity.[3] In 2017, the overall prevalence of overweight and obesity was 55.6% among adults over 18 years of age.[4] According to Schwartz and Brownell,[5] there is clear evidence that obesity is associated with poor body image. The latter refers to an individual’s perception of his or her body, which allows an estimation of his or her weight and shape.[6] It is a multifaceted construction that involves biological, psychological, and social aspects.[5] Preferences and the perception of body image are largely dependent on the cultural context of each population. In Arab and African countries, overweight has always been considered to be synonymous with prosperity, social success, good health, and beauty for women.[7],[8] In the literature, body image has been found to significantly affect attitudes and behaviors toward weight control.[9],[10] An inaccurate perception of weight is associated with poor control.[11]

Body image perception has been studied in different populations.[7],[8],[9] To our knowledge, there have been no studies on body image in Algeria other than self-esteem and body perception in high school students.[12]

The objective of this study was to describe the perception and satisfaction of the body image of adult Algerian according to their body size.


  Materials and methods Top


Sample

The sample was made up of 405 adults (25–65 years old) from the city of Constantine (Eastern Algeria). The cross-sectional study with a descriptive aim was carried out from January 13 to July 31, 2019, by a questionnaire comprising two parts. The first concerned the socioeconomic characteristics and weight of the subjects. The second devoted the evaluation of the body image. Our sample included all adults who agreed to answer the questionnaire. The participants were informed of the confidentiality and anonymity of the data collected as well as the objective of the study. Excluded were pregnant women and nonconsensual persons.

Assessment of weight status

The size was measured using a portable toise (type SECA 206) to within 0.1 cm. We used a body composition analyzer (Tanita BC-418MATM with eight electrodes) to obtain weight (kg) and body mass index (BMI) (kg/m2). This later was classified according to the World Health Organization (WHO) references.[13]

Body image assessment

The perception of the body image was defined according to the self-assessment of the silhouette and its correspondence with the BMI.

  • – The Figure Rating Scale of Stunkard et al.[14] was used to explore the body image perception. It consists of a series of nine silhouettes (one for each sex) from the thinnest (silhouette 1) to the largest (silhouette 9). Respondents are asked to identify by a number the silhouette, of the same kind, that best corresponds to their current appearance (perceived body), as well as the one they wished to look like (ideal body).


  • – Correspondence between BMI classes and the selected silhouettes was developed according to Bulik et al.[15] and the ranking of subjects according to Poveda et al.[16]


The individuals were classified as:

  • - “Underestimating” when selecting a thinner silhouette;


  • - “Estimating correct” when selecting the correct silhouette;


  • - “Overestimating” if they selected a bigger silhouette.


  • – The assessment of the body satisfaction was estimated[16] according to the discrepancy between the two responses (perceived body–ideal body). The silhouette discrepancy score is interpreted as a measure of body satisfaction and allows the following classification according to Poveda et al.[16]:
    • - Body dissatisfaction: positive score (desiring to lose weight) and/or negative (wanting to gain weight);


    • - Body satisfaction: zero score (desiring no change).




Statistical processing and analysis

Data entry and statistical processing were carried out with the Epi-Info 7 software. The quantitative results were expressed as a mean and standard deviation and the qualitative results in terms of number and percentage. We used the Student’s t for the comparison between two means, the chi-squared test for the comparison between two percentages, and the analysis of variance for the comparison of several means. Statistical significance was set at 0.05.


  Results Top


Characteristics of the population

The study population consisted of 405 subjects with a mean age of 36.0 ± 9.1 years with no gender differences [Table 1]. The youngest subjects were the most numerous (n = 336; 83%) compared with older subjects (n = 69; 17%). A little over 58% were workers (n = 236) and 53.1% were married (n = 215), with a college level of education for men and higher for women. The mean BMI was 28.8 ± 4.5 kg/m2 in women and 26.3 ± 4.5 in men (P < 0.001).
Table 1: Characteristics of the participants in Constantine (Algeria, 2019)

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Weight status

Almost 31.1% of subjects (n = 126) were classified as normal weight [Table 2]. Thinness concerned only 2.2% of them (n = 9). Regardless of gender, there was a difference between the different weight status categories: women were more affected by obesity and men were more likely to be overweight. The prevalence of overweight was higher among men with approximately 44% of them (n = 127) compared with 32.8% in women (n = 38), whereas the obesity rate was highest among women (n = 53; 45.7%).
Table 2: Weight status according to BMI by gender among participants in Constantine (Algeria, 2019)

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Body image

Perceived body and ideal body

The assessment of the silhouette according to the current appearance (perceived body) and the one the study population wanted to look like (ideal body), according to gender and weight status, is presented in [Table 3].
Table 3: Assessment of the silhouette (perceived body; ideal body) according to weight status and gender among participants in Constantine (Algeria, 2019)

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Our results showed that for the perceived body, normal weight (P = 0.0490) and overweight men (P = 0.0106) opted for a larger perceived body than women. Overweight men (BMI) wanted a larger body (ideal body) than women (P = 0.0079).

All normal weight subjects of any gender wanted a larger ideal body than the one perceived (P < 0.001). On the other hand, only the skinny men had the same wish. All overweight and obese adults wanted a thinner ideal body (P < 0.001).

In our study, the figure assessment showed that 60.0% of participants (n = 243) chose an ideal overweight figure (silhouette 5, 6, 7), compared with 39.3% (n = 159) who wanted an ideal normal weight figure (silhouette 2, 3, 4).

Perception of body image by nutritional status

Among the participants, 60.3% (n = 70) of women and 36.0% (n = 104) of men did not have a correct perception (underestimating and overestimating) of their weight [Table 4]. Almost all obese people (n = 93; 88.6%), regardless of gender, underestimated their body status (P < 0.001). Those who overestimated it were mostly normal weight men (P < 0.001) with a rate of 26.7% (n = 27). Women were more likely to underestimate their body weight (P < 0.001) with approximately 58% of them (n = 67) and men to overestimate it (P = 0.0037) with about 12% (n = 34) of them.
Table 4: Correspondence between body image and weight status among participants in Constantine (Algeria, 2019)

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Body image satisfaction

Body dissatisfaction (negative and positive scores) concerned 68.1% (n = 79) of women in this study [Table 5]. Almost, 48% (n = 60) of those who wanted to gain weight (negative score) were with a normal weight (P < 0.01). Respectively, 71.7% (n = 38) and 42.1% (n = 16) of obese and overweight women wanted to lose more weight (positive score). More than half of men (n = 175; 60.6%) were dissatisfied with their body image. Overweight and obese men had a higher positive score, respectively, 1.4 ± 0.7 and 1.9 ± 1.0, indicating a desire to lose weight (P < 0.001). Body satisfaction (zero score) was observed in 49.5% (n = 50) of normal weight men (P < 0.001).
Table 5: Distribution of adults by body satisfaction scores according to weight status among participants in Constantine (Algeria, 2019)

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Our results showed that body dissatisfaction concerned both women and men (P > 0.05).


  Discussion Top


Weight status

We evaluated the weight status of our population according to BMI. For all subjects, more than a third were overweight (40.7%) and more than one in four was obese (25.9%). The prevalence of overweight of surveyed subjects was within the range reported by national and international studies among adults. The rate of overweight and obesity in our population is similar to that shown by other Algerian studies.

The national health survey TAHINA found that 34.7% of people aged 35–70 were overweight and 21.2% were obese.[3] In 2016, the prevalence of overweight and obesity among adults (18–69 years) under (according to) the STEPwise approach was, respectively, 33.8% and 21.8%.[4] Among adults (30–64 years old) from western Algeria, 56.8% were overweight and 21.2% were obese.[19]

In Libya and Morocco,[20],[21] surveys revealed (found) that the prevalence of overweight among adults was 33.0%. It was 36.2% in Tunisia.[22] Obesity in these countries was, respectively, 30.5%, 20.0%, and 25.2%. In France, according to the league against obesity, in 2020, 17.0% of adults were obese and 30.3% were overweight.[23]

Globally, the percentage of overweight and obese adults was, respectively, 39.0% and 13.0% according to WHO in 2016.[24] Studies among workers, Emiratis,[25] and Nigeriens[26] have shown the prevalence of overweight and obesity close to those of our study.

The prevalence of obesity in African populations is attributed to many factors, including food choices, sedentary lifestyles, and cultural beliefs that view (regard) obesity as a sign of prosperity.[27]

Body image

In our study, the figure body assessment showed that the majority of participants chose an ideal overweight silhouette. Subjects with normal weight and underweight men preferred a larger ideal body, whereas the overweight and obese population desired a thinner ideal body.

Poveda et al.[16] showed that Roman adults preferred an ideal body compatible with normal weight BMI. The study by Naigaga et al.[7] about Saharawi adults showed that this population preferred an overweight silhouette; similar results have also been reported among Ghanaians[28] and Moroccans.[29] Latin-American women[30] and Moroccan Sahrawi women[31] had a preference for a voluminous body shape. North African populations, especially women, prefer a larger body that is considered a sign of beauty and an indicator of health and good social status.[31] The Algerians surveyed in the TAHINA study[3] believed that high body weight is a sign of health. Women with a large silhouette, and men with a muscular body, considered this to be a norm of social beauty.[3] It is highly likely that a higher BMI is culturally desirable by our study population, as revealed in other societies, where the body size preferences in matters of weight, by women, are socially acceptable.[29] When men choose large silhouettes, they equate higher body weight with musculature and not excess fat. These results have also been found in Italy[16] and Brazil.[32]

The misperception of body weight was prevalent among most participants in our study. The underestimation concerned more women, and the overestimation concerned the men. Almost all of the underestimates were obese, whereas the majority of the overestimates were men with normal weight. These results are in agreement with various studies, which showed that the underestimation of body weight by women was more prevalent,[7],[33] whereas men overestimated their body weight.[7],[33] According to Schuler et al.,[34] the misperception of body weight was widespread among overweight and obese American women of African and European descent. In Nigeria and Pakistan, obese adults were among the most inclined to underestimation.[26],[35] The underestimation of overweight by our population could have an impact on obesity rates in the Algerian population especially among women; this rate concerned 30.1% of women.[4] Moreover, overweight and obese African-American women[34] who did not perceive themselves as overweight did not feel the need to control their weight and were not motivated to change their diet and physical activity.

Participants in our study showed body dissatisfaction and a desire for change, as revealed in other studies.[16],[36] The majority of women with normal weight were dissatisfied and wanted to gain weight. Different studies carried out in African women with normal weight have shown that they desired a higher body weight.[7],[29],[37] Overweight and obese women and men in our study wanted to lose weight. Our results are consistent with other studies reporting that body dissatisfaction increases with weight excess.[16],[37] Contrary to our results, some authors found that women were more dissatisfied than men.[16],[36] However, body dissatisfaction often appears to be independent of BMI.[38] Indeed, the perception that individuals have on their weight (perceived body) is different[39] from that measured by the BMI (current body).

The high rate of body dissatisfaction observed by our population (men and women) could be explained by the misperception of body weight and the combination of Western norms favoring the desire for thinness and popular culture promoting weight gain.[29] Body dissatisfaction is associated with the development of symptoms related to eating disorders,[40] self-esteem, and a lower quality of life,[41] which would justify the evaluation of self-esteem.

Limitations of the study

Our study population is not representative of Algerian adults. A larger sample would allow for the comparison of body image evaluation of subjects whose body size is determined. In addition, studies on the female population in particular would be necessary because most of the work on body image has focused on women.


  Conclusion Top


Among the adults in Constantine, the ideal body image, for a majority of them, was represented by an overweight silhouette. Misperception and the refusal to consider themselves obese could considerably influence the Algerians’ eating behavior. This study, the first of its type in Algeria, provided information on the body perception of adults. It would be desirable to consider body image and self-esteem evaluation in national public health studies. Our results also justify the need to promote obesity prevention strategies among adults.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
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    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5]



 

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