Ethnic differences in perceptions of body satisfaction and body appearance among U.S. Schoolchildren: a cross-sectional study

BACKGROUND Perceived body appearance and body satisfaction are potentially related to weight problems and poor health. The purpose of this study was to examine how gender, and ethnic differences in body satisfaction, perceived body appearance and weight status change by age in a representative sample of U.S. adolescents 11-17 years old. METHODS We used the US Health Behavior in School-Aged Children (HBSC) 2001 survey which assessed perceived body appearance, body satisfaction, self-reported body mass index (BMI) and socio-demographic indicators. The associations between age and perceived appearance, age and body satisfaction, and between z-transformed BMI and body satisfaction were analyzed using separate non-parametric regression models for both genders and the three ethnic groups. RESULTS Body satisfaction did not vary significantly by age except for an increase with age in the proportion of Non-Hispanic White girls who perceived themselves as too fat. Although boys did not report being too fat unless their BMI was above the age- and gender-specific median, one third of Non-Hispanic White girls felt too fat at or below the age- and gender-specific median. Compared to other ethnicities, African-American students' perceived appearance was significantly more positive and they were less likely to perceive themselves overweight at higher BMI scores. However, during adolescence, the positive self-reported perceived appearance of African-American boys dropped substantially while it remained relatively stable in African-American girls. CONCLUSIONS There were substantial differences in body satisfaction and perceived appearance across the three largest ethnic groups of school-age children in the U.S. Stability across age indicates that these perceptions are most likely established before the age of 10 and underline the importance of primary schools and parents in prevention. Special attention should be directed to the dramatic loss of positive perceived appearance among African-American boys.