Tracing Attitudes about Thinness between 13 and 17 Years of Age A South African study found distinct changes by gender and race.

Reprinted from Eating Disorders Review
November/December Volume 25, Number 6
©2014 IAEDP

Western norms of thinness are reaching around the world, including to South Africa, according to the results of a recent study. In a study of black and mixed-ancestry teens, Dr. Tabither M. Gitau and researchers at the University of the Witwatersrand, Johannesburg, South Africa, found that black females were at higher risk of developing an eating disorder, and also had higher BMIs than did black males and mixed-race females of the same ages (PLOS One; doi 10.1371/journal.pane.0109709).

The researchers sought to examine longitudinal changes in eating attitudes, body-esteem, and weight control behaviors among adolescents from 13 to 17 years of age, and then to describe teens’ perceptions of their body image at 17 years of age. The participants in the study included 1435 urban South African black and mixed ancestry boys and girls who were part of the Birth to Twenty longitudinal birth cohort study (Int J Epidemiol 2007; 36:501). 

Height and weight were collected at both time points, and all the teens completed the Eating Attitudes Test (EAT-26) to measure attitudes toward eating (Psychol Med1982; 12:871). A score of 20 or higher was used as an at-risk cut-off point. A body esteem scale was used that consists of 21 questions that measure global feelings about one’s body, satisfaction with weight, and positive self-esteem (Assoc Res Nerv Ment Dis 1983; 60: 115).

All participants were asked a number of questions about their attempts to change their weigh. Some examples of the questions included: “During the last year, have you done anything to try to lose weight?” and “During the past year have you done anything to try to gain muscle?” If the teens responded positively, they were asked to give reasons for their actions. Then, at 17 years of age, boys and girls were asked to select a female body silhouette (Stunkard’s figures) that they associated with a series of different words, such as “looks happy,” looks strong,” I respect,” or “looks weak,” for example.

Results

Underweight at age 13 was seen in 2.1% and 7.4% in black African boys and girls, respectively, and in 3.6% and 6.6%, respectively, in mixed ancestry boys and girls. Of the entire group, 11% reported an EAT-26 score higher than 20. More girls than boys used weight-loss practices and conversely significantly more boys than girls reported trying to gain muscle. For black girls, there was higher risk of eating disorder onset and more weight loss efforts between the ages of 13 and 17. 

At 17 years of age, mixed-ancestry girls and boys had lower body-esteem than did black boys and girls. Males and females shared similar opinions about normal silhouettes being the best, getting more respect, and brining the most happiness, while the obese silhouette was associated with the “worst” and the “unhappiest,” and the underweight silhouette with the “weakest.” Adolescent females engaged in more weight loss practices, whereas males used more muscle gain practices.