Body image, self-esteem and health-related behaviors among undergraduate students, Moi University - Eldoret West campus

Abstract

Background: Body image is the mental picture individuals have of their physical appearance and the resulting attitude towards themselves. University students experiencing negative body image have high tendencies for low self-esteem, depressive illness, anxiety, poor feeding habits, suicidality, internet addiction, cyber bullying and risky health behaviors including alcoholism, drug abuse and unsafe sexual activities. This creates the need to understand the relationship between body image, self-esteem and health-related behaviors. Broad Objective: This study aimed to establish the level of body image satisfaction and the relationship between body image, self-esteem, and health-related behaviors among Moi University, Eldoret West Campus students. Specific objectives were body image satisfaction level and its relationship with body image and self-esteem. Furthermore, it assessed the association between body image, self-esteem and sociodemographic characteristics as well as health-related behaviors. Methods: A cross-sectional study was conducted among 421 undergraduate students who were stratified by academic year and sampled randomly from Eldoret West Campus‟ Schools of Business Management, School of Education and School of Arts in Eldoret-Kenya. Data was collected using a validated and pretested structured questionnaire entailing sociodemographic characteristics, Body Mass Index (BMI), Multi-Dimensional Body Self-Relations Questionnaire (MBSRQ), Rosenberg Self- Esteem Scale, Contour Drawing Rating Scale (CDRS) and Psychological General Wellbeing Index. Descriptive data were analyzed as frequencies with corresponding proportions as well as mean and corresponding standard deviation. Tests of association were conducted using both Pearson Chi-square and Fisher's exact test at a critical value of p≤0.05. Odds ratios were computed at 95% confidence interval for statistically significant relationships. Results: This study enrolled nearly equal proportions of male (48.2%; n=203) and female (51.8%; n=218); with 53.5% of all the students aged between 18-21 years. On body image, 344 (81.7%) were satisfied with their self-attitudinal aspect of appearance, 317 (75.3%) invested in their appearance, 258 (61.3%) were dissatisfied with their contour drawings (global aspect of body image) while 311 (73.9%) classified themselves as having a normal weight. There was a statistically significant association between having a normal self-classified weight and a normal BMI status (p=0.004). Gender positively affected appearance evaluation (p=0.028), appearance orientation (p<0.001), overweight preoccupation (p=0.014), weight classification (p=0.001), contour drawing rating scale (p=0.001), anxiety (p=0.001) and positive wellbeing (p=0.021). Female students were more likely (OR=1.122, 95% CI: 1.023, 1.231) to be satisfied with their appearance evaluation compared to male students. Body image was significantly affected by overweight preoccupation (p=0.035) and anxiety (p<0.001). High self-esteem positively affected overweight preoccupation (p=0.032) while anxiety significantly associated (p=0.009) with having an abnormal BMI. Conclusions: Majority of students were satisfied with their self-attitudinal aspect of their body image (MBSRQ) but dissatisfied with their global aspect of body image (CDRS) and this was gender specific. Anxiety predisposed the students to having an abnormal BMI while those with a high self-esteem had an overweight preoccupation. Recommendations: The findings could be adopted by students, parents, university administrators, health practitioners, non-governmental organizations and policy makers to create screening and intervention programmes for body image concerns. Future case control studies should be conducted to explain causality of body image concerns.