Body Image Satisfaction and Its Association with Physical Activity

and Body Mass Index among Health Students from Surakarta,

Indonesia

Anita Febrian P. Sari

, Eti Poncorini Pamungkasari

and Yulia Lanti Retno Dewi

Masters Program in Nutrition, Universitas Sebelas Maret, Surakarta, Indonesia

Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia

Keywords: Body image, Physical activity, Body mass index

Abstract: Purpose: Dissatisfaction with body shape and size raises the desire to be thinner or fatter. The desire to achieve

ideal body weight makes someone regulate eating patterns and physical activities. School life (time as a

student) is a time when a person switches from adolescence to adulthood. At this time, a person experiences

changes that can affect health. Health students have knowledge about eating patterns and recommended

physical activities. This study aims to look at body image, physical activities and nutritional status in health

students. Method: This cross sectional study recruited 120 health students. Perception of body image is

assessed using a figure rating scale consisting of nine silhouettes of body shape. Participants were asked about

body shapes that describe themselves and their ideal or desired body shape. Physical activity was measured

using an international physical activity questionnaire. Results: Most of the participants wanted normal weight

as an ideal shape. The majority of participants (75.83%) experienced body image dissatisfaction and 29.17%

experienced body image distortion. Body image dissatisfaction was not related to physical activity (p> 0.05).

Most participants (48.3%) had moderate levels of physical activity. The level of physical activity is related to

body mass index. Conclusion: most participants were not satisfied with the shape of their bodies. Body image

dissatisfaction is not related to physical activity, but physical activity is related to nutritional status.

1 INTRODUCTION

Body image is a picture of our mind about the size

and shape of our body and our feelings about the

characteristics of these limbs (Tomas-aragones and

Marron, 2016). Student’s body image, especially

women is formed due to the influence of family and

peer environment, adolescents tend to compare their

body shape with relatives or peers (Mase et al., 2015).

Exposure to social media and electronic media also

has an influence on the formation of body image in

female students (Sai et al., 2018). The description of

body shape and body size makes someone feel

satisfied or dissatisfied with body shape (Coelho et

al., 2016). Body image will affect a person's eating

behavior and physical activity so that she gets the

desired body shape. Dissatisfaction with body shape

increases the risk of eating disorders and increases

physical activity (Prioreschi et al., 2017).

Physical activity refers to all body movements

that are produced by skeletal muscle and require

energy (WHO | Physical Activity, 2017). Countries

with low average levels of physical activity have a

greater obesity prevalence (Althoff et al., 2017).

Some affect the physical activity of a person, namely

psychobiology, culture, society, availability of

choices, lifestyle, behavioral regulation, proximal

influence and distal influence (Booth et al., 2001).

The level of physical activity is related to a

person's body mass index. Active men have a lower

risk of obesity compared to those who are less active

(Lee et al., 2016). A high level of activity in a person

decreases the risk of being overweight in both men

and women (Štefan et al., 2017). Research on Italian

students shows the longer physical activity, the lower

the BMI in men and fat free mass in women

(Zaccagni, Barbieri and Gualdi-Russo, 2014). WHO

recommends moderate to heavy physical activity for

150 minutes a day, but very few students do physical

activity according to WHO recommendations (Štefan

et al., 2017).

784

Sari, A., Poncorini Pamungkasari, E. and Lanti Retno Dewi, Y.

Body Image Satisfaction and Its Association with Physical Activity and Body Mass Index among Health Students from Surakarta, Indonesia.

DOI: 10.5220/0009905807840788

In Proceedings of the 3rd Yogyakarta International Seminar on Health, Physical Education, and Sport Science in conjunction with the 2nd Conference on Interdisciplinar y Approach in Sports

(YISHPESS and CoIS 2019), pages 784-788

ISBN: 978-989-758-457-2

 2020 by SCITEPRESS – Science and Technology Publications, Lda. All r ights reserved

Figure 1: Figure Rating Scale

2 METHODS

The cross sectional survey was conducted on 120

health students majoring in nutrition, nursing,

medical, and occupational health and safety students.

The survey was conducted in May 2019. The research

subjects were also asked about how much they slept

in one day.

2.1 Anthropometric Assessment

Anthropometric measurements are carried out using

the following procedure: body weight is measured

using a digital weight scale with an accuracy of 0.1

kg. Height is measured by microtoise with a level of

accuracy of 0.1 cm. Body mass index (BMI) is

measured by weight divided by height squared.

Participants were divided into 4 groups: under weight

with BMI <18.5, Normal weight with BMI 18.5 -

22.9, over weight with BMI 23 - 24.9 and obese> 25.

2.2 Body Image Perception

Body image perception is assessed using the figure

rating scale (FRS) developed by Stunkard et al. The

rating scale figure consists of 9 silhouettes that

illustrate 9 body shapes. No. 1 is the thinnest body

shape and No. 9 is the biggest. Subjects were asked to

mark the body shape that describes themselves

(perceived body size) and the body shape they want

(ideal body size). Body shape satisfaction is assessed

through the difference between perceived and ideal

body size. A zero score indicates bodily satisfaction,

a negative or positive score indicates body image

dissatisfaction. A negative score indicates a desire to

gain weight and a positive score indicates a desire to

lose weight.

Body image distortion is assessed through

differences in perceived body size with actual body

size based on the BMI category. A zero score

indicates an undistortion body image while a negative

or positive score indicates a body image distortion.

The numbers on the scale of body image perceptions

(perceived or ideal) were also classified according to

standard procedures [25, 26] into four groups: 1 and

Body Image Satisfaction and Its Association with Physical Activity and Body Mass Index among Health Students from Surakarta, Indonesia

785

2 underweight; 3 and 4 normal weight; 5-7

overweight; and 8 and 9 obese shape.

2.3 Physical Activity

Physical activity was measured using the

International Physical Activity Questionnaire

(IPAQ). Research subjects were interviewed about

their activities and intensity over the past 7 days.

Activities interviewed included activities during

college, activities at home, and leisure activities. The

level of physical activity was then divided into 3

groups, namely low, moderate and high. Low if the

physical activity carried out does not meet the criteria

of medium and high categories. Moderate if Doing

heavy physical activity for at least 3 days for 20

minutes / day or doing moderate level physical

activity or walking for at least 5 days for 30 minutes

/ day or doing a combination of heavy and moderate

physical activity and running for 5 days and

accumulated a minimum of 600 MET / week. High

Doing Heavy Activities for a minimum of 3 days and

accumulating a minimum of 1500 MET / week or

walking, doing moderate and heavy physical activity

for 7 days and accumulated a minimum of 3000 MET

/ week.

2.4 Statistical Analysis

Data were analyzed using Statistical Package for

Social Science (SPSS) version 24. Pearson’s Chi-

square test was used to compare physical activity

between different groups of body size satisfaction or

to compare body mass index categories in different

physical activity groups. P values less than 0.05 were

considered as significant.

3 RESULTS

A total of 120 health students with mean age of

19.28 were recruited to join this study. BMI mean is

22.4 (table 1). Table 2 shows the distribution of

subjects based on body shape perception, 64.7% of

subjects have the correct body image based on BMI.

The form should be completed and signed by one

author on behalf of all the other authors.

Table 1: Characteristic of participants

Variables Mean + SD

Age (year) 19.28 + 0.67

Weight (kg) 55.25 + 13.6

Height (cm) 156.7 + 6.25

BMI (kg/m

) 22.42 + 5.02

Sleeping Hours

7.44 + 1.36

Most participants (86.64%) desire normal body

shape (fig 3,4) as an ideal body shape. The prevalence

of body image dissatisfaction is 75.83% with 50%

wanting to lose weight. The prevalence of

participants who experienced body image distortion

amounts to 29.17% and mostly experienced by obese

subjects.

Table 2: Participants distribution by perceived body image

BMI (Kg/m

)

Perceived Body Image

Under weight

(fig 1,2)

Normal weight

(fig 3,4)

Over weight (fig 5,6,7) Obese (fig 8,9 )

Under weight (n = 26) 14 (11,67%) 12 (10%) 0 (0%) 0 (0%)

Normal weight (n = 56) 2 (1,66%) 53 (44,17%) 1 (0,83%) 0 (0%)

Over weight (n = 14) 0 (0%) 6 (5%) 8 (6,67%) 0 (0%)

Obese (n = 24) 0 (0%) 5 (4,17%) 17 (14,17%) 2 (1,66%)

Table 3: Ideal body image according body mass index

BMI (Kg/m2)

Ideal Body Size

Under weight

(fig 1,2)

Normal weight

(fig 3,4)

Over weight (fig 5,6,7) Obese (fig 8,9 )

Under weight (n = 26) 1 (0,83%) 23 (19,17%) 2 (1,66%) 0 (0%)

Normal weight (n = 56) 5 (4,17%) 47 (39,17%) 4 (3,33%) 0 (0%)

Over weight (n = 14) 0 (0%) 12 (10%) 2 (1,66%) 0 (0%)

Obese (n = 24) 0 (0%) 22 (18,3%) 2 (1,66%) 0 (0%)

YISHPESS and CoIS 2019 - The 3rd Yogyakarta International Seminar on Health, Physical Education, and Sport Science (YISHPESS

2019) in conjunction with The 2nd Conference on Interdisciplinary Approach in Sports (CoIS 2019)

786

Table 4: Physical activity according body image satisfaction

Body image satisfaction

Physical Activity

Low Moderat High

Desire to be Thinner (n = 60) 23 (19,17%) 30 (25%) 7 (5,83%)

Satisfied (n = 56) 12 (10%) 15 (12,5%) 2 (1,66%)

Desire to be Fatter (n = 14) 14 (11,67%) 13 (10,83%) 4 (3,33%)

Table 5: Physical activity according physical activity

Physical Activity BMI

Under Weight Normal weight Over weight Obese

Low 13 (10,83%) 17 (14,17%) 4 (3,33%) 15 (12,5%)

Moderate 11 (9,17%) 33 (27,5%) 6 (5%) 8 (6,67%)

High 2 (1,66%) 6 (5%) 4 (3,33%) 1 (0,83%)

Most participants (48.3%) had moderate levels of

physical activity. Table 4 shows the level of physical

activity based on the satisfaction of body image. Body

image satisfaction has no relationship with the level

of physical activity (P> 0.05).

Table 5 presents the level of participants' physical

activity based on their nutritional status. In the

participants with obese nutritional status most of the

participants had a low level of physical activity.

Participants with underweight nutritional status

mostly also have a low level of physical activity. The

level of physical activity of a person is related to their

nutritional status (p <0.05).

4 DISCUSSION

This study analyzes the relationship between

perceived and ideal body image and nutritional status

of health students. Students between the ages of 18-

25 experience a transition from late adolescence to

early adulthood. At the time of being a student, many

people start a new life apart from parents where they

get more freedom including more freedom to have

friends. This transition causes new habits as a form of

adaptation to new life. Changes in behavior during the

student period would usually also have an impact on

health, one of them is nutritional status.

In our study, 29.17% of participants experienced

body image distortion. Body image of students,

especially women is formed due to the influence of

family and peer environment, adolescents tend to

compare their body shape with relatives or peers

(Mase et al., 2015). Exposure to social media and

electronic media also has an influence on the

formation of body image in female students (Sai et l.,

2018). Research on Iranian students shows a body

image distortion of around 64% (Alipour and

Abbasalizad, 2015). The description of body size and

shape gives rise to feelings of satisfaction or

dissatisfaction with body shape (Coelho et al., 2016).

Most participants (50%) want to be thinner and

only about 24% of participants are satisfied with their

body shape. Overweight and obese women have a

desire to be thinner (Prioreschi et al., 2017). Research

by Wardle et al shows that 30% of women of normal

weight want to lose weight but not all women are

overweight and obese want to lose weight.

Perceptions of overweight and efforts to lose weight

are highest in a group of Asian countries where body

weight is generally low. This shows that local culture

and norms can influence attitudes toward weight

(Wardle, Haase and Steptoe, 2006).

Satisfaction of body shape will affect dietary

behavior and physical activity that is applied to

achieve the desired weight. Dissatisfaction with body

shape increases the risk of eating disorders and

increases physical activity (Prioreschi et al., 2017). In

this study, satisfaction with body shape did not affect

the level of physical activity of participants (p> 0.05).

Most respondents (58%) have moderate level of

physical activity. The decrease in physical activity

occurs in students, one of which is caused by lack of

time to exercise. The sport of choice is usually

aerobic exercise (eg running, walking) (Majeed,

2015).

Being overweight is one of the factors associated

with low physical activity (Unick et al., 2017).

Different results were obtained in studies of female

students in Saudi Arabia, where underweight students

had lower levels of physical activity than overweight

students (Khalaf et al., 2013). In this study, most

obese participants had a low level of physical activity

as well as underweight participants.

The level of physical activity is related to a

person's body mass index. Active men have a lower

risk of obesity compared to those who are less active

Body Image Satisfaction and Its Association with Physical Activity and Body Mass Index among Health Students from Surakarta, Indonesia

787

(Lee et al., 2016). A high level of activity in a person

decreases the risk of being overweight in both men

and women (Štefan et al., 2017). This is in line with

our results of physical activity related to a person's

nutritional status (p <0.05).

5 CONCLUSION

In this study, most participants wanted a normal

body shape as an ideal body shape. Most participants

were dissatisfied with their body shape and wanted to

lose weight. Body image dissatisfaction is not related

to physical activity but physical activity is related to

participant's nutritional status.

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2019) in conjunction with The 2nd Conference on Interdisciplinary Approach in Sports (CoIS 2019)

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