Associations of overweight and of weight dissatisfaction among Palestinian adolescents: findings from the national study of Palestinian schoolchildren (HBCS-WBG2004)

Overweight and obesity as well as weight dissatisfaction have been increasing in prevalence worldwide. Body weight dissatisfaction and fear of fatness are potential contributors to disordered eating. The present study aimed to investigate the prevalence of self-reported overweight and weight dissatisfaction along with associations with socio-demographic characteristics, body image, health complaints, risk behaviours, physical activity and television viewing in adolescents in Palestine. The 2003/04 Palestinian Health Behaviour in School-aged Children (HBSC) is a cross-sectional survey of 17 817 adolescents from 405 randomly selected schools. Students from a representative sample of grades 6, 8, 10 and 12 (aged 12-18 years) self-completed a modified version of the international World Health Organization collaborative Health Behaviour in School-aged Children (HBSC-2002) questionnaire. Although 16.5% of the adolescents were overweight, almost twice that number (32.1%) were dissatisfied with their weight (i.e. dieting or perceiving a need to diet). Of those adolescents, two-thirds were not actually overweight (56.4% boys; 73.5% girls). One-fifth of the total number of adolescents (16.0% boys; 24.0% girls) were not overweight but were dissatisfied with their weight. Boys reporting overweight or weight dissatisfaction were more likely to have mothers with higher education or to be from more affluent families. Among both genders, but especially among girls, weight dissatisfaction was positively associated with most of the outcome variables (body image, health complaints, risk behaviours, and television viewing) regardless of weight status, whereas weight status was associated with only a few of the outcome variables. Weight dissatisfaction, independent of weight status, is associated with body image, health complaints, risk behaviours and television viewing, and represents a potential health risk factor for adolescents. Preventive interventions should focus not only on weight status, but also on body weight dissatisfaction