JOURNAL OF ADOLESCENT HEALTH 1992;13:396-397
CONFERENCE PROCEEDINGS -
Evaluation of Self-Image of Living in Budapest M. KERTiSZ
M.D.,
Z. POLLiK,
M.D.,
AND E. G
The objective of the present study was to analyze and evaluate correlations between Hungarian adolescents’ nutritional status, disorders of eating behavior, and body image/self-concept.
er questionnaire-interview. Distribution of body height against body mass was determined and evaluated by Eiben’s percentile standards and Body Mass Index (3).
Methods
Results
The study is based on the medical history interview, physical examination, and administration of the Offer Self-Image Questionnaire to 173 students aged between 14 and 15 years, selected from a typical high school in Budapest. A 24-hr “recall” of food consumption was administered and a face-to-face interview carried out with each student. The overweight subjects were referred to endocrinologic screening. Self-evaluation of physical appearance was measured by asking the student to circle the number on a scale from 1 (extremely thin) to 9 (extremely fat), as well as inquiring about satisfaction with present weight and plans to lose 3r gain weight. Selected items from the Offer Self-Image Questionnaire (OSIQ) for adolescents were also applied (1,2). Item numbers were 6, 27, 42, 43, 52, 62, 75, 77, 82, 90, 94, 97, 99, 119, and 130. Endorsements were evaluated on item level. Parental opinion on the physical appearance of their sons and daughters was evaluated by anothFrom the Apdthy Children iM.K.k Health Department
Hospital-Outpatient Clinic, Budapest Cenlre of Budapestand County Pest KP.k and the National hstitute of Food-Hygiene and Nutrition, Budapest (E.G.), Hungary. Address reprint requests hx Maria Kertk, M.D., 2026, Budapest,
ofSocialhsurance
Ots6-uti53, Budapest, Hunga y.
I’& paper mu presentedat the 5th Congress Association for Adolescent Health. luly 3-6, SWlkerhItld. Manuscript accepted Janus y 31, 1992. 3%
1054439xl92l$3.00
of the International 2991, Montreux,
More than 80% of overweight or obese students had at least one obese parent. Hypertension, myocardial infarction, and diabetes mellitus were more frequently reported in these families than in those of the “normal” body-mass student group. Triceps skinfold thickness measurements revealed that 17% of the boys and 23% of the girls were overweight or obese. Obstacles to having a healthy breakfast included inadequate time, fear of being late to school, and “no one to prepare breakfast.” Excessive daily work overload was an important factor resulting in their “eating on the run.” Overweight or obese teenagers had poorer body image and are 1~s satisfied with their body shape than schoolmates with “normal” body sizes. Underweight or overweight students believe themselves less attractive to the opposite sex. Overweight girls often feel ugly and want to reduce their body mass whereas overweight boys feel stronger and more “manlike” than their “normal” counterparts, and no more than 6% of them want to become thinner. It is of interest that 11% of the girls with “normal” body mass consider themselves obese and want to lose weight. Parental view of physical appearance is different from that of the children as parents feel overweight children are more attractive than slim ones. It was found that 84% of overweight or obese boys’ parents and 88% of overweight or obese girls’ parents are
QSociety for Adolescent Medicine, 1992 Published by El*vier Science Publishing Co., Inc., 655 Avenue of the Americas,New York, NY 10010
July 1992
satisfied with the actual nutritional sons or daughters.
SELF-IMAGE OF OVERWEIGHT TEENAGERS OF BUDAPEST
status of their
Discussion The choice of the topic for this study was motivated by the fact that physical appearance, nutritional condition, and health status influence teenager behavior and personality development (1,4). Anxiety and depression cause several types of psychosomatic syndromes that are partly induced and/or increased by disturbed nutrition and body dissatisfaction (5,6). Assessment of overweight or obesity has been found rather difficult. Its criteria are not universally accepted in children and adolescents (7). Incidence of adolescent overweight or obesity in Hungary resembles that observed in other industrialized countries. Comparative evaluation of results of data analysis concerning 5938 adolescents in ten countries was performed and reported (8). Evaluation revealed similarities and differences in selfimage including body shape, physical appearance, self-satisfaction, and interpersonal relationships (family, adults, peers). The main obstacles to voluntary change of body shape of Hungarian adolescents are their preferences for traditional high energy foods and the high satisfaction of parents with the physical appearance of their overweight or obese children. Future tasks of health education must include nutritional education and the early recognition and treatment of overweight adolescents (9-11). The Offer Self-Image Questionnaire proved useful in tapping the teenagers’ anxiety about the body image in its latent or early stage of obesity. Its ex-
397
tend.ed use may be a tool for prevention of obesityinduced disorders of personality. The Author thanks M. Saliga, M.D., pediatrician, head of the Health Department of the Social Insurance Centre of Budapest and Pest County.
References 1. Offer D, Ostrov E, Howard KI. The adolescent: A psychological self-portrait. New York, Basic Books, 1981. 2. Offer D, Ostrov E, Howard KI. The Offer Self-Image Questionnaire for adolescents: A manual. Chicago, Michael Reese Hospital and Medical Center, 1982. 3. Eiben OG, Panto E. The Hungarian national growth standards. Anthropologiai Kiizlemenyek 1986; 30:5-23. 4. Kertesz M, Offer D, Ostrov E, Howard KI. Hungarian adolescents’ self-concept. J Youth Adolesc 1986;15:275-86. 5. Hammen CL. Depression in college students: Beyond the Beck Depression Inventory. J Consult Clin Psycho1 1980; 48:126-8. 6. Smith MS, Womack WM, Chen ACN. Anxiety and depression in the behavioral treatment of headache in children and adolescents. Int J Adolesc Med Health 1989;5:17-35. 7. KnittIe JL, Merritt RJ, Dixon-Shanies D, et al. Childhood obesity. In: Suskind RM, ed. Textbook of Pediatric Nutrition. New York: Raven Press, 1981. Bellisle F, Louis-Sylvestre J. -4nxiety and food intake in men. Psychosom Med 1990;52:452-7. 8. Offer D, Ostrov E, Howard Kl, Atkinson R. The teenage world: Adolescents’ self-image in ten countries. New York, Plenum, 1988. 9. Pollak 2. Kemenes I, Kertesz M. Testsdlytiibblet, mozgastevekenydg es betegsegek lisszefiigg&e kiizepiskolas tanuIoknal. (Correlation between overweight, physical exercise and disease in high school students.) Egbzskgnevek 1986;27:8-10.
10. Greiner E, K&p&i T, Mauk P. Application of soya products in low energy diets. Acta Alimentaria 1987;16:299. 11. Czinner A. Adrteriosclerosis rizikdfaktorok vizsgalata kiiver gyermekekben. (Evaluation of risk factors of arterioslerosis in obese children.) Kandidatusi Brtekezes (Dissertation). Budapest, 1983.
CONFERENCE PROCEEDINGS -
Evaluation of Self-Image of Living in Budapest M. KERTiSZ
M.D.,
Z. POLLiK,
M.D.,
AND E. G
The objective of the present study was to analyze and evaluate correlations between Hungarian adolescents’ nutritional status, disorders of eating behavior, and body image/self-concept.
er questionnaire-interview. Distribution of body height against body mass was determined and evaluated by Eiben’s percentile standards and Body Mass Index (3).
Methods
Results
The study is based on the medical history interview, physical examination, and administration of the Offer Self-Image Questionnaire to 173 students aged between 14 and 15 years, selected from a typical high school in Budapest. A 24-hr “recall” of food consumption was administered and a face-to-face interview carried out with each student. The overweight subjects were referred to endocrinologic screening. Self-evaluation of physical appearance was measured by asking the student to circle the number on a scale from 1 (extremely thin) to 9 (extremely fat), as well as inquiring about satisfaction with present weight and plans to lose 3r gain weight. Selected items from the Offer Self-Image Questionnaire (OSIQ) for adolescents were also applied (1,2). Item numbers were 6, 27, 42, 43, 52, 62, 75, 77, 82, 90, 94, 97, 99, 119, and 130. Endorsements were evaluated on item level. Parental opinion on the physical appearance of their sons and daughters was evaluated by anothFrom the Apdthy Children iM.K.k Health Department
Hospital-Outpatient Clinic, Budapest Cenlre of Budapestand County Pest KP.k and the National hstitute of Food-Hygiene and Nutrition, Budapest (E.G.), Hungary. Address reprint requests hx Maria Kertk, M.D., 2026, Budapest,
ofSocialhsurance
Ots6-uti53, Budapest, Hunga y.
I’& paper mu presentedat the 5th Congress Association for Adolescent Health. luly 3-6, SWlkerhItld. Manuscript accepted Janus y 31, 1992. 3%
1054439xl92l$3.00
of the International 2991, Montreux,
More than 80% of overweight or obese students had at least one obese parent. Hypertension, myocardial infarction, and diabetes mellitus were more frequently reported in these families than in those of the “normal” body-mass student group. Triceps skinfold thickness measurements revealed that 17% of the boys and 23% of the girls were overweight or obese. Obstacles to having a healthy breakfast included inadequate time, fear of being late to school, and “no one to prepare breakfast.” Excessive daily work overload was an important factor resulting in their “eating on the run.” Overweight or obese teenagers had poorer body image and are 1~s satisfied with their body shape than schoolmates with “normal” body sizes. Underweight or overweight students believe themselves less attractive to the opposite sex. Overweight girls often feel ugly and want to reduce their body mass whereas overweight boys feel stronger and more “manlike” than their “normal” counterparts, and no more than 6% of them want to become thinner. It is of interest that 11% of the girls with “normal” body mass consider themselves obese and want to lose weight. Parental view of physical appearance is different from that of the children as parents feel overweight children are more attractive than slim ones. It was found that 84% of overweight or obese boys’ parents and 88% of overweight or obese girls’ parents are
QSociety for Adolescent Medicine, 1992 Published by El*vier Science Publishing Co., Inc., 655 Avenue of the Americas,New York, NY 10010
July 1992
satisfied with the actual nutritional sons or daughters.
SELF-IMAGE OF OVERWEIGHT TEENAGERS OF BUDAPEST
status of their
Discussion The choice of the topic for this study was motivated by the fact that physical appearance, nutritional condition, and health status influence teenager behavior and personality development (1,4). Anxiety and depression cause several types of psychosomatic syndromes that are partly induced and/or increased by disturbed nutrition and body dissatisfaction (5,6). Assessment of overweight or obesity has been found rather difficult. Its criteria are not universally accepted in children and adolescents (7). Incidence of adolescent overweight or obesity in Hungary resembles that observed in other industrialized countries. Comparative evaluation of results of data analysis concerning 5938 adolescents in ten countries was performed and reported (8). Evaluation revealed similarities and differences in selfimage including body shape, physical appearance, self-satisfaction, and interpersonal relationships (family, adults, peers). The main obstacles to voluntary change of body shape of Hungarian adolescents are their preferences for traditional high energy foods and the high satisfaction of parents with the physical appearance of their overweight or obese children. Future tasks of health education must include nutritional education and the early recognition and treatment of overweight adolescents (9-11). The Offer Self-Image Questionnaire proved useful in tapping the teenagers’ anxiety about the body image in its latent or early stage of obesity. Its ex-
397
tend.ed use may be a tool for prevention of obesityinduced disorders of personality. The Author thanks M. Saliga, M.D., pediatrician, head of the Health Department of the Social Insurance Centre of Budapest and Pest County.
References 1. Offer D, Ostrov E, Howard KI. The adolescent: A psychological self-portrait. New York, Basic Books, 1981. 2. Offer D, Ostrov E, Howard KI. The Offer Self-Image Questionnaire for adolescents: A manual. Chicago, Michael Reese Hospital and Medical Center, 1982. 3. Eiben OG, Panto E. The Hungarian national growth standards. Anthropologiai Kiizlemenyek 1986; 30:5-23. 4. Kertesz M, Offer D, Ostrov E, Howard KI. Hungarian adolescents’ self-concept. J Youth Adolesc 1986;15:275-86. 5. Hammen CL. Depression in college students: Beyond the Beck Depression Inventory. J Consult Clin Psycho1 1980; 48:126-8. 6. Smith MS, Womack WM, Chen ACN. Anxiety and depression in the behavioral treatment of headache in children and adolescents. Int J Adolesc Med Health 1989;5:17-35. 7. KnittIe JL, Merritt RJ, Dixon-Shanies D, et al. Childhood obesity. In: Suskind RM, ed. Textbook of Pediatric Nutrition. New York: Raven Press, 1981. Bellisle F, Louis-Sylvestre J. -4nxiety and food intake in men. Psychosom Med 1990;52:452-7. 8. Offer D, Ostrov E, Howard Kl, Atkinson R. The teenage world: Adolescents’ self-image in ten countries. New York, Plenum, 1988. 9. Pollak 2. Kemenes I, Kertesz M. Testsdlytiibblet, mozgastevekenydg es betegsegek lisszefiigg&e kiizepiskolas tanuIoknal. (Correlation between overweight, physical exercise and disease in high school students.) Egbzskgnevek 1986;27:8-10.
10. Greiner E, K&p&i T, Mauk P. Application of soya products in low energy diets. Acta Alimentaria 1987;16:299. 11. Czinner A. Adrteriosclerosis rizikdfaktorok vizsgalata kiiver gyermekekben. (Evaluation of risk factors of arterioslerosis in obese children.) Kandidatusi Brtekezes (Dissertation). Budapest, 1983.
