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Abstract Overweight in mothers and children in sub‐Saharan Africa is rapidly increasing and may be related to body size perceptions and preferences. We enrolled 268 mother–child (6–59 months) pairs in central Malawi; 71% of mothers and 56% of children were overweight/obese, and the remainder were normal weight. Interviewers used seven body silhouette drawings and a questionnaire with open‐ and closed‐ended questions to measure mothers' perceptions of current, preferred and healthy maternal and child body sizes and their relation to food choices. Overweight/obese and normal weight mothers' correct identification of their current weight status (72% vs. 64%), preference for overweight/obese body size (68% both) and selection of an overweight/obese silhouette as healthy (94% vs. 96%) did not differ by weight status. Fewer overweight/obese than normal weight mothers' preferred body silhouette was larger than their current silhouette (74% vs. 29%, p < .001). More mothers of overweight than normal weight children correctly identified the child's current weight status (55% vs. 42%, p < .05) and preferred an overweight/obese body size for the child (70% vs. 58%, p < .01), and both groups selected overweight/obese silhouettes as healthy for children. More than half of mothers in both groups wanted their child to be larger than the current size. Mothers said that increasing consumption of fruits, vegetables, meat, milk, grains, fizzy drinks and fatty foods could facilitate weight gain, but many cannot afford to purchase some of these foods. Their desired strategies for increasing weight indicate that body size preferences may drive food choice but could be limited by affordability.

Overweight in mothers and children in sub‐Saharan Africa is rapidly increasing and may be related to body size perceptions and preferences. We enrolled 268 mother–child (6–59 months) pairs in central Malawi; 71% of mothers and 56% of children were overweight/obese, and the remainder were normal weight. Interviewers used seven body silhouette drawings and a questionnaire with open‐ and closed‐ended questions to measure mothers' perceptions of current, preferred and healthy maternal and child body sizes and their relation to food choices. Overweight/obese and normal weight mothers' correct identification of their current weight status (72% vs. 64%), preference for overweight/obese body size (68% both) and selection of an overweight/obese silhouette as healthy (94% vs. 96%) did not differ by weight status. Fewer overweight/obese than normal weight mothers' preferred body silhouette was larger than their current silhouette (74% vs. 29%, p <.001). More mothers of overweight than normal weight children correctly identified the child's current weight status (55% vs. 42%, p <.05) and preferred an overweight/obese body size for the child (70% vs. 58%, p <.01), and both groups selected overweight/obese silhouettes as healthy for children. More than half of mothers in both groups wanted their child to be larger than the current size. Mothers said that increasing consumption of fruits, vegetables, meat, milk, grains, fizzy drinks and fatty foods could facilitate weight gain, but many cannot afford to purchase some of these foods. Their desired strategies for increasing weight indicate that body size preferences may drive food choice but could be limited by affordability. [ABSTRACT FROM AUTHOR]

The current study examined college students’ perceptions of male victims compared to female victims in a female abuser–male victim scenario and a male abuser–female victim scenario. Victim blaming, minimization of the seriousness of the abuse, and body size perceptions and how gender-role traditionality (GRT) affects these perceptions were investigated. Male victims were blamed as the victim more and their abuse was minimized more compared to female victims. These differences were moderated by GRT. Only the female victim and abuser varied in body size perceptions, and these perceptions were also moderated by GRT. Males blamed the victim and minimized the seriousness of the abuse more than did females. Implications for intervention programs and new directions in IPV research are discussed. [ABSTRACT FROM AUTHOR]

The PhD thesis of Gradidge, entitled ‘Factors associated with obesity and metabolic syndrome in an ageing cohort of black women living in Soweto, Johannesburg (Study of Women in and Entering Endocrine Transition [SWEET])’, attempts to understand the determinants of obesity and metabolic syndrome (MetS) in a population of urban-dwelling black South African women. A conceptual framework is presented, which positions obesity as the central risk factor for MetS, and includes the possible influence of socioeconomic status, lifestyle behaviours and body size perceptions, as key determinants of obesity. This commentary focuses on the two main findings of Gradidge’s thesis, namely, (i) physical activity and sedentary behaviour, and (ii) body composition and adiponectin, as risk factors for obesity and MetS in black South African women. Despite a high prevalence of obesity (48%), Gradidge showed that 75% of the women taking part in the study were meeting WHO guidelines on physical activity. This commentary suggests that the relationship between physical activity and cardiometabolic risk may be confounded by socioeconomic status. Alternatively, the intensity, and not necessarily the volume, of activity, as well as high rates of sedentary behaviour are posited as important determinants of obesity and MetS in black South African women. Accordingly, this commentary questions the veracity of the WHO guidelines on physical activity in developing countries, where most women meet the guidelines but have very poor cardiorespiratory fitness, are obese and are at high risk of MetS. Gradidge also showed that the most consistent and significant correlate of MetS in this cohort of middle-aged women was low serum levels of adiponectin. This commentary highlights various lifestyle interventions that have been shown to increase adiponectin levels. Finally, the importance of immediate action to address the problem of obesity and MetS is emphasised.

Purpose Underestimating body size hinders healthy behavior modification needed to prevent obesity. However, initiatives to improve body size misperceptions may have detrimental consequences on self-esteem and self-efficacy. Methods Using sex-specific multiple mixed-effect logistic regression models, we examined the association of underestimating versus accurate body size perceptions with self-esteem and self-efficacy in a provincially representative sample of 5075 grade five school children. Body size perceptions were defined as the standardized difference between the body mass index (BMI, from measured height and weight) and self-perceived body size (Stunkard body rating scale). Self-esteem and self-efficacy for physical activity and healthy eating were self-reported. Results Most of overweight boys and girls (91% and 83%); and most of obese boys and girls (93% and 90%) underestimated body size. Underestimating weight was associated with greater self-efficacy for physical activity and healthy eating among normal-weight children (odds ratio: 1.9 and 1.6 for boys, 1.5 and 1.4 for girls) and greater self-esteem among overweight and obese children (odds ratio: 2.0 and 6.2 for boys, 2.0 and 3.4 for girls). Conclusions Results highlight the importance of developing optimal intervention strategies as part of targeted obesity prevention efforts that de-emphasize the focus on body weight, while improving body size perceptions. [ABSTRACT FROM AUTHOR]

Background: Parents typically do not recognise their child's weight status accurately according to clinical criteria, and thus may not take appropriate action if their child is overweight. We developed a novel visual intervention designed to improve parental perceptions of child weight status according to clinical criteria for children aged 4-5 and 10-11 years. The Map Me intervention comprises age- and sex-specific body image scales of known body mass index and supporting information about the health risks of childhood overweight. Design: This cluster randomised trial will test the effectiveness of the Map Me intervention. Primary schools will be randomised to: paper-based Map Me; web-based Map Me; no information (control). Parents of reception (4-5 years) and year 6 (10-11 years) children attending the schools will be recruited. The study will work with the National Child Measurement Programme which measures the height and weight of these year groups and provides feedback to parents about their child's weight status. Before receiving the feedback, parents will complete a questionnaire which includes assessment of their perception of their child's weight status and knowledge of the health consequences of childhood overweight. The control group will provide pre-intervention data with assessment soon after recruitment; the intervention groups will provide post-intervention data after access to Map Me for one month. The study will subsequently obtain the child height and weight measurements from the National Child Measurement Programme. Families will be followed-up by the study team at 12 months. The primary outcome is any difference in accuracy in parental perception of child weight status between pre-intervention and post-intervention at one month. The secondary outcomes include differences in parent knowledge, intention to change lifestyle behaviours and/or seek advice or support, perceived control, action planning, coping planning, and child weight status at 12 month follow-up. Discussion: The Map Me tool has potential to make a positive impact on children's health at a population level by introducing it into current intervention programmes to improve accuracy of parental perception of child's weight status. This trial will inform the action of researchers, educators, health professionals and policy makers. [ABSTRACT FROM AUTHOR]

Objective To examine the relationships among weight-related criticism (WRC), body size perceptions, and body size dissatisfaction among a sample of preadolescent children. Method A community sample of 382 fifth and sixth graders (M age = 10.8) completed measures of WRC, nonweight-related criticism (NWRC), body size perceptions, body size dissatisfaction, and general self-esteem. Body mass index for each participant was collected during a standard school assessment. Results WRC was a significant and unique predictor of body size perceptions and body size dissatisfaction, controlling for actual BMI percentile and NWRC. Weight status moderated these relationships, with significant effects for WRC found only in the overweight group. NWRC was a significant predictor of self-esteem. Discussion The results suggest that WRC is specifically and uniquely associated with preadolescent children’s body self-perceptions beyond its association with general, nonweight-related victimization. Prevention efforts may be needed to limit WRC and its potentially harmful effects. [ABSTRACT FROM AUTHOR]

South Asians are prone to diabetes type 2 and cardiovascular diseases, which can be prevented by a diet leading to weight reduction. Body size perceptions may influence compliance to dietary advice. The objective was to study body size perceptions among Pakistani immigrant women in Norway, enrolled in a controlled trial to prevent deterioration of glucose tolerance by focussing on diet and physical activity. Participants (n=198) were 25-62 years of age, 79.8% had BMI > 25 and mean BMI was 29.6. Data were collected by questionnaire interviews with Punjabi/Urdu speaking interviewers, and body weight and height were measured. This article is based on baseline data. Stunkard's Figure Rating Scale was used. The scale consists of nine figures, representing women with different body shapes, from very thin (1-2) to very obese (6-9). The women were asked which body size they thought would connote health and wealth. A significantly smaller body size was related to health (mean 2.9) than to wealth (mean 3.3), p<0.01, and both were smaller than their self-rated own body size (mean 5.7), p<0.01. The women perceived that Pakistanis in Norway prefer women to have a smaller body size (mean 3.4) than people in Pakistan (mean 4.5), but larger than Norwegians (mean 2.5). A discrepancy score was calculated between self-rated own body size and perceived body size preference among Pakistanis in Norway. BMI was positively associated, and level of education negatively associated, with the discrepancy score. The women related body size numbers to BMI similarly to what has been described for US women. In conclusion, body size preferences among Pakistani women in this study were within the range of normal weight. However, there was a large discrepancy between own self-rated body size and the perceived ideal for Pakistanis in Norway. [ABSTRACT FROM AUTHOR]

Abstract: Preschool-age children hold negative attitudes toward overweight peers (i.e., anti-fat attitudes), but little is known about individual differences in these attitudes. The current study investigated actual weight status and perceived body size in relation to preschool-age children''s anti-fat attitudes. Sixty-nine 4–6 year-olds (61% girls) were individually interviewed about their body size perceptions using a figure rating scale and anti-fat attitudes using multiple methods (including an adjective rating scale and ratings of acceptability for different body shapes). Results suggested that children''s perceived body size, not actual body size, was related to their attitudes about an overweight figure and the number of figures rated as acceptable. Children who perceived themselves as heavier held fewer anti-fat attitudes. Perceived and actual body size ratings were not related to ratings of a thin figure. This study suggests the importance of examining children''s body image, particularly their perceived body size, in understanding their anti-fat attitudes. [Copyright &y& Elsevier]

The purpose of this study was to assess attitudes towards body size of urban Tunisian women. Firstly, to determine body size satisfaction amongst women and investigate the body size that women associate with good health, high social status and individual desirability; and secondly, to study whether perception varies in different groups of society, to see if there is a difference of attitudes in younger women and those of higher socioeconomic status. A cross-sectional, population based study was conducted in a peri-urban area of the capital, Tunis with 203 randomly selected women, aged 18-52 years. They were asked to associate 31 items with 1 of 6 photographic silhouettes of different body size; BMI was measured and over half of women were overweight or obese (BMI ≥ 25kg/m2). Almost two-thirds of all women were dissatisfied with their current body size. A normal body size (BMI 20-24 kg/m2) was seen in the most positive light by Tunisian women, although some positive attributes were associated with overweight silhouettes. Obesity was seen as undesirable, associated with greediness and poor health. There was no marked preference by younger women for slimmer body sizes, as had been expected. However, there was a preference by women with higher socioeconomic status for slimmer body sizes for some items. The finding that Tunisian women did not prefer larger body sizes may suggest a preference for a slimmer norm, closer to that in Western societies. [ABSTRACT FROM AUTHOR]

OBJECTIVE:: To examine the cultural ideals for body size held by urban Senegalese women; to determine the body size that women associate with health; and to estimate the change in prevalence of female obesity in an urban neighbourhood of Dakar. DESIGN:: Cross-sectional, population-based study in the subject's home, using a structured interviewer-administered questionnaire, conducted in the same Dakar neighbourhood as that of a previous survey conducted in 1996. SUBJECTS:: A total of 301 randomly selected women, aged 20-50?y, living in a specific Dakar neighbourhood, Senegal. MEASUREMENTS:: A total of 32 items concerning body satisfaction, social status, health and individual attributes to associate with one of six photographic silhouettes; body mass index (BMI), waist circumference, waist-to-hip ratio by anthropometry; and measures of economic status. RESULTS:: In all, 26.6%of women were overweight (BMI 25-29.9?kg/m2) and 18.6%were obese (BMI=30?kg/m2) compared with 22.4 and 8.0%respectively in 1996. Overweight was the most socially desirable body size, although obesity itself was seen as undesirable, associated with greediness and the development of diabetes and heart disease. Lay definitions of overweight and normal weight differed substantially from health definitions, as one-third of the sample saw the‘overweight’category as normal. Over a third of women with BMI=25?kg/m2 wanted to gain more weight. CONCLUSION:: There has been a sharp rise in the prevalence of obesity in Senegalese women living in a Dakar neighbourhood over the last 7?y. In general, overweight body sizes (but not obese) were seen in a positive light. The finding that the term‘overweight’made little sense to these Senegalese women could have important implications for developing public health policies.International Journal of Obesity (2004) 28, 1561-1568. doi:10.1038/sj.ijo.0802739 Published online 27 July 2004 [ABSTRACT FROM AUTHOR]

Objective. The purpose of this study was to assess grade, race, socioeconomic status and gender differences in perceptions of body size, weight concerns, and weight control practices between 4th and 7th grade students in South Carolina. Design. Two random samples, consisting of a total of 1,597 children (53.1% white, 51.97% female, 44.9% 4th graders) participated in two questionnaire surveys. Both surveys included a series of seven female and seven male body size drawings, body image and weight concern questions, and questions pertaining to weight control practices. Responses to the questionnaire were analyzed using chi-square analysis and the General Linear Model. Results. Using socioeconomic status (SES), race, gender, and grade as independent variables, differences in ideal adult body size, opposite gender ideal adult body size, weight concerns, perceptions of family/peer weight concerns, perceptions of own body size and weight control practices were studied. Analyses revealed that 4th grade males select a larger ideal adult body size and opposite gender ideal adult body size when compared to 7th grade males (p < 0.0001 and p = 0.0078, respectively). Fourth grade females indicated less personal concern about their weight than 7th grade females (p = 0.0009). Fourth graders also perceived less family/peer concern about weight than 7th graders (p = 0.0027) and 7th graders described themselves as being more overweight than 4th graders (p = 0.0039). Blacks selected a significantly larger body size than white children for ideal adult (p = 0.0287) and ideal opposite gender adult body size (p < 0.0001 for males, p = 0.0030 for females). Blacks also perceived less personal and family/peer concern about weight when compared to whites (p = 0.0083). More whites reported that they were trying to lose weight, as compared to blacks (p = 0.0010). Males also selected significantly larger body size silhouettes than females for ideal adult body size (p = 0.0012). Males expressed less personal concern about weight (p < 0.0001), perceived less family/peer concern about weight (p < 0.0001), and were less likely than females to be engaged in weight loss (p < 0.0001). Females in the high SES category selected a significantly smaller ideal male adult body size than females in the low SES group (p = 0.0124) and more females in the high SES category were trying to lose weight when compared to females in the low SES group (p = 0.0055).) Conclusion. This study indicates that early in a child’s sociocultural development, grade level, gender, race, and SES are influential in the perception of ideal adult body size and opposite gender ideal adult body size. These factors are also influential in determining concerns about weight and weight control practices. The findings of this study support the need to begin health and wellness education efforts early in childhood while taking into account racial, gender, age, and SES disparities. This knowledge can also be useful in targeting interventions for both obesity and eating disorders. [ABSTRACT FROM AUTHOR]

The PhD thesis of Gradidge, entitled ‘Factors associated with obesity and metabolic syndrome in an ageing cohort of black women living in Soweto, Johannesburg (Study of Women in and Entering Endocrine Transition [SWEET])’, attempts to understand the determinants of obesity and metabolic syndrome (MetS) in a population of urban-dwelling black South African women. A conceptual framework is presented, which positions obesity as the central risk factor for MetS, and includes the possible influence of socioeconomic status, lifestyle behaviours and body size perceptions, as key determinants of obesity. This commentary focuses on the two main findings of Gradidge’s thesis, namely, (i) physical activity and sedentary behaviour, and (ii) body composition and adiponectin, as risk factors for obesity and MetS in black South African women. Despite a high prevalence of obesity (48%), Gradidge showed that 75% of the women taking part in the study were meeting WHO guidelines on physical activity. This commentary suggests that the relationship between physical activity and cardiometabolic risk may be confounded by socioeconomic status. Alternatively, the intensity, and not necessarily the volume, of activity, as well as high rates of sedentary behaviour are posited as important determinants of obesity and MetS in black South African women. Accordingly, this commentary questions the veracity of the WHO guidelines on physical activity in developing countries, where most women meet the guidelines but have very poor cardiorespiratory fitness, are obese and are at high risk of MetS. Gradidge also showed that the most consistent and significant correlate of MetS in this cohort of middle-aged women was low serum levels of adiponectin. This commentary highlights various lifestyle interventions that have been shown to increase adiponectin levels. Finally, the importance of immediate action to address the problem of obesity and MetS is emphasised. [ABSTRACT FROM PUBLISHER]