Body Image and Disturbed Eating Attitudes Among Adolescents


  • Wajeha Zainab University of Karachi
  • Shafaq Ahmad University of Karachi


Body image, preoccupation with weight and shape, over estimation of weight, disturbed eating attitude


Among all the psychiatric conditions, eating disorders has the highest mortality rates and most of the sufferers are adolescents. As the standards for beauty and attraction are changing and creating a bigger gap between actual and ideal body images resulting in dissatisfied, striving individuals to attain ideal body weight and shape. The current study is intended to explore the impact of closely related but discrete aspects of body image on disturbed eating attitudes among adolescents in Pakistan. Schools and universities were selected through convenient sampling, based on cross sectional research study involved 300 students of 15-20 years (M = 17.23, SD = 1.42) who completed the Eating Attitudes Test and Multidimensional Body-Self Relations Questionnaires. Analyses revealed that the adolescents with disturbed eating attitudes had scored significantly more on cognitive and affective components of body image that is overweight preoccupation and dissatisfaction with their body parts when compared to adolescents with normal eating patterns. Findings of this study are consistent with the existing literature in western culture that suggests that Preoccupation with weight and shape and body dissatisfaction is a risk factor for disturbed eating attitudes among adolescents.


Alkazemi, D., Zafar, T. A., Ebrahim, M., & Kubow, S. (2018). Distorted weight perception correlates with disordered eating attitudes in Kuwaiti college women. International Journal of Eating Disorders, 51(5), 449-458. doi:10.1002/eat.22852

Almenara, C. A., Fauquet, J., López-Guimerà, G., Massana, M. P., & Sánchez-Carracedo, D. (2014). Self-perceived weight status, dieting and unhealthy weight-control behaviors among Spanish male adolescents. Nutricionhospitalaria, 30(2), 301-305. doi:10.3305/nh.2014.30.2.7596

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author.

Arcelus, J., Mitchell, A. J., Wales, J., & Nielsen, S. (2011). Mortality rates in patients with anorexia nervosa and other eating disorders: A meta-analysis of 36 studies. Archives of General Psychiatry, 68(7), 724-731. doi:10.1001/archgenpsychiatry.2011.74

Babar, N., Alam, M., Ali, S. S., Ansari, A., Atiq, M., Awais, A.,&Israr, S. M. (2002). Anorexic behaviour and attitudes among female medical and nursing students at a private university hospital. Journal of Pakistan Medical Association, 52(6), 272-276.

Baker, J. H., Higgins Neyland, M. K., Thornton, L. M., Runfola, C. D., Larsson, H., Lichtenstein, P., & Bulik, C. (2019). Body dissatisfaction in adolescent boys. Developmental psychology, 55(7), 1566. doi:10.1037/de v0000724.

Bardwell Mumford, D., & Choudry, I. Y. (2000). Body dissatisfaction and eating attitudes in slimming and fitness gyms in London and Lahore: A cross-cultural study. European Eating Disorders Review, 8(3), 217-224.

Cash, T. F. (2000). The Multidimensional Body-Self Relations Questionnaire. Retrieved from

Chisuwa, N., & O’Dea, J. A. (2010). Body image and eating disorders amongst Japanese adolescents: A review of the literature. Appetite, 54(1), 5-15. doi:10.1016/j.appet.2009.11.008

Dakanalis, A., Clerici, M., Bartoli, F., Caslini, M., Crocamo, C., Riva, G., & Carrà, G. (2017). Risk and maintenance factors for young women’s DSM-5 eating disorders. Archives of Women's Mental Health, 20(6), 721-731. doi:10.1192/bjp.128.6.549

Garner, D. M., Olmsted, M. P., Bohr, Y., & Garfinkel, P. E. (1982). The Eating Attitudes Test: Psychometric features and clinical correlates. Psychological Medicine, 12, 871-878. doi:10.1017/S0033291700049163

Granese, V., Pietrabissa, G., & Mauro Manzoni, G. (2018). Do subjects with obesity underestimate their body size? A Narrative review of estimation methods and explaining theories. Psychology, Society, and Education, 10(3), 265-273. doi:10.25115/psye.v10i1.2150

Groesz, L. M., Levine, M. P., & Murnen, S. K. (2002). The effect of experimental presentation of thin media images on body satisfaction: A meta?analytic review. International Journal of Eating Disorders, 31(1), 1-16. doi:10.1002/eat.10005

Hoek, H. W., van Harten, P. N., Hermans, K. M., Katzman, M. A., Matroos, G. E., & Susser, E. S. (2005). The incidence of anorexia nervosa on Curacao. American Journal of Psychiatry, 162(4), 748-752. doi:10.1176/ appi.ajp.162.4.748

Jalees, T., & de Run, E. C. (2014). Body image of Pakistani consumers. Journal of Management Science, 1(1), 16-34. doi:10.20547/jms.2014.14 01102

Jan, M. J. (2018). The body image in media and its impact on female adolescents in Pakistan. Retrieved from 12469/2192

Kamps, C. L., & Berman, S. L. (2011). Body image and identity formation: The role of identity distress. Revista Latinoamericana de Psicología, 43(2), 267-277. Retrieved from script=sci_arttext&pid=S0120-05342011000200006

Khan, A. N., Khalid, S., Khan, H. I., & Jabeen, M. (2011). Impact of today's media on university student's body image in Pakistan: a conservative, developing country's perspective. BMC Public Health, 11(1), 1-8. Retrieved from

Machado, P. P., Machado, B. C., Gonçalves, S., & Hoek, H. W. (2007). The prevalence of eating disorders not otherwise specified. International Journal of Eating Disorders, 40(3), 212-217. doi:10.1002/eat.20358

Mahmood, A., & Bibi, Z. (2014). Eating disorders among MBA students in a Business School of Karachi. Journal of Nutrition & Food Sciences, 4(6), 1. doi:10.4172/2155-9600.1000309

Malik, M., Shaukat, W., & Hussain, A. (2019). Binge eating disorder among obese/overweight in Pakistan: Under-diagnosed, undertreated and misunderstood. Clinical Investigation, 9(2), 75-80.

Memon, A. A., Adil, S. E. E. R., Siddiqui, E. U., Naeem, S. S., Ali, S. A., & Mehmood, K. (2012). Eating disorders in medical students of Karachi, Pakistan-a cross-sectional study. BMC Research Notes, 5(1), 84. Retrieved from 1756-0500-5-84

Micali, N., Hagberg, K. W., Petersen, I., & Treasure, J. L. (2013). The incidence of eating disorders in the UK in 2000–2009: Findings from the general practice research database. BMJ open, 3(5), e002646. doi:10.113 6/bmjopen-2013-002646

Mitchison, D., Hay, P., Griffiths, S., Murray, S. B., Bentley, C., Gratwick?Sarll, K., ...& Mond, J. (2017). Disentangling body image: The relative associations of overvaluation, dissatisfaction, and preoccupation with psychological distress and eating disorder behaviors in male and female adolescents. International Journal of Eating Disorders, 50(2), 118-126. Retrieved from /doi/full/10.100 2/eat. 22592

Moreira, N. F., Luz, V. G., Moreira, C. C., Pereira, R. A., Sichieri, R., Ferreira, M. G., ... & Rodrigues, P. R. M. (2018). Self-reported weight and height are valid measures to determine weight status: Results from the Brazilian National Health Survey (PNS 2013). Cadernos De Saudepublica, 34, e00063917. doi:10.1590/0102-311x00063917

Mumford, D. B., Whitehouse, A. M., & Choudry, I. Y. (1992). Survey of eating disorders in English?medium schools in Lahore, Pakistan. International Journal of Eating Disorders, 11(2), 173-184. doi:10.1002/ 1098-108X(199203)11:2<173

Najam, N., & Ashfaq, H. (2012). Gender differences in physical fitness, body shape satisfaction, and body figure preferences. Pakistan Journal of Psychological Research, 187-200. Retrieved from https://www.pjprnip.

Neagu, A. (2015). Body image: A theoretical framework. The Publishing House of Romanian Academy, 17(1), 29-38. Retrieved from https:/ / pdf

Olfert, M., Barr, M., Charlier, C., Famodu, O., Zhou, W., Mathews, A., ...& Colby, S. (2018). Self-reported vs. measured height, weight, and BMI in young adults. International Journal of Environmental Research and Public Health, 15(10), 2216. doi:10.3390/ijerph15102216

Pike, K. M., Dunne, P. E., & Grant, A. (2015). Prevalence and incidence of eating disorders in Asian societies. Handbook of eating disorders (pp. 64-78). Hoboken, New Jersey: John Wiley & Sons.

Pike, K. M., Hoek, H. W., & Dunne, P. E. (2014). Cultural trends and eating disorders. Current Opinion in Psychiatry, 27(6), 436-442.

Puhl, R., & Brownell, K. D. (2001). Bias, discrimination, and obesity. Obesity Research, 9(12), 788-805. doi:10.1038/oby.2001.108

Robinson, E. (2017). Overweight but unseen: A review of the underestimation of weight status and a visual normalization theory. Obesity Reviews, 18(10), 1200-1209. doi:10.1111/obr.12570

Rohde, P., Stice, E., & Marti, C. N. (2015). Development and predictive effects of eating disorder risk factors during adolescence: Implications for prevention efforts. International Journal of Eating Disorders, 48(2), 187-198. doi:10.1002/eat.22270

Saleem, M. D., Ahmed, G., Mulla, J., Haider, S. S., & Abbas, M. (2013). Weight misperception amongst youth of a developing country: Pakistan-a cross-sectional study. BMC Public Health, 13(1), 1-8. doi:10.1186/1471-2458-13-707

Saleem, T. (2017). Body Dissatisfaction and Social Comparison among Pakistan University Students. Paper presented at National Conference of Psychology (NCP 2017): Emerging Social and Mental Health Issues in Society, Lahore Garrison University, Lahore.

Sharpe, H., Griffiths, S., Choo, T. H., Eisenberg, M. E., Mitchison, D., Wall, M., & Neumark?Sztainer, D. (2018). The relative importance of dissatisfaction, overvaluation and preoccupation with weight and shape for predicting onset of disordered eating behaviors and depressive symptoms over 15 years. International Journal of Eating Disorders, 51(10), 1168-1175. doi:10.1002/eat.22936

Sirang, Z., Bashir, H. H., Jalil, B., Khan, S. H., Hussain, S. A., Baig, A., ... &Kadir, M. M. (2013). Weight patterns and perceptions among female university students of Karachi: A cross sectional study. BMC Public Health, 13(1), 1-8. doi:10.1186/1471-2458-13-230

Stice, E., & Shaw, H. E. (2002). Role of body dissatisfaction in the onset and maintenance of eating pathology: A synthesis of research findings. Journal of Psychosomatic Research, 53(5), 985-993. doi:10.1016/S0022-3999(02)00488-9

Stice, E., Marti, C. N., & Durant, S. (2011). Risk factors for onset of eating disorders: Evidence of multiple risk pathways from an 8-year prospective study. Behaviour Research and Therapy, 49(10), 622-627. doi:10.1016/ j.brat.2011.06.009

Striegel-Moore, R. H. (1993). Etiology of binge eating: A developmental perspective. Retrieved from

Suhail, K. (2002). Prevalence of eating disorders in Pakistan: Relationship with depression and body shape. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity, 7(2), 131-138. doi:10.1007/BF03354439

Swami, V. (2015). Cultural influences on body size ideals. European Psychologist, 20(1) 44-51. doi:10.1027/1016-9040/a000150

Syed, A., Din, Z., Zeb, F., Ghaffar, F., Khan, S., Iqbal, M., & Ali Khan, B. (2017). Eating attitude related to the nutritional status of university girls in Peshwawar Khyber Pakhtunkhwa. Pakistan. Journal of Clinical Nutrition and Dietetics, 3(1), 1-8. doi:10.4172/2472-1921.100042

Tuschen-Caffier, B., Bender, C., Caffier, D., Klenner, K., Braks, K., & Svaldi, J. (2015). Selective visual attention during mirror exposure in Anorexia and Bulimia Nervosa. PLoS One, 10(12), e0145886. doi:10.137 1/journal. pone.0145886

Ung, E. K. (2003). Eating disorders in Singapore: A review. Annals of the Academy of Medicine Singapore, 32(1), 19-24. Retrieved from https://

Verschueren, M., Claes, L., Bogaerts, A., Palmeroni, N., Gandhi, A., Moons, P., & Luyckx, K. (2018). Eating disorder symptomatology and identity formation in adolescence: A cross-lagged longitudinal approach. Frontiers in Psychology, 9, 816. doi:10.3389/fpsyg.2018.00816

Voelker, D. K., Reel, J. J., & Greenleaf, C. (2015). Weight status and body image perceptions in adolescents: Current perspectives. Adolescent health, Medicine and Therapeutics, 6, 149. doi:10.2147/AHMT.S68344

Williamson, D. A., White, M. A., York-Crowe, E., & Stewart, T. M. (2004). Cognitive-behavioral theories of eating disorders. Behavior Modification, 28(6), 711-738. doi:10.1177/0145445503259853

World Health Organization. (2016). [online] [cited 2016 Dec 22]. Retrieved from

Zulfiqar, A., Laghari, Z., Warsi, J., Memon, M., Lashari, K., & Muhammad, S. A. (2014). Detection of eating disorders in university students using Scoff questionnaire. International Journal of Development Research, 4(8) 1634-1637.