An ethnic comparison of eating attitudes and associated body image concerns in adolescent South African schoolgirls
Objective The purpose of this study was to investigate whether differences exist in eating attitudes and body shape concerns amongst adolescent schoolgirls representing South Africa's ethnically and culturally diverse population currently undergoing epidemiological transition. Method A questionnaire survey, including the Eating Attitudes Test, Body Shape Questionnaire and a Body Silhouette Chart, was administered to 228 South African schoolgirls (60 black, 83 mixed race and 85 white) aged 15-18 years from five secondary schools in the greater Cape Town area. Results Black girls had significantly higher mean BMI values (24.1 (3.3)) than either white (21.9 (3.0)) or mixed race girls (22.1 (3.7)) (P < 0.05). Controlling for differences in BMI, white subjects scored significantly higher on the Body Shape Questionnaire than did mixed race or black subjects, whereas no ethnic differences were found for Eating Attitude Test scores. A comparable percentage (mean=18.8%) of black, mixed race and white girls had scores indicative of eating disorder pathology on the Eating Attitudes Test, while a higher percentage of white, compared to mixed race and black, girls had abnormal scores on the Body Shape Questionnaire (33%, 26% and 20%, respectively; P < 0.05). The ideal body size desired by white girls was significantly smaller than that of the mixed race or black samples. Dissatisfaction with present body size was significantly higher in white, compared to black or mixed race girls (P < 0.001). Conclusion These findings suggest that the prevalence of abnormal eating attitudes is equally common in South African schoolgirls from different ethnic backgrounds. White girls exhibit greater body image concerns and body image dissatisfaction than mixed race or black individuals. These findings reinforce the notion that eating disorders are culture-reactive rather than culture-bound phenomena and provide insight into the extent of eating-related problems and body image issues in developing societies.