Body Image, Body Mass Index, and Body Composition: In Young Adults

PURPOSE: Associations were examined between body image and body mass index (BMI) in comparison with body composition in healthy weight, overweight, and obese young adults. METHODS: Weight and height were determined, and the percentage of fat mass (%FM) and percentage of fat-free mass (%FFM) were measured by dual energy X-ray absorptiometry in 75 male and 87 female young adults (21.1 ± 1.9 years; 25.2 ± 4.4 kg/m² [mean ± standard deviation]). Body image was measured using the three subscales Weight Esteem, Appearance Esteem, and External Attribution of the Body-Esteem Scale for Adolescents and Adults (BESAA). RESULTS: Body mass index and %FM were highly correlated (r for males = 0.74, r for females = 0.82; both p<0.001), and were inversely associated with body image, particularly Weight Esteem. After adjustment for physical activity, BMI and %FM (and %FFM, although in the opposite direction) were associated with each BESAA subscale: %FM, %FFM, and BMI explained 12% to 14% of the variance in Appearance Esteem for both sexes, 33% to 41% in Weight Esteem in women and 16% to 18% in men, and 8% to 10% in External Attribution in women (all p<0.05) and <5% for men (NS). CONCLUSIONS: Clinicians should be aware that as their clients' BMI and %FM increase, body image decreases, particularly in women.