Eating attitudes, body image satisfaction and self-esteem of South African Black and White male adolescents and their perception of female body silhouettes

This cross-sectional study of urban high schools in Johannesburg, South Africa, sought to examine eating attitudes, body image and self-esteem among male adolescents (n = 391). Anthropometric measurements, Eating Attitudes Test-26 (EAT-26), Rosenberg self-esteem, body image satisfaction and perception of females were collected at age 13, 15 and 17 years. Descriptive analysis was done to describe the sample, and non-parametric Wilcoxon Mann-Whitney test was used to test for significant differences between data that were not normally distributed (EAT-26). Spearman's rank correlation coefficient analyses were conducted to test for associations between self-esteem scores and eating attitudes, body mass indices and body image satisfaction scores. To assess the differences between groups that were normally distributed chi-square tests were carried out. Ethnic differences significantly affected adolescent boys' body mass index (BMI), eating attitudes and self-esteem; White boys had higher self-esteem, BMI and normal eating attitudes than the Black boys did. BMI was positively associated with self-esteem (p = 0.01, r = 0.134) and negatively with dieting behaviour in White boys (p = 0.004, r = -0.257), and with lower EAT-26 bulimic and oral control scores in Black boys. In conclusion, the findings highlight ethnic differences and a need to better understand cultural differences that influence adolescent attitudes and behaviour.