How do adolescents perceive body image and respond to body dissatisfaction?

Abstract Objectives To assess adolescents’ attitudes, satisfaction, and practices regarding their body image across body mass index (BMI) categories. Methods In this cross-sectional survey (2019–2020), we recorded anthropometry of 2,089 girls and boys between 13 and 17 years from semi-urban schools in western India. Multidimensional Body-Self Relations Questionnaire (MBSRQ) was used for multidimensional attitudinal assessment of body image and weight-related variables. The Stunkard scale was used to assess body shape perception. Results In higher age categories, boys were more satisfied with their appearance (p=0.012, p linearity=0.001), cared more about grooming (p=0.007, p linearity=0.001), and regarded themselves more physically fit (p=0.003, p linearity 0.030 up to 16 years). Boys with normal BMI were more satisfied with their appearance (p=0.001), fitness (p=0.024), and more alert about symptoms of illness (p<0.000) than others. With increasing BMI, older girls and boys were more preoccupied with their weight and perceived themselves to be heavier (p=0.001). A majority of underweight girls perceived their weight as normal. Students engaged in weight loss practices irrespective of their BMI category. Boys wanted a bigger, and girls a smaller body shape than their current shape. We found body shape dissatisfaction in 66.4 % adolescents, more in boys than in girls (p=0.001). Conclusions Body shape dissatisfaction is quite common among semiurban adolescents, with boys outnumbering girls. BMI, age, and sex are associated with weight perception and attitude toward body image. Unindicated weight loss practices are prevalent.