Assessing associations amongst body dissatisfaction, eating disorder symptoms and sociocultural influences in adolescents from rural Nicaragua

Abstract Introduction We conducted a cross-sectional study with adolescents in rural Nicaragua to assess the associations amongst body dissatisfaction, eating disorder symptoms and sociocultural influences (sociocultural pressures and media internalization), and assessed gender and ethnic group differences. Methods A total of 122 adolescents aged 11–18 years (77 girls; M age = 13.8, SD = 1.55) from small rural communities completed validated, culturally adapted questionnaires measuring perceived sociocultural pressures, media internalization, body dissatisfaction and eating disorder symptoms. Results Stronger perceived sociocultural pressures and greater media internalization were associated with higher levels of body dissatisfaction and more eating disorder symptoms in both boys and girls. Perceived sociocultural pressure from family, friends and the media was the strongest predictor of body dissatisfaction in hierarchical regression models. Although general media internalization did not predict body dissatisfaction, athletic internalization emerged as a significant predictor for girls in exploratory analyses. Girls showed lower body dissatisfaction and lower media internalization compared to boys. Compared to participants of Afro-descended ethnicity, Indigenous participants showed higher body dissatisfaction, higher media internalization and higher perceived sociocultural pressure. There were no gender or ethnic differences in eating disorder symptoms. Conclusions Our results suggest that perceived pressures from family, friends and the media are stronger predictors for body dissatisfaction than media internalization - for both boys and girls. Furthermore, differences between Indigenous and Afro-descended participants highlight the importance of taking cultural context and ethnicity into account when assessing body dissatisfaction and eating disorder symptoms in rural, Latin American populations.