Body image, body mass index, and body composition in young adults

Associations were examined between body image and body mass index (BMI) in comparison with body composition in healthy weight, overweight, and obese young adults.

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).

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).

Clinicians should be aware that as their clients' BMI and %FM increase, body image decreases, particularly in women.