Perception of being "about right size" and high body satisfaction by BMI in adolescents

The slim and muscular body ideals are well-established, and adolescence is a phase sensitive to developing negative body image. This study aimed to identify the BMI at which most adolescents 1) perceive themselves as being the right size and 2) experience high body satisfaction.

Data from the Danish National Youth Study included 64,451 adolescents aged 15-19 years. Multilevel logistic regression using restricted cubic splines modelled associations between BMI, body size perception and body satisfaction.

The highest ORs for perceiving oneself as "about right size" and experiencing high body satisfaction were at BMIs of 19.0 kg/m2 and 15.9 kg/m2 in females, corresponding to the 21st and second percentiles of the BMI distribution. In males, the highest ORs were at BMIs of 22.2 kg/m2 and 21.9 kg/m2, near the male median of 21.6 kg/m2. Significant variations in ORs for both body size perception and body satisfaction were observed across the entire BMI range, even within the healthy weight range of 18.5-24.9 kg/m2.

Among females, the perception of being "about right size" and experiencing high body satisfaction was most prevalent at BMIs well below the median, whereas for males, these perceptions were most common around the median. These findings strongly confirm that gender-specific body ideals are highly internalized, placing many adolescents at risk of developing a negative body image. TRIAL REGISTRATION not relevant.

This work was supported by Centre for Childhood Health, Denmark (ID: 2024_F_001).