Skip to main content
    • Aa
    • Aa
  • Access
  • Cited by 27
  • Cited by
    This article has been cited by the following publications. This list is generated based on data provided by CrossRef.

    Okop, Kufre Joseph Mukumbang, Ferdinand C. Mathole, Thubelihle Levitt, Naomi and Puoane, Thandi 2016. Perceptions of body size, obesity threat and the willingness to lose weight among black South African adults: a qualitative study. BMC Public Health, Vol. 16, Issue. 1,

    Som, Nivedita Mishra, Shailendra Kumar and Mukhopadhyay, Susmita 2016. Weight concerns and food habits of adolescent girls in two contrasting ecological regions: A comparative study in India. Eating Behaviors, Vol. 20, p. 21.

    Darling, Stephen Uytman, Clare Allen, Richard J. Havelka, Jelena and Pearson, David G. 2015. Body image, visual working memory and visual mental imagery. PeerJ, Vol. 3, p. e775.

    Maximova, Katerina Khan, Mohammad K.A. Austin, S. Bryn Kirk, Sara F.L. and Veugelers, Paul J. 2015. The role of underestimating body size for self-esteem and self-efficacy among grade five children in Canada. Annals of Epidemiology, Vol. 25, Issue. 10, p. 753.

    Mchiza, Zandile J. Parker, Whadi-ah Makoae, Mokhantso Sewpaul, Ronel Kupamupindi, Takura and Labadarios, Demetre 2015. Body image and weight control in South Africans 15 years or older: SANHANES-1. BMC Public Health, Vol. 15, Issue. 1,

    Zandile Mchiza, Z. 2014. Eating disorders in South African schools: a public health crisis that needs immediate intervention. South African Journal of Clinical Nutrition, Vol. 27, Issue. 4, p. 185.

    Abdullah Ben‐Ammar, Albandri and Al‐Holy, Murad Ahmad 2013. Body image and lifestyle attitudes of female gymnasium users in Saudi Arabia. Nutrition & Food Science, Vol. 43, Issue. 4, p. 365.

    Devanathan, Rynal Devanathan, Viveka and Esterhuizen, Tonya M. 2013. Incongruence in body image and body mass index: A surrogate risk marker in Black women for type 2 diabetes mellitus. African Journal of Primary Health Care & Family Medicine, Vol. 5, Issue. 1,

    Giardina, Elsa-Grace V. Sciacca, Robert R. Flink, Laura E. Bier, Michael L. Paul, Tracy K. and Moise, Nathalie 2013. Cardiovascular Disease Knowledge and Weight Perception Among Hispanic and Non-Hispanic White Women. Journal of Women's Health, Vol. 22, Issue. 12, p. 1009.

    Petracci, Elisabetta and Cavrini, Giulia 2013. The effect of weight status, lifestyle, and body image perception on health-related quality of life in children: a quantile approach. Quality of Life Research, Vol. 22, Issue. 9, p. 2607.

    Puoane, Thandi R. Fourie, Jean M. Tsolekile, Lungiswa Nel, Johanna H. and Temple, Norman J. 2013. What Do Black South African Adolescent Girls Think About Their Body Size?. Journal of Hunger & Environmental Nutrition, Vol. 8, Issue. 1, p. 85.

    Wilson, Michael Viswanathan, Bharathi Rousson, Valentin and Bovet, Pascal 2013. Weight Status, Body Image and Bullying among Adolescents in the Seychelles. International Journal of Environmental Research and Public Health, Vol. 10, Issue. 5, p. 1763.

    Wittenberg, Martin 2013. The Weight of Success: The Body Mass Index and Economic Well-Being in Southern Africa. Review of Income and Wealth, Vol. 59, p. S62.

    Gualdi-Russo, Emanuela Manzon, Vanessa Samantha Masotti, Sabrina Toselli, Stefania Albertini, Augusta Celenza, Francesca and Zaccagni, Luciana 2012. Weight status and perception of body image in children: the effect of maternal immigrant status. Nutrition Journal, Vol. 11, Issue. 1,

    Alwan, Heba Viswanathan, Bharathi Paccaud, Fred and Bovet, Pascal 2011. Is Accurate Perception of Body Image Associated with Appropriate Weight-Control Behavior among Adolescents of the Seychelles. Journal of Obesity, Vol. 2011, p. 1.

    Khan, Amad N Khalid, Salema Khan, Hussain I and Jabeen, Mehnaz 2011. Impact of today's media on university student's body image in Pakistan: a conservative, developing country's perspective. BMC Public Health, Vol. 11, Issue. 1,

    Matoti-Mvalo, T. and Puoane, T. 2011. Perceptions of body size and its association with HIV/AIDS. South African Journal of Clinical Nutrition, Vol. 24, Issue. 1, p. 40.

    Mchiza, Zandile J Goedecke, Julia H and Lambert, Estelle V 2011. Intra-familial and ethnic effects on attitudinal and perceptual body image: a cohort of South African mother-daughter dyads. BMC Public Health, Vol. 11, Issue. 1,

    Monteiro Gaspar, Marisa J. Amaral, Teresa F. Oliveira, Bruno M.P.M. and Borges, Nuno 2011. Protective effect of physical activity on dissatisfaction with body image in children – A cross-sectional study. Psychology of Sport and Exercise, Vol. 12, Issue. 5, p. 563.

    Alwan, Heba Viswanathan, Bharathi Williams, Julita Paccaud, Fred and Bovet, Pascal 2010. Association between weight perception and socioeconomic status among adults in the Seychelles. BMC Public Health, Vol. 10, Issue. 1,


Development and validation of instruments measuring body image and body weight dissatisfaction in South African mothers and their daughters

  • Zandile Mciza (a1) (a2), Julia H Goedecke (a1), Nelia P Steyn (a3), Karen Charlton (a3), Thandi Puoane (a4), Shelly Meltzer (a1), Naomi S Levitt (a1) and Estelle V Lambert (a1)
  • DOI:
  • Published online: 01 January 2007

We sought to validate questionnaires concerning body image perception, body size dissatisfaction and weight-related beliefs in multi-ethnic South African mothers and their daughters.

Settings and subjects: Girls attending primary school (ages 9–12 years, n = 333) and their mothers (n = 204) were interviewed regarding their demographics and body image. Weight, height and skinfold thicknesses were measured. Body image questions and body mass index (BMI) were compared with silhouettes adapted from the Pathways Study for girls and Stunkard's body image figures for mothers. A Feel–Ideal Difference (FID) index score was created by subtracting the score of the silhouette selected by the participants as ‘Ideal’ from the one selected as most closely representing their current appearance or ‘Feel’. We hypothesised that a higher FID index score would be associated with greater body size dissatisfaction.


BMI percentiles in girls (r = 0.46, P < 0.05) and BMI in mothers (r = 0.68, P < 0.05) were positively correlated with the selected silhouettes based on size. Participants who reported feelings of being ‘fat’ and those who perceived that their family and friends were more dissatisfied with their body size had significantly higher FID index scores. Scores were lower in black than white girls (all P < 0.05). No differences were found in FID index scores between ethnic groups of mothers. Internal reliability of the ‘thin’ and ‘fat’ belief constructs for girls was demonstrated by standardised Cronbach's α values ≥0.7.


Silhouettes, FID index, ‘fat’ and ‘thin’ belief constructs (in girls) are age-appropriate, culturally sensitive and can be used in further intervention studies to understand body image.

    • Send article to Kindle

      To send this article to your Kindle, first ensure is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle.

      Note you can select to send to either the or variations. ‘’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Development and validation of instruments measuring body image and body weight dissatisfaction in South African mothers and their daughters
      Your Kindle email address
      Available formats
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your Dropbox account. Find out more about sending content to Dropbox.

      Development and validation of instruments measuring body image and body weight dissatisfaction in South African mothers and their daughters
      Available formats
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your Google Drive account. Find out more about sending content to Google Drive.

      Development and validation of instruments measuring body image and body weight dissatisfaction in South African mothers and their daughters
      Available formats
Corresponding author
*Corresponding author: Email
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

2BM Popkin . The nutrition transition in low-income countries: an emerging crisis. Nutrition Reviews 1994; 52(9): 285–95.

5T Ota , T Takamura , N Hirai , K Kobayashi . Preobesity in World Health Organization classification involves the metabolic syndrome in Japanese. Diabetes Care 2002; 25(7): 1252–3.

6T Puoane , K Steyn , D Bradshaw , R Laubscher , J Fourie , V Lambert , Obesity in South Africa: the South African demographic and health survey. Obesity Research 2002; 10(10): 1038–48.

8FX Pi-Sunyer . Medical hazards of obesity. Annals of Internal Medicine 1993; 119(7 Pt 2): 655–60.

9K Steyn , JM Kazenellenbogen , CJ Lombard , LT Bourne . Urbanization and the risk for chronic diseases of lifestyle in the black population of the Cape Peninsula, South Africa. Journal of Cardiovascular Risk 1997; 4(2): 135–42.

10T Young , PE Peppard , DJ Gottlieb . Epidemiology of obstructive sleep apnea: a population health perspective. American Journal of Respiratory and Critical Care Medicine 2002; 165(9): 1217–39.

11MB Schwartz , R Puhl . Childhood obesity: a societal problem to solve. Obesity Reviews 2003; 4(1): 5771.

12N Stettler . Obesity in children and adolescents. Therapeutische Umschau 2000; 57(8): 532–6.

14M Altabe . Ethnicity and body image: quantitative and qualitative analysis. International Journal of Eating Disorders 1998; 23(2): 153–9.

15CM Bulik , TD Wade , AC Heath , NG Martin , AJ Stunkard , LJ Eaves . Relating body mass index to figural stimuli: population-based normative data for Caucasians. International Journal of Obesity and Related Metabolic Disorders 2001; 25(10): 1517–24.

16TF Cash , JR Grant , JM Shovlin , RJ Lewis . Are inaccuracies in self-reported weight motivated distortions? Perceptual and Motor Skills 1992; 74(1): 209–10.

17DA Dawson . Ethnic differences in female overweight: data from the 1985 National Health Interview Survey. American Journal of Public Health 1988; 78(10): 1326–9.

18ML Fitzgibbon , LR Blackman , ME Avellone . The relationship between body image discrepancy and body mass index across ethnic groups. Obesity Research 2000; 8(8): 582–9.

19AA Caradas , EV Lambert , KE Charlton . An ethnic comparison of eating attitudes and associated body image concerns in adolescent South African schoolgirls. Journal of Human Nutrition and Dietetics 2001; 14(2): 111–20.

20GR Henriques , LG Calhoun . Gender and ethnic differences in the relationship between body esteem and self-esteem. Journal of Psychology 1999; 133(4): 357–68.

21H Madrigal , A Sanchez-Villegas , MA Martinez-Gonzalez , J Kearney , MJ Gibney , J Irala , Underestimation of body mass index through perceived body image as compared to self-reported body mass index in the European Union. Public Health 2000; 114(6): 468–73.

22FM Cachelin , RM Rebeck , GH Chung , E Pelayo . Does ethnicity influence body-size preference? A comparison of body image and body size. Obesity Research 2002; 10(3): 158–66.

23KJ Miller , DH Gleaves , TG Hirsch , BA Green , AC Snow , CC Corbett . Comparisons of body image dimensions by race/ethnicity and gender in a university population. International Journal of Eating Disorders 2000; 27(3): 310–6.

24S Paeratakul , MA White , DA Williamson , DH Ryan , GA Bray . Sex, race/ethnicity, socioeconomic status, and BMI, in relation to self-perception of overweight. Obesity Research 2002; 10(5): 345–50.

25LA Sanchez-Johnsen , ML Fitzgibbon , Z Martinovich , MR Stolley , AR Dyer , L Van Horn . Ethnic differences in correlates of obesity between Latin-American and black women. Obesity Research 2004; 12(4): 652–60.

28AA Brewis , ST McGarvey , J Jones , BA Swinburn . Perceptions of body size in Pacific Islanders. International Journal of Obesity and Related Metabolic Disorders 1998; 22(2): 185–9.

29P Rasheed . Perception of body weight and self-reported eating and exercise behavior among obese and non-obese women in Saudi Arabia. Public Health 1998; 112(6): 409–14.

30Z Mvo , J Dick , K Steyn . Perceptions of overweight African women about acceptable body size of women and children. Curationis 1999; 22(2): 2731.

32T Puoane , JM Fourie , M Shapiro , L Rosling , NC Tshaka , A Oelofse . ‘Big is beautiful’ – an exploration of urban black women in a South African township. South African Journal of Clinical Nutrition 2005; 18(1): 615.

34J Wardle , J Waller , L Rapoport . Body dissatisfaction and binge eating in obese women: the role of restraint and depression. Obesity Research 2001; 9(12): 778–87.

38FJ Van Lenthe , HC Kemper , W Van Mechelen , JW Twisk . Development and tracking of central patterns of subcutaneous fat in adolescence and adulthood: the Amsterdam Growth and Health Study. International Journal of Epidemiology 1996; 25(6): 1162–71.

39PJ Cooper , MJ Taylor , Z Cooper , CG Fairburn . The development and validation of the Body Shape Questionnaire. International Journal of Eating Disorders 1987; 6(4): 485–94.

41R Sands . Reconceptualization of body image and drive for thinness. International Journal of Eating Disorders 2000; 28(4): 397407.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Public Health Nutrition
  • ISSN: 1368-9800
  • EISSN: 1475-2727
  • URL: /core/journals/public-health-nutrition
Please enter your name
Please enter a valid email address
Who would you like to send this to? *