Body dissatisfaction in the classroom context and adolescent psychological complaints

BACKGROUND: Body dissatisfaction, which refers to negative feelings towards one's own body shape, size, weight, or appearance, has been indicated to be a risk factor for a range of adverse health-related outcomes among youth. Although previous research has investigated the link between adolescents’ own body image and psychological outcomes, the contextual effect of body dissatisfaction on individual health has not been explored. The purpose of this study was to examine if the concentration of students with a negative body image in the classroom was associated with individual students’ psychological complaints. METHODS: Data was obtained from the 2017/18 Swedish Health Behaviour in School-aged Children (HBSC) study, a cross-sectional survey among 13- and 15-year-olds (n = 2,619 in 145 school classes). Body image was captured by one question on perceived body size and one question on weight change attitude/behaviour. Psychological complaints were measured by self-reports on the frequency of feeling low, irritable, nervous, and having difficulties falling asleep, which were summed to an index. Gender, school grade, socioeconomic status, and immigration background were included as covariates. Two-level random intercept linear regression models were performed. RESULTS: The proportion of students in the classroom with a negative body image was associated with higher levels of psychological complaints (dissatisfaction with perceived body size b = 0.02, p < 0.05; desire/attempts to change weight b = 0.02, p < 0.01), even when adjusting for the corresponding measures at the student level. These associations were driven by the class-level dissatisfaction related to perceiving oneself as too fat or wanting to lose weight. CONCLUSIONS: The study found that body dissatisfaction among classmates was associated with psychological complaints in individual students. Reducing body dissatisfaction among adolescents could improve the well-being not only of the individual but also of their peers. KEY MESSAGES: • The study found that the proportion of classmates who reported body dissatisfaction was associated with individual-level psychological complaints. • Interventions aimed at reducing body dissatisfaction among adolescents have the potential to improve the well-being of both the individual and their peers.