Clustering of obesogenic behaviors and association with body image among Brazilian adolescents in the national school-based health survey (PeNSE 2015)

This study aimed to examine the association between clusters of obesogenic behaviors and body image indicators among a population-based sample of Brazilian adolescents. Data from a cross-sectional country representative survey of 9th grade students (N = 102,301) were analyzed. Physical activity (PA), sedentary behavior (SB) and body image indicators (i.e. satisfaction, perception, value, and weight control attitudes and behaviors) were self-reported. Three clusters were previously validated with two-steps cluster analysis: “Health-promoting SB and diet”, “Health-promoting PA and diet”, and “Health-risk”. Multinomial and binary logistic regression were used to associate clusters with body image indicators. Adolescents in the healthier clusters were more likely to be satisfied/very satisfied with body image and perceive themselves as having normal weight than those in the “Health-risk” cluster. Boys in both health-promoting clusters were more likely to consider body image as being important/very important and perceive themselves to be thin/very thin. Adolescents in the “Health-promoting PA and diet” cluster were more likely to be trying to lose or gain weight than those in the “Health-risk” cluster. Girls in the “Health-promoting SB and diet” cluster had lower odds of adopting unhealthy weight control behaviors than those in the “Health-risk” cluster. The effect of obesogenic behaviors on distinct aspects of body image was confirmed and found to vary according to different synergies between adolescents’ health-related behavior. These findings provide important insights on the understanding of behavioral profiles which can be targeted to prevent unhealthy weight control behaviors and weight related disorders, especially among girls.