Investigating the Association Between Body Mass Index (BMI) and Body Image Perceptions Among High School Students

Abstract

Background: Adolescence is a critical period for physical growth and psychological development,
during which body mass index (BMI) and body image perceptions play an important role in health
and well-being. Concerns about overweight, obesity, and body dissatisfaction are increasingly
common among Malaysian adolescents. Therefore, this study aimed to determine the association
between BMI status and body image perceptions among high school students in Kuantan, Pahang.
Methods: A cross-sectional study was conducted among 140 students aged 13 to 15 years in
Kuantan, Pahang. Participants were selected using purposive sampling, and only those with parental
consent and valid responses were included. Anthropometric measurements were used to calculate
BMI, while body image perceptions were assessed using a validated questionnaire, Body Self-Image
Questionnaire Short-Form (BSIQ-SF) across four domains: Negative Affect, Attractiveness Evaluation,
Physical Functionality Awareness, and Height Dissatisfaction. Statistical analyses included
descriptive statistics, independent t-tests, and Pearson correlation. Results: The majority of students
(75.0%) had a normal BMI, while 10.0% were overweight, 7.1% obese, 4.3% thin, and 3.6% severely
thin, indicating a dual burden of malnutrition. Female students reported significantly greater
dissatisfaction in the Height Dissatisfaction domain (p = 0.031). No significant gender differences
were found in the Negative Affect, Attractiveness Evaluation, and Physical Functionality Awareness
domains. BMI was significantly correlated with Negative Affect (r = 0.338, p < 0.001) and Physical
Functionality Awareness (r = 0.218, p = 0.010), suggesting that students with higher BMI were more
likely to experience body dissatisfaction and greater awareness of physical functionality. Conclusion:
Our findings reveal that BMI and gender significantly influence body image perceptions among
adolescents, reflecting both overweight/obesity and underweight concerns. Despite the growing
importance of adolescent body image in public health, there remains a need for further research on
sociocultural and environmental factors shaping these perceptions.