Association between mass media and body weight concern among Jordanian adolescents’ residents of Amman: the role of gender and obesity

Abstract

Objectives

Body image in the mass media promotes an unrealistic picture of body shape that leads to body dissatisfaction among adolescentsQuery. Therefore, the study presented in this paper aimed to assess the association between mass media and adolescents’ weight concerns and perceptions of body weight and shape.

Methods

A cross-sectional survey was conducted on school adolescents aged between 15 and 18 years during the academic year 2013–2014. Multistage stratified sampling method was used. The number of participants in the study was 795 students: 400 boys and 395 girls.

Results

All participants have a common behavior in rarely reading magazines, but they spend more than 2 h in watching television or less than 3 h using the internet. However, most of obese/non-obese adolescents, boys or girls, have shown high influence (p < 0.05) of reading magazines on the subject of dieting to lose weight.

Conclusion

While obese students read more magazines on dieting to lose weight, other mass media did not show the same results on weight concerns and body shape among Jordanian adolescents.

Introduction

Adolescence is a critical developmental period that occurs between the ages 10 and 19. It is characterized by physical, psychological, and social changes [1]. Additionally, the body undergoes many physical alterations in this age period as result of maturation process and growth acceleration in boys and girls. This is manifested in the increase of lean mass in boys and fat mass in girls [2, 3]. These morphological changes may directly affect the individual’s mental image, which may elicit concerns on body weight among boy and girl adolescents [4]. For instance, [5] revealed that 21.2 % of Jordanian girl adolescents aged between 10 and 16 experience body image dissatisfaction due to physical changes of puberty and this dissatisfaction led them to practicing negative eating behaviors [5].

Body image can be defined as a person’s perception, feelings and thoughts towards his or her body shape and size that are derived from biological, psychological, and social factors [6, 7]. Furthermore, there are other factors that can be associated with the construction of positive or negative body images among adolescents such as family environment [8, 9], peer pressure [9–11], socio-cultural and economic context [8, 12], media mass [9, 13], gender [14, 15], and age [15, 16]. Therefore, body dissatisfaction is part of the attitude related to body image and includes disregard for one’s own weight and appearance [10, 17].

Nowadays, adolescents grow up in a world submerged with the mass media (television, movies, magazines, music, advertising, fashion designers and the internet) [18]. They may spend a third to a half of their time indulging in some form of these mass media [19]. The media plays a significant role in contributing towards body shape, weight dissatisfaction and eating disorders in both boys and girl teenagers [20–22]. Several studies have indicated that both boy and girl adolescents frequently report body dissatisfaction; the girl adolescents have a higher concern for their body weight and a passion for thinness in comparison to their boy peers [4, 20, 23]. In general, adolescent girls are more influenced by television adverts and fashion magazines that represent slim, young and beautiful models and most of those young adolescents try to keep their body thin and/or exercise and diet to lose weight [20, 24, 25]. On the other hand, adolescent boys perceive more pressures from the media on muscularity [9, 26]. Even though, adolescent boys are more likely to become concerned with weight and diet in an attempt to appear like boy individuals celebrities in the media [20].

The pressure and concern stemming from the mass media for body weight of adolescents may lead them to practice unhealthy weight control diets and, consequently, eating disorders [27]. In Jordan, the pressure from mass media on the body weight concern of young girls has been studied [28, 29]. However, these studies have focused on adults. We are not aware of similar studies among both boy and girl adolescents in the Arab world in general and specifically in Jordan. Therefore, this study aimed to investigate the influence of mass media on adolescents’ weight concerns and perceptions of body weight and shape in Jordan.

Methods

Design and participants

This study is part of the ARABEAT-2 project, which aimed at evaluating the association between mass media and adolescents’ weight concerns and perceptions of body weight and shape in the Arab world including Amman, the capital of Jordan. A multistage stratified random sampling method was used to select the students. A sample of 795 (out of 818) adolescents (400 boys and 395 girls) was obtained. The sample was obtained from students enrolled in both public and private schools in Amman. The response rate was about 97 %. First, schools were randomly selected and stratified according to gender, type of school (private and public), and location (West and East of the city of Amman). Four schools were selected from each location. Then, one classroom from each grade (10th, 11th, and 12th) was randomly chosen in each selected school. Hence, a total of 16 classrooms were surveyed.

Sample size was calculated with a 5 % margin of error and with 95 % confidence of interval. In Amman, the total number of boy and girl students in the public and private secondary schools during the years 2013/2014 was about 80,000. The survey was conducted over 3 months from April to June 2013. Amman city was divided into four geographical areas, and then the secondary schools were selected proportionally to the student population in each area.

Ethical permission

The Ministry of Education and the selected schools in Jordan approved the study protocol. Consent forms were obtained from the students before starting data collection.

The questionnaire

A pre-tested questionnaire was used to measure the frequency of using mass media and the association of mass media with body weight concern [13, 30]. However, the reliability of the questionnaire was applied on a group of students before applying the questionnaire and tested again using the Cronbach’s alpha Coefficient. The questionnaire was applied twice on the same 30 students of the same age, before and after 1 week. The value of Cronbach’s alpha coefficient was calculated to be 0.721 and 0.733 for pre and after testing, respectively. This indicates an acceptable reliability of the questionnaire, and this reliability is very close to that in the previously tested questionnaire [30]. The questionnaire consisted of three sections: (1) frequency of using the media (magazines, TV and internet). (2) influence of media on dieting to lose weight and (3) influence of media on ideas of a perfect body shape. For the first section, the question was “how often you read magazines per week/watching TV per day/using Internet per day?”. The second section aimed to measure the associations between media and dieting: ‘Does reading magazines/watching TV/using internet influence you to dieting to lose weight?’ (High influence/moderate influence/no influences). The third section measured the influence of media on idea of a perfect body shape: ‘Does reading magazines/watching TV/using internet influence what you consider the perfect body shape?’ (High influence/moderate influence/no influences) [13].

Anthropometric measurements

Weight and height were measured by trained nutritionists, with minimum clothes and without shoes. For the purpose of analysis, the adolescents were divided into two groups: non-obese and obese. The obese group included both overweight and obese adolescents. Non-overweight, overweight and obesity were calculated for each age and sex using the International obesity task force standard (IOTF) for children aged between 15 and 18 years [31].

Statistical analysis

The data were analyzed using SPSS statistical package version 20. Chi square tests were performed to find out the differences between gender and obesity with exposure to media and body weight concern. Multivariate analysis of covariance (MANCOVA) and liner logistic regression were used to calculate odds ratio (OR), CI, and P-_Trend, and significance level was at <0.05.

Results

The prevalence of overweight and obesity was 7.8 and 14.0 % for boy students and 3.0 and 20.0 % for girls, respectively. Table 1 demonstrates that there was no significant difference among obese and non-obese boy and girl students for the time and frequency of using mass media. Additionally, no significant effect of reading magazines, watching television or using the internet was detected on having diets to lose weight between boys and girls (Table 2). Table 3 shows the influence of types of mass media on having diet to lose weight among Jordanian adolescents by weight status. The influence of reading magazines on having diet to lose weight on obese adolescent, either boys or girls, was a high or moderate influence. Furthermore, the Internet had a high significant influence to having diet to lose weight in obese boys compared to non-obese boys (71.3 and 56.7 % for obese and non-obese, respectively; p = 0.023). The influence of mass media on idea of a perfect body shape among Jordanian adolescents based on either gender or weight status did not show any significant difference as shown in Tables 4 and 5. The results of Table 6 showed that as the influence of reading magazines on having diet to lose weight increased, the risk for obesity was found to be duplicated (OR 2.01; CI 1.23–3.29, P-_Trend = 0.046) and specifically among girls (OR 2.55; CI 1.25–5.21, P-_Trend = 0.017). The risk of mass media on having idea of a perfect body shape did not show any significant risk for being obese among obese or non-obese students as shown in Table 7.

Table 1.

Frequency of using mass media among Jordanian adolescents by weight status

Frequency of using the media	Boy					Girls					Total
	Non-obese		Obese		p value	Non-obese		Obese		p value	Non-obese		Obese		p value
	No.	%	No.	%		No.	%	No.	%		No.	%	No.	%
Frequency of reading magazines/week
Daily	53	16.9	16	18.4	0.350	35	11.5	17	18.7	0.317	88	14.5	33	18.5	0.230
2–4	68	21.7	25	28.7	–	83	27.3	23	25.3	–	15.1	24.5	48	27.0	–
5–6	17	5.4	2	2.3	–	16	5.3	3	3.3	–	33	5.3	5	2.8	–
Rarely or none	175	55.9	44	50.6	–	170	55.9	48	52.7	–	345	55.9	92	51.7	–
Hours of watching television/day
<2	87	27.8	29	33.3	0.315	88	28.9	29	31.9	0.593	175	28.4	58	32.6	0.276
2+	226	72.2	58	66.7	–	216	71.1	62	68.1	–	442	71.6	120	67.4	–
Hours of using internet/day
<3	174	55.6	46	52.9	0.650	159	52.3	48	52.7	0.948	333	54.0	94	52.8	0.784
3+	139	44.4	41	47.1	–	145	47.7	43	47.3	–	284	46.0	84	47.2	–

Table 2.

Influence of mass media on dieting to lose weight among Jordanian adolescents by gender

Exposure to media and dieting to lose weight	Boy		Girls		p value
	No.	%	No.	%
Influence of reading magazines to having diet to lose weight
High influence	166	41.5	187	47.3	0.144
Moderate influence	94	23.5	94	23.8	–
Not influence	140	35.0	114	28.9	–
Influence of watching television to having diet to lose weight
High influence	233	58.2	238	60.3	0.356
Moderate influence	75	18.8	82	20.8	–
Not influence	92	23.0	75	18.9	–
Influence of using internet to having diet to lose weight
High influence	239	59.7	229	58.0	0.806
Moderate influence	71	17.8	77	19.5	–
Not influence	90	22.5	89	22.5	–

Table 3.

Influence of mass media on dieting to lose weight among Jordanian adolescents based on weight status

Exposure to media and dieting to lose weight	Boy					Girls					Total
	Non-obese		Obese		p value	Non-obese		Obese		p value	Non-obese		Obese		p value
	No.	%	No.	%		No.	%	No.	%		No.	%	No.	%
Influence of reading magazines to dieting to lose weight
High influence	129	41.2	37	42.5	0.015	136	44.7	51	56.0	0.024	265	42.9	88	49.4	0.001
Moderate influence	65	20.8	29	33.3	–	70	23.1	24	26.4	–	135	21.9	53	29.8	–
Not influence	119	38.0	21	24.2	–	98	32.2	16	17.6	–	217	35.2	37	20.8	–
Influence of watching television to having diet to lose weight
High influence	180	57.5	53	60.9	0.500	183	60.2	55	60.4	0.478	363	58.8	108	60.7	0.244
Moderate influence	57	18.2	18	20.7	–	60	19.7	22	24.2	–	117	19.0	40	22.4	–
Not influence	76	24.3	16	18.4	–	61	20.1	14	15.4	–	137	22.2	30	16.9	–
Influence of using internet to having diet to lose weight
High influence	177	56.7	62	71.3	0.023	176	57.9	53	58.2	0.270	353	57.3	115	64.6	0.204
Moderate influence	63	20.2	8	9.2	–	55	18.1	22	24.2	–	118	19.2	30	16.9	–
Not influence	73	23.1	17	19.5	–	73	24.0	16	17.6	–	146	23.5	33	18.5	–

0.05 > Significance set at p

Table 4.

Influence of mass media on idea of a perfect body shape among Jordanian adolescents based on gender

Exposure to media and body shape concern	Boys		Girls		p value
	No.	%	No.	%
Influence of reading magazines on idea of a perfect body shape
High influence	49	12.3	52	13.2	0.514
Moderate influence	181	45.2	191	48.4	–
Not influence	170	42.5	152	38.4	–
Influence of watching television on idea of a perfect body shape
High influence	156	39.0	167	42.3	0.177
Moderate influence	169	42.3	173	43.8	–
Not influence	75	18.7	55	13.9	–
Influence of using internet on idea of a perfect body shape
High influence	180	45.0	185	46.8	0.563
Moderate influence	135	33.7	138	34.9	–
Not influence	85	21.3	72	18.3	–

Table 5.

Influence of mass media on idea of a perfect body shape among Jordanian adolescents based on weight status

Exposure to media and body shape concern	Boys					Girls					Total
	Non-obese		Obese		p value	Non-obese		Obese		p value	Non-obese		Obese		p value
	No.	%	No.	%		No.	%	No.	%		No.	%	No.	%
Influence of reading magazines on idea of a perfect body shape
High influence	35	11.2	14	16.1	0.459	39	12.8	13	14.3	0.875	74	12.0	27	15.2	0.501
Moderate influence	144	46.0	37	42.5		149	49.0	42	46.2	–	293	47.5	79	44.4	–
Not influence	134	42.8	36	41.4		116	38.2	36	39.5	–	250	40.5	72	40.4	–
Influence of watching television on idea of a perfect body shape
High influence	120	38.3	36	41.4	0.793	127	41.8	40	44.0	0.983	247	40.0	76	42.7	0.730
Moderate influence	135	43.1	34	39.1	–	135	44.4	38	41.8	–	270	43.8	72	40.4	–
Not influence	58	18.6	17	19.5	–	42	13.8	13	14.2	–	100	16.2	30	16.9	–
Influence of using internet on idea of a perfect body shape
High influence	143	45.8	37	42.5	0.589	142	46.7	43	47.2	0.984	285	46.2	80	44.9	0.835
Moderate influence	106	34.0	28	32.2	–	106	34.9	32	35.2	–	212	34.4	60	33.7	–
Not influence	64	20.2	22	25.3	–	56	18.4	16	17.6	–	120	19.4	38	21.4	–

Table 6.

OR and 95 % CI for Influence of mass media on having diet to lose weight and risk of obesity

Frequency	No influencea	Moderate influence	High influence	p value
Reading magazines (per week)
Total
No. of non-obese	217	125	265	0.046
No. of obese	37	53	88
OR (95 % CI)	1	2.41 (1.43–4.04)	2.01 (1.23–3.29)
Boys
No. of non-obese	119	65	129	0.659
No. of obese	21	29	37
OR (95 % CI)	1	2.64 (1.29–5.41)	1.66 (0.82–3.33)
Female
No. of non-obese	98	70	136	0.017
No. of obese	16	24	51
OR (95 % CI)	1	2.19 (1.02–4.73)	2.55 (1.25–5.21)
Watching television (h/day)
Total
No. of non-obese	137	117	363	0.513
No. of obese	30	40	108
OR (95 % CI)	1	1.16 (0.68–2.07)	0.84 (0.48–1.46)
Boys
No. of non-obese	76	57	180	0.651
No. of obese	16	18	53
OR (95 % CI)	1	1.17 (0.50–2.69)	0.81 (0.37–1.81)
Girls
No. of non-obese	61	60	183	0.665
No. of obese	14	22	55
OR (95 % CI)	1	1.08 (0.47–2.46)	0.80 (0.37–1.75)
Using internet (h/day)
Total
No. of non-obese	145	118	353	0.242
No. of obese	33	30	115
OR (95 % CI)	1	0.88 (0.49–1.60)	1.13 (0.68–1.88)
Boys
No. of non-obese	72	63	177	0.061
No. of obese	17	8	62
OR (95 % CI)	1	0.44 (0.17–1.15)	1.24 (0.60–2.65)
Girls
No. of non-obese	73	55	176	0.785
No. of obese	16	22	53
OR (95 % CI)	1	1.47 (0.66–3.26)	1.03 (0.45–2.13)

0.05 > Significance set at p

^aReference category

Table 7.

OR and 95 % CI for influence of mass media on idea of a perfect body shape and risk of obesity

Frequency	No influencea	Moderate influence	High influence	p value
Reading magazines (per week)
Total
No. of non-obese	250	293	74	0.572
No. of obese	72	79	27
OR (95 % CI)	1	0.94 (0.65–1.34)	1.27 (0.76–2.12)
Boys
No. of non-obese	134	144	35	0.149
No. of obese	36	37	14
OR (95 % CI)	1	0.99 (0.57–1.76)	1.50 (0.71–3.19)
Girls
No. of non-obese	116	149	39	0.972
No. of obese	36	42	13
OR (95 % CI)	1	0.88 (0.52–1.49)	1.08 (0.51–2.26)
Watching television
Total				0.740
No. of non-obese	100	270	247
No. of obese	30	72	76
OR (95 % CI)	1	0.89 (0.55–1.44)	1.03 (0.63–1.66)
Boys
No. of non-obese	58	135	120	0.702
No. of Obese	17	34	36
OR (95 % CI)	1	1.02 (0.487–2.13)	1.19 (0.54–2.61)
Girls
No. of non-obese	42	135	127	0.863
No. of obese	13	38	40
OR (95 % CI)	1	0.89 (0.42–1.89)	1.02 (0.47–2.20)
Using internet
Total
No. of non-obese	119	212	285	0.608
No. of obese	38	60	80
OR (95 % CI)	1	0.89 (0.56–1.41)	0.88 (0.56–1.37)
Boys
No. of non-obese	63	106	143	0.267
No. of obese	22	28	37
OR (95 % CI)	1	0.72 (0.36–1.44)	0.68 (0.34–1.35)
Girls
No. of non-obese	56	106	142	0.918
No. of obese	16	32	43
OR (95 % CI)	1	1.0 (0.54–2.23)	1.11 (0.55–2.24)

^aReference category

Discussion

The present study was targeted to explore the effect of three types of mass media on adolescents’ weight concerns and perceptions of body weight and shape in Jordan.

The results shown in this study are similar to [32] who showed that most of Jordanian adolescents exceeded the current screen time (television and computer) recommendation and were spending more than 2 h a day watching TV and using computers [32]. Although this study suggests that watching television and using the internet are not associated with increased risk of obesity, [33] found that watching television for more than 2 hours per day was significantly linked with increased risk of obesity among 6–12-year-old Jordanian children [33].

Moreover, our results revealed that some types of mass media can exert significant influences on having diet to lose weight among obese and non-obese boys, but not the idea of a perfect body shape. However, based on weight status, reading magazines had a significant influence on having diet to lose weight on obese than non-obese adolescents in both boys and girls. Being obese from dieting to lose weight due to the high influence of reading magazines increased the risk for obesity twice as compared to no influence of reading magazines in general and specifically among girls. These results are in agreement with [29] who studied the association between exposure to media and body weight concern among girl university students in five Arab countries (Bahrain, Egypt, Jordan, Oman and Syria) using cross-cultural design [29]. They demonstrated that the association of exposure to magazines with having diets to lose weight was only significant among girls in Jordan (p < 0.001). Exposure to magazines had a stronger association with body weight concerns of girls than exposure to television [29].

While the influence of using the internet on having a diet to lose weight was highly significant in obese boys (71.3 %) compared to non-obese boys (56.7 %). The influence of watching television to having a diet to lose weight among obese and non-obese in both sexes was high but insignificant. Nevertheless, the majority of our sample (all girl obese and non- obese as well as non-obese boys except obese boys) used television more frequently, followed by browsing the internet and reading magazines to having diet to lose weight. This could be attributed to the wide availability of television and higher cost of internet connectivity/usage rate in Jordan. Furthermore, the print media, like books and magazines, is less attractive to adolescents nowadays, who prefer to spend their time on television and online. When comparing our results to the findings of a recent study conducted in United Arab Emirates, the internet was the most influential method on body image 47.3 and 42 % of boys and girls, respectively, followed by television (31 % boys and 37 % girls) [34].

The impact of the media on body weight perceptions among adolescents has been examined by numerous studies from western countries [12, 35–37]. Achtenberg [36] reported that magazine and printed media had very strong and consequential effect on body image among American adolescent girls [36]. Findings from a survey of adolescent girls conducted in the United States showed that 69 % of the participants reported that images of girls displayed in magazines influence their concerns of the perfect body shape and 47 % reported that the images forced them to lose weight [37]. Some researchers illustrated that girls who read fashion magazines often compared themselves with the models that appear in the television advertisements and the magazine articles, resulting in more negative feelings about their own body figure [12, 35, 37]. On the one hand, [20, 37] showed that adolescent boys also were making a lot of effort to look like boy models in the media [37]. Field et al. [37] also found boys who read men, teen, fashion, health or fitness magazines were twice more likely than their peers who did not read magazines to use products to enhance their appearance, muscle mass, or strength. On the other hand, [38] revealed that half of the boys reported that the media had no effect on their body image or eating behaviors [38].

There is one limitation of this study that should be considered in future studies. It is the challenge of self-measuring influence of media rather than establishing criteria for frequency of exposure. Despite this difficulty, this study showed a trend in exposure to media and level of influence of media in weight concern. We did crosstab between frequency of media used and level of influence of media and findings suggested that the participants’ estimation of media influence was positively related to frequency of media used.

In conclusion, this study indicated that the mass media did not show the significant effect on the idea of a perfect body shape among boys and girls as well as obese and non-obese Jordanian adolescents. However, the influence of reading magazines was significant on undertaking diets to lose weight among both obese and non-obese adolescents and also among both boys and girls. Using the Internet had a high significant influence in obese boys.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.