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01.12.2015 | Research article | Ausgabe 1/2016 Open Access

BMC Public Health 1/2016

The association of body image distortion with weight control behaviors, diet behaviors, physical activity, sadness, and suicidal ideation among Korean high school students: a cross-sectional study

BMC Public Health > Ausgabe 1/2016
Jounghee Lee, Youngmin Lee
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​s12889-016-2703-z) contains supplementary material, which is available to authorized users.

Competing interests

The authors declare that they have no conflict of interest.

Authors’ contributions

JL analyzed the data. JL and YL drafted and revised the original manuscript. JL and YL approved the final version as submitted.



The identification of predictors for body image distortion would be an especially important first step in targeting a vulnerable population and developing a nutrition intervention program. We aimed to investigate the prevalence of body image distortion and the factors associated with body image distortion among Korean high school students.


We selected 20,264 normal weight high school students from the 10th Korea Youth Risk Behavior Web-based Survey using nationally representative data in 2014. With multivariate logistic regression, we assessed the association of body image distortion with individual demographic and socio-economic factors, weight control behaviors, and mental health characteristics.


The over-estimation group of body weight status, compared with the correct estimation group, was significantly more likely to be a 3rd year high school student [adjusted odds ratio (AOR): 1.27, 95 % confidence interval (CI): 1.16–1.39], to be female [AOR: 3.52, 95 % CI: 3.25–3.81], to employ unhealthy weight control behaviors [AOR: 1.54, 95 % CI: 1.37–1.72], and to have a sadness [AOR: 1.25, 95 % CI: 1.16–1.35] and suicidal ideation [AOR: 1.20, 95 % CI: 1.08–1.33]. The under-estimation group, compared with the correct estimation group, was significantly less likely to be female [AOR: 0.23, 95 % CI: 0.21–0.25] and to employ unhealthy weight control behaviors [AOR: 0.50, 95 % CI: 0.43–0.59] but were more likely to have a sadness [AOR: 1.12, 95 % CI: 1.03–1.21] and suicidal ideation [AOR: 1.12, 95 % CI: 1.00–1.25].


Not only the over-estimation but also the under-estimation of body weight is prevalent among high school students in South Korea. Body image distortion was significantly associated with sadness and suicidal ideation.
Additional file 1: Table S1. International child cut-offs corresponding to BMI cut-offs at 18 years. Table S2. Agreement between body image and actual body weight status based on the BMI of high school students, by gender. (DOCX 19 kb)
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