Self-Esteem, Body Mass Index Status and Risk of Eating Disorders among Health Sciences Students
Article Sidebar
Issue
Vol. 19 No. 3 (2024)
Accepted
6 August 2024
Published
29 November 2024
Keywords:
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Body Mass Index (BMI), risk of eating disorder, self-esteem
Abstract
This study aimed to ascertain the association between eating disorder risk, Body Mass Index (BMI), and self-esteem level among Universiti Sains Malaysia (USM) undergraduate health sciences students at Health Campus, Kubang Kerian, Kelantan, Malaysia. The self-esteem level and eating disorder risk of 166 USM health sciences students were evaluated in this cross-sectional study using the Rosenberg's Self Esteem Score and the Eating Attitude Test 26 (EAT-26) questionnaire, respectively. Based on their self-reported height and weight, the BMI was computed. The Fisher Exact Test and Chi-Square were used to determine the associations between the self-esteem level and BMI and the risk of eating disorders, respectively. Out of the 166 students, the majority (65.1%) had self-esteem levels within the normal range, while 57.8% had normal BMI. In the meantime, it was found that 19.9% had a high chance of getting an eating disorder. This study demonstrated a substantial association (p=0.012) between self-esteem and BMI status as well as between eating disorder risk and self-esteem (p=0.002). Self-esteem has a major impact on the psychological factors influencing BMI and contributing to the development of eating disorders. Additionally, future research should consider incorporating factors like body perception and body dissatisfaction. Additional research was required to validate the existing findings.
References
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Bujang MA. 2021. A step-by-step process on sample size determination for medical research. Malays J Med Sci 28(2):15–27. https://doi.org/10.21315/mjms2021.28.2.2
Chan YL, Samy AL, Tong WT, Islam MA, Low WY. 2020. Eating disorder among Malaysian university students and its associated factors. Asia Pac J Public Health 32(6–7):334–339. https://doi.org/10.1177/1010539520947879
Chaudhari B, Tewari A, Vanka J, Kumar S, Saldanha D. 2017. The relationship of eating disorders risk with body mass index, body image and self-esteem among medical students. Ann Med Health Sci Res 7(3):144–149.
Fakaruddin FN, Tharbe IHA. 2018. Self-esteem and Emotional Intelligence Among Students in a Public Higher Learning Institution in Malaysia. Proceedings of The Universitas Indonesia International Psychology Symposium for Undergraduate Research (UIPSUR 2017) (page 243–248), 24–25th September. Jakarta (ID): Universitas Indonesia.
García JA, Olmos FC, Matheu ML, Carreño TP. 2019. Self esteem levels vs global scores on the Rosenberg self-esteem scale. Heliyon 5(3):1–17. https://doi.org/10.1016/j.heliyon.2019.e01378
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Gilbert N, Meyer C. 2005. Fear of negative evaluation and the development of eating psychopathology: A longitudinal study among nonclinical women. Int J Eat Disord 37(4):307–312. https://doi.org/10.1002/eat.20105
Keane L, Loades M. 2017. Low self-esteem and internalizing disorders in young people – a systematic review. Child and Adolescent Mental Health 22(1):4–15. https://doi.org/10.1111/camh.12204
Keshk MM, Fahim HI, Hassan AM, Boulos DN, Sector P. 2019. Body image perception and self-esteem among university students in Cairo. Egypt J Community Med 37(1):82–96. https://doi.org/10.21608/ejcm.2019.28135
Kiviruusu O, Konttinen H, Huurre T, Aro H, Marttunen M, Haukkala A. 2016. Self-esteem and body mass index from adolescence to mid-adulthood. A 26-year follow-up. Int J Behav Med 23(3):355–363. https://doi.org/10.1007/s12529-015-9529-4
Lee PY, Cheah WL, Chang CT. 2012. Childhood obesity, self-esteem and health-related quality of life among urban primary schools children in Kuching, Sarawak, Malaysia. Mal J Nutr 18(2):207–219.
Luciano EC, Orth U. 2017. Transition in romantic relationship and development of self-esteem. J Pers Soc Psychol 112(2):307–328. https://sci-hub.se/https://psycnet.apa.org/doi/10.1037/pspp0000109
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Minev M, Petrova B, Mineva K, Petkova M, Strebkova R. 2018. Self-esteem in adolescents. Trakia J Sci 16(2):114–118. https://doi.org/10.15547/tjs.2018.02.007
Moksnes UK, Espnes GA. 2012. Self-esteem and emotional health in adolescents—Gender and age as potential moderators. Scand J Psychol 53(6):483–489. https://doi.org/10.1111/sjop.12021
Naeimi AF, Haghighian HK, Gargari BP, Alizadeh M, Rouzitalab T. 2016. Eating disorders risk and its relation to self-esteem and body image in Iranian university students of medical sciences. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity 21:597–605 https://doi.org/10.1007/s40519-016-0283-7
Naing NN. 2009. A Practical Guide on Determination of Sample Size in Health Science Research. Sample Size Determination In Descriptive Studies. Kelantan (KL): Pustaka Aman Press Sdn. Bhd.,
Pengpid S, Peltzer K. 2018. Risk of disordered eating attitudes and its relation to mental health among university students in ASEAN. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity 23(3):349–355. https://doi.org/10.1007/s40519-018-0507-0
Pitil PP, Ghazali SR. 2022. Overweight and obesity: A study among university students in Sarawak, Malaysia. Int J Health Promot Educ 1–13. https://doi.org/10.1080/14635240.2022.2040380
Ren X, Chen Y, He L, Jin Y, Tian L, Lu M, Lu W, Ding L, Guo D, Wang L et al. 2015. Prevalence of underweight, overweight and obesity in university students from the region of Anhui (China). Nutr Hosp 31(3):1089–1093. https://doi.org/10.3305/nh.2015.31.3.8395
Rosenberg M. 1989. Society and the Adolescent Self-Image. Revised edition. Middletown (CT): Wesleyan University Press.
Sajwani R, Shoukat S, Raza R, Shiekh M, Rashid Q, Siddique M, Panju S, Raza H, Chaudhry S, Kadir MM. 2009. Knowledge and practice of healthy lifestyle and dietary habits in medical and non-medical students of Karachi, Pakistan. J Pak Med Assoc 59(9):650–5.
Sari N, Noviasty R, Ifroh RH. 2021. Dietary behavior and the risk of developing eating disorders among adolescent girls who participate in modern dance. J Gizi Pangan 16(28):81–88.
Stavrou P. 2018. How does a woman experience bulimia nervosa? the link between bulimia nervosa, low self‒esteem and insecure attachment: A phenomenological approach. J Psychol Clin Psychiatry 9(5):502–503. https://doi.org/10.15406/jpcpy.2018.09.00580
Suhaimi NF, Ibrahim Z, ‘Asyura Adznam SN, Md Noor S. 2020. Sleep quality and body weight status of Malaysian university students. Malays J Nutr 26(3):461–470. https://doi.org/10.31246/MJN-2020-0048
Tan ST, Tan CX, Tan SS. 2021. Physical activity, sedentary behavior, and weight status of university students during the COVID-19 lockdown: a cross-national comparative study. Int J Environ Res Public Health 18(7125): https://doi.org/10.3390/ijerph18137125
Tienxhi JY. 2017. The gender gap in Malaysian public universities: Examining the lost boys. J Int Comp Educ 6(1):1–16. https://doi.org/10.14425/jice.2017.6.1.0116
Tomiyama AJ, Carr D, Granberg EM, Major B, Robinson E, Sutin AR, Brewis Alexandra. 2018. How and why weight stigma drives the obesity “epidemic” and harms health. BMC Medicine 16(1):1–6. https://doi.org/10.1186/s12916-018-1116-5
Ümmet D. 2015. Self-esteem among college students: A study of satisfaction of basic psychological needs and some variables. Procedia Soc Behav Sci 174:1623–1629. https://doi.org/10.1016/j.sbspro.2015.01.813
Vasantha Raju NNSH, Harinarayana NS 2016. Online Survey Tools: A Case Study Of Google Forms. National Conference on Scientific, Computational & Information Research Trends in Engineering, (1–12), 30th January. Mysore (IN): GSSS Institute of Engineering and Technology for Women.
[WHO] World Health Organization. 2000. WHO Consultation on Obesity (1999: Geneva, Switzerland) & World Health Organization. Obesity: Preventing and managing the global epidemic: Report of a WHO consultation. https://iris.who.int/handle/10665/42330 [Accessed 5th April 2024].
Wager J, Lüdtke O, Jonkmann K, Trautwein U. 2013. Cherish yourself: Longitudinal patterns and conditions of self-esteem change in the transition to young adulthood. J Pers Soc Psychol 104(1):148–163. https://doi.org/10.1037/a0029680
Wilson GT, Grilo CM, Vitousek KM. 2007. Psychological treatment of eating disorders. Am Psychol 62(3):199–216. https://doi.org/10.1037/0003-066X.62.3.199
Yusoff NR, Shukri M. 2020. Self–esteem and perfectionism as predictors of eating disorders among university students. UMT Jur 2(4):115–122. https://doi.org/10.46754/umtjur.v2i4.185
Zainal NH, Romziman NS, Aminuddin BA, Idros SAKS, Wajih WAS. 2021. The relationship of body image perception, self-esteem and academic performance in University of Cyberjaya (UoC) Undergraduates. Mal J Med Health Sci 17(11):33–39.
Alotaibi N, Al-Sayegh N, Nadar M, Shayea A, Allafi A, Almari M. 2021. Investigation of health science students’ knowledge regarding healthy lifestyle promotion during the spread of COVID-19 Pandemic: A randomized controlled trial. Front Public Health 9:774678. https://doi.org/10.3389/fpubh.2021.774678
Arsandaux J, Montagni I, Macalli M, Bouteloup V, Tzourio C, Galéra C. 2020. Health risk behaviors and self-esteem among college students: Systematic review of quantitative studies. Int J Behav Med 27(2):142–159. https://doi.org/10.1007/s12529-020-09857-w
Azman A, Singh PSJ, Isahaque A. 2021. Implications for social work teaching and learning in Universiti Sains Malaysia, Penang, due to the COVID-19 pandemic: A reflection. Qual Soc Work 20(1–2):553–560. https://doi.org/10.1177/1473325020973308
Bujang MA. 2021. A step-by-step process on sample size determination for medical research. Malays J Med Sci 28(2):15–27. https://doi.org/10.21315/mjms2021.28.2.2
Chan YL, Samy AL, Tong WT, Islam MA, Low WY. 2020. Eating disorder among Malaysian university students and its associated factors. Asia Pac J Public Health 32(6–7):334–339. https://doi.org/10.1177/1010539520947879
Chaudhari B, Tewari A, Vanka J, Kumar S, Saldanha D. 2017. The relationship of eating disorders risk with body mass index, body image and self-esteem among medical students. Ann Med Health Sci Res 7(3):144–149.
Fakaruddin FN, Tharbe IHA. 2018. Self-esteem and Emotional Intelligence Among Students in a Public Higher Learning Institution in Malaysia. Proceedings of The Universitas Indonesia International Psychology Symposium for Undergraduate Research (UIPSUR 2017) (page 243–248), 24–25th September. Jakarta (ID): Universitas Indonesia.
García JA, Olmos FC, Matheu ML, Carreño TP. 2019. Self esteem levels vs global scores on the Rosenberg self-esteem scale. Heliyon 5(3):1–17. https://doi.org/10.1016/j.heliyon.2019.e01378
Garner DM. 2004. Eating Attitudes Test (EAT-26): Scoring and interpretation. https://www.eat-26.com/eat-26/ [Accessed 22nd March 2024].
Gilbert N, Meyer C. 2005. Fear of negative evaluation and the development of eating psychopathology: A longitudinal study among nonclinical women. Int J Eat Disord 37(4):307–312. https://doi.org/10.1002/eat.20105
Keane L, Loades M. 2017. Low self-esteem and internalizing disorders in young people – a systematic review. Child and Adolescent Mental Health 22(1):4–15. https://doi.org/10.1111/camh.12204
Keshk MM, Fahim HI, Hassan AM, Boulos DN, Sector P. 2019. Body image perception and self-esteem among university students in Cairo. Egypt J Community Med 37(1):82–96. https://doi.org/10.21608/ejcm.2019.28135
Kiviruusu O, Konttinen H, Huurre T, Aro H, Marttunen M, Haukkala A. 2016. Self-esteem and body mass index from adolescence to mid-adulthood. A 26-year follow-up. Int J Behav Med 23(3):355–363. https://doi.org/10.1007/s12529-015-9529-4
Lee PY, Cheah WL, Chang CT. 2012. Childhood obesity, self-esteem and health-related quality of life among urban primary schools children in Kuching, Sarawak, Malaysia. Mal J Nutr 18(2):207–219.
Luciano EC, Orth U. 2017. Transition in romantic relationship and development of self-esteem. J Pers Soc Psychol 112(2):307–328. https://sci-hub.se/https://psycnet.apa.org/doi/10.1037/pspp0000109
McLean CP, Utpala R, Sharp G. 2022. The impacts of COVID-19 on eating disorders and disordered eating: A mixed studies systematic review and implications. Front Psychol 13:926709. https://doi.org/10.3389/fpsyg.2022.926709
Minev M, Petrova B, Mineva K, Petkova M, Strebkova R. 2018. Self-esteem in adolescents. Trakia J Sci 16(2):114–118. https://doi.org/10.15547/tjs.2018.02.007
Moksnes UK, Espnes GA. 2012. Self-esteem and emotional health in adolescents—Gender and age as potential moderators. Scand J Psychol 53(6):483–489. https://doi.org/10.1111/sjop.12021
Naeimi AF, Haghighian HK, Gargari BP, Alizadeh M, Rouzitalab T. 2016. Eating disorders risk and its relation to self-esteem and body image in Iranian university students of medical sciences. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity 21:597–605 https://doi.org/10.1007/s40519-016-0283-7
Naing NN. 2009. A Practical Guide on Determination of Sample Size in Health Science Research. Sample Size Determination In Descriptive Studies. Kelantan (KL): Pustaka Aman Press Sdn. Bhd.,
Pengpid S, Peltzer K. 2018. Risk of disordered eating attitudes and its relation to mental health among university students in ASEAN. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity 23(3):349–355. https://doi.org/10.1007/s40519-018-0507-0
Pitil PP, Ghazali SR. 2022. Overweight and obesity: A study among university students in Sarawak, Malaysia. Int J Health Promot Educ 1–13. https://doi.org/10.1080/14635240.2022.2040380
Ren X, Chen Y, He L, Jin Y, Tian L, Lu M, Lu W, Ding L, Guo D, Wang L et al. 2015. Prevalence of underweight, overweight and obesity in university students from the region of Anhui (China). Nutr Hosp 31(3):1089–1093. https://doi.org/10.3305/nh.2015.31.3.8395
Rosenberg M. 1989. Society and the Adolescent Self-Image. Revised edition. Middletown (CT): Wesleyan University Press.
Sajwani R, Shoukat S, Raza R, Shiekh M, Rashid Q, Siddique M, Panju S, Raza H, Chaudhry S, Kadir MM. 2009. Knowledge and practice of healthy lifestyle and dietary habits in medical and non-medical students of Karachi, Pakistan. J Pak Med Assoc 59(9):650–5.
Sari N, Noviasty R, Ifroh RH. 2021. Dietary behavior and the risk of developing eating disorders among adolescent girls who participate in modern dance. J Gizi Pangan 16(28):81–88.
Stavrou P. 2018. How does a woman experience bulimia nervosa? the link between bulimia nervosa, low self‒esteem and insecure attachment: A phenomenological approach. J Psychol Clin Psychiatry 9(5):502–503. https://doi.org/10.15406/jpcpy.2018.09.00580
Suhaimi NF, Ibrahim Z, ‘Asyura Adznam SN, Md Noor S. 2020. Sleep quality and body weight status of Malaysian university students. Malays J Nutr 26(3):461–470. https://doi.org/10.31246/MJN-2020-0048
Tan ST, Tan CX, Tan SS. 2021. Physical activity, sedentary behavior, and weight status of university students during the COVID-19 lockdown: a cross-national comparative study. Int J Environ Res Public Health 18(7125): https://doi.org/10.3390/ijerph18137125
Tienxhi JY. 2017. The gender gap in Malaysian public universities: Examining the lost boys. J Int Comp Educ 6(1):1–16. https://doi.org/10.14425/jice.2017.6.1.0116
Tomiyama AJ, Carr D, Granberg EM, Major B, Robinson E, Sutin AR, Brewis Alexandra. 2018. How and why weight stigma drives the obesity “epidemic” and harms health. BMC Medicine 16(1):1–6. https://doi.org/10.1186/s12916-018-1116-5
Ümmet D. 2015. Self-esteem among college students: A study of satisfaction of basic psychological needs and some variables. Procedia Soc Behav Sci 174:1623–1629. https://doi.org/10.1016/j.sbspro.2015.01.813
Vasantha Raju NNSH, Harinarayana NS 2016. Online Survey Tools: A Case Study Of Google Forms. National Conference on Scientific, Computational & Information Research Trends in Engineering, (1–12), 30th January. Mysore (IN): GSSS Institute of Engineering and Technology for Women.
[WHO] World Health Organization. 2000. WHO Consultation on Obesity (1999: Geneva, Switzerland) & World Health Organization. Obesity: Preventing and managing the global epidemic: Report of a WHO consultation. https://iris.who.int/handle/10665/42330 [Accessed 5th April 2024].
Wager J, Lüdtke O, Jonkmann K, Trautwein U. 2013. Cherish yourself: Longitudinal patterns and conditions of self-esteem change in the transition to young adulthood. J Pers Soc Psychol 104(1):148–163. https://doi.org/10.1037/a0029680
Wilson GT, Grilo CM, Vitousek KM. 2007. Psychological treatment of eating disorders. Am Psychol 62(3):199–216. https://doi.org/10.1037/0003-066X.62.3.199
Yusoff NR, Shukri M. 2020. Self–esteem and perfectionism as predictors of eating disorders among university students. UMT Jur 2(4):115–122. https://doi.org/10.46754/umtjur.v2i4.185
Zainal NH, Romziman NS, Aminuddin BA, Idros SAKS, Wajih WAS. 2021. The relationship of body image perception, self-esteem and academic performance in University of Cyberjaya (UoC) Undergraduates. Mal J Med Health Sci 17(11):33–39.
Authors
Mohd Azman A. N., ShamsudinJ., & Mohd NorZ. (2024). Self-Esteem, Body Mass Index Status and Risk of Eating Disorders among Health Sciences Students. Jurnal Gizi Dan Pangan, 19(3), 137-146. https://doi.org/10.25182/jgp.2024.19.3.137-146
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