Abstract:
Objective: To determine if the perceived ideal body
size of urban women in Accra, Ghana influences current
body size.
Methods: The sample (n=2,814) consisted of Ghanaian
women aged 18 years and older, living in the Accra
Metropolitan Area. Data were collected between October
2008 and June 2009 in the Women’s Health Study
of Accra, Wave II household survey. Height (m),
weight (kg), waist (cm) and hip (cm) measurements
were used to calculate body mass index (BMI, measured
in kg/m2), waist circumference, and waist-to-hip
ratio. In addition to reported socio-demographic characteristics,
medical history, and exercise and diet history,
the standardized Stunkard Figure Rating Scale
(FRS) was used to identify silhouettes of varying body
sizes that most closely resemble a woman’s current
body image (CBI), the body image she sees as the ideal
for Ghanaian women (IBI), and the body image she
sees as healthiest (HBI). The validity of using the
standardized Stunkard FRS to assess body image in a
population of Ghanaian women was assessed using
Receiver Operating Curve (ROC) analysis. Household
wealth, a proxy for income, was assessed using an index
derived by principal components analysis from a
selection of 20 variables measuring quality of the
dwelling (e.g water source, sewage arrangements, type
of housing, roof etc.) and possession of household durable
goods (e.g. television, radio, iron, refrigerator and
car).1 Logistic and linear regression was used to test the
association between various socio-demographic characteristics,
BMI and body image satisfaction.
Results: Using the WHO criteria for BMI, 3.6% (95)
of women were underweight, 31.5% (828) normal
weight, 27.8% (730) overweight and 37.1% (973)
obese. In total, 64.9% of women sampled were either
overweight or obese. A WC of greater than 88 cm revealed
78.7% (2,113) obesity. A WHR cut-off for obesity
of 0.8 revealed 78.9% (2,119) obesity. ROC analysis
confirmed the validity of using the standardized
Stunkard FRS to assess body image in a population of
Ghanaian women. Age, relative wealth, being married,
having grown up in an urban environment and havingparity >2 are associated with higher risk of overweight
or obesity. Education level is not associated with overweight
status. Overall, 72.2% (1,936) of women were
dissatisfied with their current body size and 41.8% of
women preferred a smaller figure. Overweight and
obese women were significantly more likely than normal
weight women to desire weight loss (OR: 10.12,
CI: 8.04 – 12.72).
Conclusion: Ideal body image in urban, Ghanaian
women should not be viewed as an inhibitor to healthy
weight maintenance. Interventions should be designed
to help women achieve their ideal and healthy weights.