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Weight Satisfaction and Dieting Practices among College Males in Taiwan

Department of Nutrition, Chungshan Medical and Dental College, TAIWAN (Y.W., S.-L.C.)
Department of Food and Nutrition, Providence University, TAIWAN (Y.-C.C., M.-F.W.)
Department of Nutrition, Tokushima University, JAPAN (S.Y.)

Address reprint requests to: Yueching Wong, MS, RD, Department of Nutrition, Chungshan Medical and Dental College, 110 Sec 1, Jien-Kuo North Road, Taichung City 402, TAIWAN, R.O.C.

	ABSTRACT

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Objective: To obtain baseline data regarding body mass index (BMI), weight satisfaction and weight perception in male college students. Approaches used to lose weight and characteristics of dieters were also investigated.

Methods: Written questionnaires and height and weight measurements were used to collect data. Nine-hundred thirty male college students selected by multiple stage sampling among colleges in Taiwan participated in this study. Simple frequency and ANOVA were used to analyze data. Post hoc analyses were performed with the LSD test when the F ratio for the ANOVA was significant at p<0.05.

Results: The mean BMI for all subjects was 21.7. Males with a BMI 22.5 are considered thin by Taiwanese and world standards. Yet 34% of these males were attempting to lose weight and 14% percent perceived themselves as either overweight or obese. Exercise was the main approach to losing weight for subjects in all weight categories. Subjects in the dissatisfied/dieting group tended to measure body weight more frequently (p<0.05), spent more time exercising and reading nutrition information (p<0.05) and skipped breakfast and lunch more frequently (p<0.05) than non-dieters. Male dieters ate fewer vegetables and less meat than non-dieters.

Conclusions: Male college students had frequent misconceptions and dissatisfaction with their body weight. Behavioral characteristics among those dissatisfied with their weight indicate they are at risk for developing eating disorders.

Key words: weight satisfaction, characteristics of dieters, male college students

	INTRODUCTION

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Anorexia nervosa and bulimia nervosa occur at alarming rates in Western countries [1,2], and the frequency of these ailments in Eastern countries such as Japan [3] and Hong Kong [4] is increasing. The most common onset for these eating disorders occurs around age 18 [5], but they are prevalent throughout adolescence and early adulthood. Rosen and Gross reported that 63% of adolescent girls and 16% of adolescent boys are already trying to lose weight [6]. The much lower incidence of boys trying to lose weight is probably because there is less social pressure for young boys to be thin [7]. Society idolizes strong, muscular men, and many young men try to gain weight in order to attain a larger and more muscular physique [6]. However, two studies [8,9] report that some men are concerned about being overweight and diet in an attempt to achieve a leaner stature. These men are frequently dissatisfied with their body image and practice dieting, binge eating and purging behaviors [10].

Social judgment of appearance is partly responsible for unrealistic weight goals sought by young adults. Overestimation of body fatness and inappropriate body image are closely related to developing eating disorders [11]. Both unrealistic weight goals [12] and misperception of body image [13] are major risk factors responsible for the increasing incidence of eating disorders.

Dieting is one of the most common practices employed to induce weight loss and is often a precursor to an eating disorder [14]. Hsu [15] has reported that the incidence of dieting is directly proportional to the prevalence of eating disorders. Dieting occurs in a high percentage of females regardless of their weight category [8,16]; however, when young men apply dieting as a weight control practice, they are just as drastic as young women [17]. Studies of eating disorders are mainly focused on females, and there is a lack of information concerning male eating behavior and risk factors for eating disorders. Further, there is a dearth of information on male eating and dieting practices in the Eastern countries.

This study was designed to obtain baseline data regarding current body weight (CBW), desired body weight (DBW), body-weight satisfaction, self-perceived weight categories, nutrition knowledge, attitude toward nutrition and prevalence of dieting among male college students in Taiwan. The target population consisted entirely of non-nutrition-major male college students in Taiwan. Multiple-stage sampling was used to select the subjects. The characteristics of male dieters and non-dieters are also discussed in this study.

	METHODS

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Sample Selection
The target population consisted entirely of non-nutrition-major male college students in Taiwan. Subjects were selected by multiple-stage sampling in the following order: colleges, schools, majors, then classes. The majors included in the study were agriculture, business, education, law, literature, mechanical engineering, journalism and science. One thousand and seventy male undergraduate students were selected for this study. The subjects’ ages were from 19 to 24 years with the mean age of 20.94±2.37 years.

Instrument and Data Collection
Data was collected by administration of a written questionnaire that has been described in detail by Wong and Huang [18]. The questionnaire contained items to measure 1) the students’ concerns and behaviors related to body weight, 2) their general nutrition knowledge, 3) their attitudes toward nutrition and 4) their current nutrition-related practices.

Three representative questions asked to assess students’ concerns and behaviors related to body weight were (1) What is your current weight category? (2) Do you plan to lose weight? (3) If you plan to "lose weight," what method will you use to do so? The possible responses were "dieting," "exercise," "taking medicine" and "vomiting."

The general nutrition knowledge of the subjects was assessed by 34 items divided into four domains. The domains were basic nutrition concepts (nine items), nutrient sources (nine items), disease and nutrition (nine items) and general dietary guidelines (seven items). A score of one was given for each correct response with a maximum score of 34 for the knowledge test.

Twenty-five questions were used to determine attitudes toward nutrition, foods and eating habits. A 5-point response scale ranging from "strongly disagree" to "strongly agree" was utilized for all questions. Sample statements from this instrument were "I should take a multiple vitamin supplement every day" and "I think that it is very important to eat breakfast every day." The best possible overall score on the attitude section of the questionnaire was 125.

Questions relating food intake and eating behavior were included in the "current nutrition practices" section. Sample questions were "How many servings of fruit do you eat in a day?" and "How many times do you skip lunch in a week?" The respondents were also asked to report two demographic characteristics: age and gender.

Questionnaires were distributed to the subjects, and height and body weight were measured by research assistants after completion of the questionnaires. Body Mass Index (BMI) was computed from weight and height measurements as kg/m². "Desired BMI" (DBMI) was calculated from subjects’ self-reported "desired body weight (DBW)" and measured height.

Subjects were classified into five categories; these were "severely underweight" (BMI<17.6), "underweight" (17.6BMI<19.4), "acceptable" (19.4BMI22.5), "overweight" (22.5<BMI25.8) and "obese" (BMI>25.8). These weight categories were classified by the cutoff points at "below 5^th," "5^th to 25^th," "25^th to 75^th," "75^th to 95^th" and "above 95^th" percentile according to BMI distribution of 20-to-24-year-old males in Taiwan [19]. Subjects were divided into three subgroups according to their reported weight satisfaction and their dieting practice in order to examine characteristics of dieters and non-dieters. The three subgroups were (1) "satisfied/not dieting" (S/ND), (2) "dissatisfied/dieting" (DS/D) and (3) "dissatisfied/not dieting" (DS/ND).

Data Analysis
The Statistical Package for the Social Science (SPSS, Version 6.1, 1996) [20] was used for data compilation and statistical analysis. The numbers and percentages for body-weight perception and weight-loss methods were calculated by frequency. The results are presented as means ±SD. One-way analysis of variance (ANOVA) was used to compare means among groups. Post hoc analyses were performed with the Least Significant Difference (LSD) test when the F ratio for the ANOVA was significant at p<0.05.

	RESULTS

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Study Participation
Out of the 1,070 randomly selected subjects, 125 potential subjects were absent during the days that the test was performed. Ten subjects did not return the questionnaire, and five subjects left before weight and height measurements could be obtained. Thus, 930 subjects completed the questionnaire and were measured for height and weight.

BMI, Desired Body Weight and Weight Perceptions
The mean actual BMI for all subjects was 21.65 ±2.47 and was similar to the mean desired BMI of 21.77 ±1.63. Table 1 compares self-perceived weight categories to standard weight categories for 20-to-24-year-old males in Taiwan [19]. In general, the subjects’ self-perceived weight categories were similar to the standard weight categories. However, 50% of the subjects in the obese category felt they were overweight, but not obese, and 36.4% of the severely underweight subjects acknowledged they were underweight, but did not feel they were severely underweight.

	DISCUSSION

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Approximately two thirds of the subject population had a BMI of 22.5, which is considered underweight or acceptable weight by Taiwanese [19], WHO (World Health Organization, [21]) and US (United States, [22]) standards. Despite not being overweight, 34% of these subjects were attempting to lose weight. However, the percentage of males attempting to lose weight was smaller than what Wong and Huang [18] found for female college students in Taiwan. That study reported nearly 60% of females in the acceptable weight category utilized methods to lose weight even though they were not overweight.

Drewnowski et al. [8] and Herzog et al. [16] found female dissatisfaction with body weight is not dependent on whether women are overweight, but instead characterizes women of all weight categories. We found similar results for college-age males. Fourteen percent of the males with BMI 22.5 perceived themselves as either overweight or obese. Dissatisfaction with body weight and overestimation of body fat frequently lead to chronic dieting and eating disorders [23]. An inverse relationship between BMI and satisfaction with body weight was observed in males as was similarly observed in females [24,25].

The percentage of subjects in all weight categories selecting exercise as the main method to lose weight was greater than the percentage selecting dieting (Table 2). This result is similar to that found in previous studies [8,26]; males are more likely to increase physical activity to lose weight than restrict food intake.

Similar to Taiwanese female college students [18], males in the DS/D group tended to measure their weight more often, and they spent more time exercising and reading nutrition information than the other subjects (p<0.05) (Table 3). These results suggest the DS/D group had a great preoccupation with weight status and with creating a negative energy balance. However, there was no significant difference among groups in the frequency of eating fried foods. Other studies report that restrained eaters consume less energy-dense food, that is, less meat but more vegetables, than unrestrained individuals [27,28]. We also found that the DS/D group consumed meat less frequently than the non-dieting groups. However, the companion study of female college students in Taiwan [18] found that female dieters and non-dieters ate meat with similar frequency. Future studies should focus on quantifying differences in food consumption between dieters and non-dieters and between the genders within college populations in Taiwan.

Dieters are often preoccupied with food and calorie counting, and they are avid readers of articles about food and body weight in the popular press. This gives the impression that they are very knowledgeable about nutrition [28]. However, our results showed that members of the DS/D group did not score higher in general nutrition knowledge or attitude toward nutrition than did members of the other two groups. These results are similar to those reported by Reiff and Reiff [28] and Wong and Huang [18]. Also, Beaumont and Chambers found 25% of the subjects with eating disorders had nutrition knowledge scores below that of controls [29]. Moreover, a similar frequency in consuming snacks and fried foods and a lower frequency in consuming low-energy vegetables suggest that the DS/D group either lacks knowledge concerning the energy content of these foods or that the energy content of food is not the main criterion governing food selection.

Another behavior typical of weight-conscious individuals is the practice of skipping lunch [24]. Our results showed that the dieters skipped lunch more frequently than non-dieters; this finding is similar to those of Mortenson et al. [24] and Wong and Huang [18]. We also found that members of the DS/D group skipped breakfast more frequently than members of other groups; however, this is a different finding from that in both Mortenson’s [24] and Wong and Huang’s [18] studies of females. Males in the DS/D group ate bedtime snacks less frequently than subjects in the S/ND or in the DS/ND group. Similar results were reported for female college students in Taiwan [18].

Most studies on eating disorders focus on females. The results of the present study showed that college males in Taiwan have a relatively low BMI (mean BMI=21.7). Yet a significant number of students in all weight categories were dissatisfied with their weight and were exercising or dieting to lose weight. Since these behaviors frequently lead to eating disorders, health professionals should be alert for eating disorders in both young males and females. Recent studies have related males’ eating disorders to their sexual orientation [30,31]. Whether there is a relationship between eating disorders and sexual preference in Taiwanese male college students remains to be determined.

	ACKNOWLEDGMENTS

 
The authors thank Dr. Maurice R. Bennink for his help in preparation of the manuscript.

Received November 1, 1998. Accepted March 1, 1999.

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