Academic journal article Perspectives in Public Health

An Exploration of the Relationship between Self-Esteem, Health Knowledge, Chronic Dieting and Body Shape Accuracy

Academic journal article Perspectives in Public Health

An Exploration of the Relationship between Self-Esteem, Health Knowledge, Chronic Dieting and Body Shape Accuracy

Article excerpt

Key words

health knowledge; selfesteem; chronic dieting; body image accuracy


Aims: To explore the relationship between self-esteem, health knowledge, chronic dieting and perceived body size and shape.

Method: The study design was cross-sectional in nature; 41 women from diet and health clubs participated by completing a questionnaire containing scales that assessed levels of self-esteem, health knowledge and chronic dieting. They also responded to a body shape accuracy instrument that was designed to measure accurately the percentage of over- or underestimation of body size and shape.

Results: Correlational analyses showed that there was a statistically significant negative relationship between self-esteem and chronic dieting and a significant positive relationship between chronic dieting and health knowledge. Chi squared (χ^sup 2^) analysis revealed that women with higher levels of health knowledge had low self-esteem and that low self-esteem women were significantly more likely than women with high self-esteem to underestimate their body size.

Conclusions: Levels of health knowledge and self-esteem appear to play a complex role in chronic dieting and subjective perceptions of body shape and it is an area that warrants further investigation. The body shape scale proved to be a successful instrument and further trials using this scale are recommended.


It has been shown that gaining knowledge in a particular area can help build informed choices. In the health domain one study has shown that being informed about the risk for skin cancer correlated with decisive preventative action, or at least helped in future experiences.1 In the UK, informing the public about health issues has led to a recent investment in public awareness campaigns such as Change4Life.2 The underlying conjecture is that educating individuals about why to change their lifestyle and how, such as taking more exercise and cutting down on high-fat foods, could facilitate a change in unhealthy habits.3 However, knowledge does not always have a positive impact on behaviour and it has been shown that physical education and home economic teachers showed high characteristics of bulimia and anorexia, a surprising finding given their occupations.4 Maladaptive behaviour was also shown in an intervention study where adolescent girls were educated about eating disorders in order to raise awareness and facilitate preventative behaviour.5 Results showed initial raised awareness, but this changed six months after the intervention where an increase of dietary restraint was reported. However, there was no control group with which to compare dietary habits and the extent of dietary restraint practised by the adolescents is unclear because there was no further follow-up. Thus, some authors claim that there is a more complex relationship between healthy dietary behaviour and health knowledge than may previously have been thought, and it is clear that further studies are needed to establish the direction of the relationship.6

Individuals' health behaviour may also be related to their weight and body image.7 Body image can be described as an individual's perception of their body, which includes size estimation and attractiveness,8 and it has been shown that over/underestimation of perceived body image is apparent in all shapes and sizes of women.9 Explanations of distorted body shape image include individuals' perceptions of their ideal body size,10 self-esteem11 and media image exposure.9 One area that has not been explored as thoroughly is the relationship between body image and health knowledge. While higher levels of general education achievement have been shown to be associated with more accurate body shape estimation,12 the relationship between specific knowledge (such as health knowledge) is not thoroughly documented. It is expected that this association is similar to dietary behaviour and knowledge and is expected to be complex. …

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