The mean age and BMI of participants were 16.2 ± 0.9 years and 24.3 ± 8.0 kg/m2, respectively. The majority of participants had married parents and about half of both mothers and fathers of participants had academic degrees. More than two thirds of participants’ mothers were housewives and the majority of participants’ fathers were employed. Residential, paternal and maternal characteristics of study participants are presented in Table 1.
Table 1
Descriptive statistics of study participants
|
Boys
(n = 42)
|
Girls
(n = 42)
|
Total
(n = 84)
|
Residential area n(%)*
|
|
|
|
- North of Tehran
|
20(47.6)
|
28(66.7)
|
48(57.1)
|
- South of Tehran
|
22(52.4)
|
14(33.3)
|
36(42.9)
|
Marital status of parents n(%)
|
|
|
|
- Married
|
33(84.6)
|
37(90.2)
|
70(87.5)
|
- Divorced/widowed
|
6(15.4)
|
4(9.8)
|
10(12.5)
|
Maternal level of education n(%)
|
|
|
|
- Primary
|
4(10.3)
|
9(21.4)
|
13(16.0)
|
- Secondary
|
13(33.3)
|
13(31.0)
|
26(32.1)
|
- Higher
|
22(56.4)
|
20(47.6)
|
42(51.9)
|
Maternal working status n(%)
|
|
|
|
- Housewife
|
25(67.6)
|
30(71.4)
|
55(69.6)
|
- Employed
|
12(32.4)
|
12(28.6)
|
24(30.4)
|
Paternal level of education n(%)
|
|
|
|
- Primary
|
5(13.5)
|
10(24.4)
|
15(19.2)
|
- Secondary
|
12(32.4)
|
10(24.4)
|
22(28.2)
|
- Higher
|
20(54.1)
|
21(51.2)
|
41(52.6)
|
Paternal working status n(%)
|
|
|
|
- Employed
|
34(91.9)
|
37(90.3)
|
71(91.0)
|
- Unemployed/retired
|
3(8.1)
|
4(9.7)
|
7(9.0)
|
* North and south areas represents high and low socio-economic status, respectively |
The body image components that emerged from the data were categorized into three main themes: 1) perceived face/hair, 2) perceived body and 3) perceived physical functioning. The first two themes are related to body appearance, while the latter refers to how body functions. Themes, subthemes, and codes are summarized in Table 2.
Table 2
Themes
|
Subthemes
|
Codes
|
Perceived face/hair
|
Facial features
|
- Size and shape of nose
- Size, shape and color of eyes
- Characteristics of mouth
- Smoothness and color of skin
|
Facial shape/form
|
- Jawline shape
- Cheekbones shape
- Natural face
|
Hair
|
- Scalp Hair
- Eyelash, eyebrow and beard
|
Perceived body
|
Body size
|
- Body weight
- Body height
|
Body shape
|
- Body waist and abdomen
- Body muscles
- Feminine curves
|
Bone structure
|
- Neck length
- Clavicle form
- Knee angle
- Shoulder width
- Posture
|
Perceived physical functioning
|
Physical ability
|
- Physical readiness
- Routine activities
|
Physical health
|
- Lack of disability and illness
- Abnormal symptoms
|
Voice tone
|
None
|
Theme 1: Perceived face/hair
This theme refers to the main characteristics of adolescents’ face/hair which could affect their perception of and satisfaction with their body. These facial characteristics were categorized into three main subthemes including: 1) facial features, 2) facial shape/form and 3) hair. In the current study, girls more frequently focused on their facial appearance than did boys. Regarding facial features, most participants indicated that their nose, eyes, skin and mouth were the most important components of their face. Characteristics related to the nose and mouth were mostly referenced by girls, with a considerable number of girls commenting on the size and shape of their nose: “I see some flaws in my face that I would like to change; for example, I don't like my nose, it may need cosmetic surgery when I grow older” (a 16- year old girl). All comments related to characteristics of the mouth were stated by girls, which mainly focused on teeth “If I have money, after doing vision correction surgery, I would spend the remaining on straightening my teeth” (a 16-year old girl), and lips “Beautiful lips must be plump” (a 17- year old girl). On the other hand, characteristics related to skin and eyes were addressed by both girls and boys. In terms of eyes, participants commonly referred to size: "I personally like a person who has pretty eyes, beautiful eyes like big eyes." (a 17-year old boy) and color: “I hate the dark color of my eyes” (a 15-year old girl). Regarding skin characteristics, most participants commented on acne as an unpleasant factor that brought them dissatisfaction, for example: “The first change that I would make in my body would be in my face, because I have acne on my face for almost 5–6 years, it’s always been a desire for me to use something like a sticker on my acne that would clear it up” (a 15-year old girl), and “But for a while now I am not satisfied with my face because of these pimples” (a 16-year old boy).
Facial shape/form was another subtheme that was referenced frequently, such as jawline shape, cheekbone shape and natural face (i.e., not cosmetically enhanced). These characteristics were mentioned more frequently by girls than boys. Jawline shape was a characteristic that was mentioned by both girls and boys: “For example, some individuals have angles on their faces, when you look at them this part of their face (the participant referred to the angles of her chin and ears) is angled.” (a 16-year old girl). Another comment made by a boy in reference to his jawline shape was: “In terms of face form, I'm not very satisfied with myself at all, I like certain things that I don't have, so I'm not satisfied. For example, an angled face.” (a 17-year old boy). Cheekbone shape and natural face were two characteristics that emerged from comments made only by girls: “An attractive girl has cheekbones” (a 17- year old girl), and “In my opinion, she [an Iranian actress] is very good, she is whatever she is, she doesn’t have any cosmetic surgery” (a 16-year old girl).
Another feature of the face that was pointed out by both adolescent boys and girls was hair. Adolescents mentioned characteristics related to the density and color of the hair on their head: “I have hair loss and I cannot make a series of hairstyles because of my little hair, so I lose my body points because of it” (a 16- year old girl) and “Another feature of an ideal body is blond hair” (a 17-year old boy). In addition, facial hair including eyelashes, eyebrows and a beard were other characteristics that influenced adolescents’ perception of body image: “Some individuals have very long lashes, some have very good eyebrows” (a 17-year old boy), and “He has a beautiful face, his beard is nice” (a 16- year old boy).
Theme 2: Perceived body
The second main theme that emerged from the data is perceived body which mainly focused on its shape and size. This concept was further categorized into three subthemes: 1) body size, 2) body shape and 3) bone structure. Body size, more specifically body weight and height, was the most frequently discussed subtheme by both boys and girls. In terms of weight, most adolescent boys and girls were dissatisfied with their perceived excess weight:" I hate my thighs, I hate my abdomen, I hate my sides, I hate all my body! I’m not obese in just certain areas, I am overall obese.” (a 16-year old girl). “I'm overweight, a good body has a weight and height that are proportionate, being muscular doesn't matter.” (a 17-year old boy). On the other hand, a few of them were dissatisfied with their thinness: “I subtract my body score a bit because of being thin” (a 16-year old boy). In terms of body height, boys and most girls indicated that a feature of an ideal body is tall height: “If I wanted to give a score to my body, I would give 20 minus the score that people would give to height. If I was a step taller, I'd give it 20.” (a 16-year old boy). “For example I'm short, my height is not tall enough, I've always liked to be tall” (a 15- year old girl). However, a few girls were dissatisfied with their tall height and preferred to be shorter: “I don't like my height, I think I'm too tall” (a 16-year old girl).
Another subtheme of perceived body was body shape which mainly relates to the waist and abdomen, body muscles and feminine curves. Waist and abdomen were referred to by both boys and girls with a higher frequency in girls: “I am not very satisfied with myself for many years, for example, I sit down and say how big my abdomen is, it is really big! I mean for example when I wear tight clothes it seems that it is bigger than other parts” (a 15-year old girl).” The ideal body should have no abdomen, no flank!” (a 16-year old boy). Adolescents, primarily boys, referred to a muscular body as an ideal body: “The body has to be in shape, because it's not just about being lean. Sometimes thinness makes the body ugly, a thin body with muscles has a good shape, and an individual must go to gym and have toned muscle.” (a 15-year old girl). “Actually, a good body should have a six-pack” (an 18-year old boy). Feminine curves was exclusively mentioned by girls, in which bust and hips were areas that were emphasized: “It is obvious, an attractive body should be like an hourglass!” (a 17-year old girl).
With regards to the next subtheme of perceived body entitled as bone structure, comments made were related to different parts of skeletal structure. Some comments referring to neck length, clavicle form and knee angle were made only by girls: “An ideal body should have a long neck” (a 16-year old girl), and “An attractive body is a body with a distinct clavicle bone” (a 17-year old girl) and “The knee angle and its shape is important. For example, it is important whether it is x-shaped, bowed or normal.” (a 17-year old girl). Shoulder width was a bone structure characteristic that was exclusively pointed out by boys “I tried to create what I had in my mind, I was interested in body building and athletic body style and I tried to work out and broad shoulders was one of the things that mattered to me”. (a 17-year old boy). Finally, posture was another feature that was brought up by both adolescent girls and boys: “It's also really bad, like trying to wear something and you have a hump on your back! It's so ugly!” (a 15-year old girl) and “One point was my hunchback; for example, relatives said my mother, why does your son have a hunchback? And I was humiliated constantly” (a 16-year old boy).
Theme 3: Perceived physical functioning
In addition to face and body appearance, according to perspectives of current study participants, how the body functions influence adolescents’ perception regarding their bodies. The physical functioning theme had three main subthemes including 1) physical ability, 2) physical health and 3) voice. Physical ability referred to both physical readiness "Whenever we had a race with other kids, I was out of breath because I’m overweight, it gave me a bit of trouble, I was always the last person” (a 16-year old boy); “In my opinion, many of the effects of body shape are on body abilities rather than its appearance and beauty. I have understood this in my everyday life many times; for example, I went to the mountains with my family on holiday. Compared to my cousin who is very obese, I climbed up the mountain very quickly. Also my aunt who doesn’t exercise and get fit barely climbed up the mountain and she had a leg ache.” (a 16-year old girl) and ability for doing routine activities: “Obesity is not really good in some situations, for example, if an earthquake happen, I am slower than thin people, I may fall under the rubble” (a 17-year old boy). In terms of physical ability, adolescent boys focused more on physical readiness compared to adolescent girls.
Another feature of physical functioning referred to adolescents’ assessment of their physical health which encompassed two main components: lack of disability and illness, and abnormal symptoms. From the perspective of adolescents, physical functioning was tied to lack of illness “I don't give a full score to my body, because of the problems I have, like headache or the diseases I have, including sinusitis” (a 16-year old girl) and disability “I give myself a full score because I'm healthy, there are some people who don't even have hands” (a 15-year old boy). In addition, abnormal symptoms was another feature of physical functioning which influenced adolescents’ perceived body image: “I lose two points because I don’t have regular menstruation, for example, I menstruate every three months” (a 15-year old girl) which in some cases could also have negative effects on their social interactions “I also lose 5 points for having sweaty palms, because for example when I get in touch with someone, I feel sweaty and it hurts a lot.” (a 17-year old boy).
Voice was a component of physical functioning that was mainly mentioned by boys: "I am dissatisfied with my voice, for example, two years ago, my classmates made fun of my voice and said I sound like an addict". (a 16-year old boy), and “One of my friends has a six-pack and his voice is attractive, that's why everyone pays attention to him. For example, once we went to the park, everyone gathered around him.” (a 16-year old boy).