A representative sample of Palestinian female university students from different universities in West Bank, Palestine was included in this study. The mean body satisfaction scale BAS-2 score was 4.22 ± 0.74, which reflects a high degree of satisfaction among students. In contrast, high body dissatisfaction prevalence was found among Jordanian women in a study. 66% of Jordanian women wanted to lose weight and 13.7% wanted to gain weight (Madanat et al., 2011). Similarly, a study found that 87% of Saudi women attending fitness centers were dissatisfied with their body shape (Albawardi et al., 2021). This difference might be caused by the difference in age group, as the Jordanian study reported that older women desired more weight change (Madanat et al., 2011), and older Saudi women had higher body dissatisfaction (Albawardi et al., 2021).
Body image and eating disorders
A-SCOF test revealed that 40.3% of students had a positive result that indicates a presence of an eating disorder. As expected, students with positive results had significantly lower body satisfaction scores (3.92 ± .82) than those who had negative A-SCOF results (4.42 ± .62) (p < .001). Similarly, body dissatisfaction was associated with disordered eating behaviors in female undergraduate students in the UAE (Radwan et al., 2018; Thomas et al., 2010). The same relationship was reported in a Spanish study on female college students. It was found that a significant relationship between lower body satisfaction scores and a higher probability of having eating disorders (Aparicio-Martinez et al., 2019).
Body image and BMI
A significant relationship was found between BMI and body satisfaction (p < .001). Normal and underweight students had higher body satisfaction scores than overweight and obese students. And overweight students had higher body satisfaction levels than obese ones. This was also seen in Saudi women, where those with higher BMI had a significantly higher level of body image dissatisfaction (Albawardi et al., 2021; Aljadani, 2019). Likewise, Emirati studies reported that higher BMI was significantly related to higher body dissatisfaction for both women and men (Alharballeh & Dodeen, 2021; Radwan et al., 2019). Moreover, body satisfaction was significantly negatively correlated with BMI (r = .034, P-value < .001). This correlation was smaller than the correlation between BMI and women body image dissatisfaction found by a Saudi study (r = .135, P-value > 0.01) (Aljadani, 2019).
Body image and social media
The most used social media platform by students was Instagram (48.8%) followed by Facebook (37.7%). However, no significant relationship was found between the most used social media platform and body satisfaction among students in this study. A recent study found that spending 7 minutes on Instagram had a more negative effect on the body image of undergraduate females than Facebook. This was explained by the more image-focused content on Instagram (Engeln et al., 2020). However, the comparison in our study was between the overall usage of the different social media platforms rather than the effect of scrolling on them for a short time. Additionally, there could be a similar pattern of content on Facebook and Instagram exposed to our sample.
68.6% of students follow either models or celebrities on social media. Following models or celebrities was significantly negatively related to body satisfaction (p < .001). This agrees with the results if a study stated that following appearance-focused Instagram account was significantly related to body image concerns among young women living in Australia (Cohen et al., 2017). A study revealed that exposure to Instagram pictures of attractive celebrities and peers had a significantly greater negative effect on the body image of female university students compared to travel pictures. The study reported that appearance comparison was the reason behind this effect (Brown & Tiggemann, 2016). Similarly, a study found that female university students Facebook users had a significantly lower rate of their body image after comparing themselves with celebrities than comparing themselves with friends or peers (Fardouly & Vartanian, 2015). Perhaps this explanation leads us to another observation among our sample where lower body satisfaction was significantly related to following models or celebrities' nutritional advice (p < .05). Thus, students might follow such advice believing that they could have the similar body shape of models and celebrities they are comparing themselves with.
However, no significant relationship was found between engagement by like/share/comment on models or celebrities’ posts and body satisfaction. A study found that rather than the engagement with Instagram pictures; appearance comparisons negatively affected body image in female university students in the US (Hendrickse et al., 2017). Hence that, harmful comparing behavior may occur no matter social media users engage actively or passively with what they are exposed to.
Body image and social pressure
In this study, 24.5% and 15.1% of students received criticizing or mocking from their families and friends, respectively. Those family and friends' comments were significantly negatively related to body satisfaction (p < .001). A study in Emirati young women reported that many of them are being pressured by their families or friends about their body weight. This pressure was not only on obese or overweight women but some underweight women as well (Trainer, 2010). Another study reported that students living in the UAE were more influenced by family and friends' attitudes than media on their body image perception (Sreedharan & Antony, 2012). Moreover, the family influence was significantly related to disordered eating behaviors among Emirati university students. Besides, this study found that disordered eating behaviors were correlated with body image concerns (Radwan et al., 2018). A study on undergraduate females in the US reported that family influence was related to both body image dissatisfaction and bulimic symptoms (Kluck, 2010). Hence that family pressure may cause body image concerns that turn into behaviors. 39.1% of students in this study criticize or mock their body shape. Personal criticizing or mocking body shape was also significantly negatively related to body satisfaction (p < .001). Which agrees with previous studies, a meta-analysis found that negative self-talk on the body known as “Fat talk” was linked to body dissatisfaction in women. Moreover, it was suggested that this kind of self-talk is a risk factor to body dissatisfaction rather than a consequence of it (Mills & Fuller-Tyszkiewicz, 2017).
Body image and lifestyle
Physical activity and body satisfaction were significantly related (p < .05). Those who are not physically active had lower body satisfaction levels than students who are regularly and irregularly active. Similarly, More body-satisfied women were more physically active than those who were dissatisfied with their bodies in Saudi (Albawardi et al., 2021) and Emirati studies (Radwan et al., 2019).
Dieting was also significantly related to body satisfaction (p < .001). Students who have been on a diet had significantly lower body satisfaction scores. The reason for dieting was also significantly related to body satisfaction among students. Those who have been on a diet to lose weight or for therapeutic reasons had significantly lower body satisfaction scores than those who dieted for “other reasons”. Similar to our findings, a Saudi study reported that weight loss attempts were significantly associated with higher body dissatisfaction among women (Albawardi et al., 2021). Also an Emeriti study found that the percentage of body dissatisfied female university students and had been on a diet were higher than those who are satisfied with their bodies. Moreover, the percentage of students who wanted to lose weight and have been on a diet was higher than those who wanted to gain weight and dieted (Radwan et al., 2019).
Daily phone hours were significantly correlated with body satisfaction score (r = .011, p < .01). Likewise, screen time was significantly correlated to perceived body image (r = 0.108, p = 0.032) in Saudi women (Albawardi et al., 2021).