Associations of self-esteem with body mass index and body image among Saudi college-age females

  • Tasneem ALAhmari
  • Abdulaziz Z. AlomarEmail author
  • Jumanah ALBeeybe
  • Nawal Asiri
  • Reema ALAjaji
  • Reem ALMasoud
  • Hazzaa M. Al-Hazzaa
Original Article



To examine the association of self-esteem with the body mass index (BMI), perceived body image (BI), and desired BI of college-age Saudi females.


A cross-sectional study was conducted with 907 randomly selected females using a multistage stratified cluster sampling technique. Self-esteem and BI were assessed using the Rosenberg Self-Esteem Scale and Stunkard Figure Rating Scale, respectively.


The prevalence of low self-esteem was only 6.1% among college females; however, this percentage was higher (9.8%) among overweight or obese participants. The total self-esteem scores showed significant negative correlations with actual BMI and perceived BI, but not with desired BI. Meanwhile, multivariate analyses revealed significant differences in total self-esteem scores according to obesity/overweight status and perceived BI group, but not desired BI group.


Despite the high prevalence of overweight and obesity in Saudi Arabia, few Saudi college females have low self-esteem. In addition, body weight, BMI, perceived BI, and the BMI corresponding to the perceived BI all significantly differed between females with low self-esteem and those with normal self-esteem.

Level of evidence

Level V, cross-sectional descriptive study.


Body image Body mass index College female Obesity Saudi Arabia Self-esteem 



This study was funded by Students’ Research Funds provided by the Deanship for Scientific Research, King Saud University. We would like to thank the students who assisted with the data collection. We would also like to extend our appreciation to all the students who participated in this study.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the ethical committee (IRB) of the College of Medicine at King Saud University.

Informed consent

Informed consent was obtained from all individual participants included in the study.


  1. 1.
    Moradi-Lakeh M, El Bcheraoui C, Tuffaha M, Daoud F, Al Saeedi M, Basulaiman M et al (2016) The health of Saudi youths: current challenges and future opportunities. BMC Fam Pract 17:26. CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Al-Hazzaa HM, Abahussain NA, Al-Sobayel HI, Qahwaji DM, Musaiger AO (2012) Lifestyle factors associated with overweight and obesity among Saudi adolescents. BMC Public Health 12:354. CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Al-Hazzaa HM (2007) Rising trends in BMI of Saudi adolescents: evidence from three national cross sectional studies. Asia Pac J Clin Nutr 16:462–466. CrossRefPubMedGoogle Scholar
  4. 4.
    Erermis S, Cetin N, Tamar M, Bukusoglu N, Akdeniz F, Goksen D (2004) Is obesity a risk factor for psychopathology among adolescents? Pediatr Int 46:296–301. CrossRefPubMedGoogle Scholar
  5. 5.
    Muris P, Meesters C, van de Blom W, Mayer B (2005) Biological, psychological, and sociocultural correlates of body change strategies and eating problems in adolescent boys and girls. Eat Behav 6:11–22. CrossRefPubMedGoogle Scholar
  6. 6.
    Koyuncu M, tok S, Canpolat M, Catikkas F (2010) Body image satisfaction and dissatisfaction, social physique anxiety, self-esteem, and body fat ratio in female exercisers and non-exercisers. Soc Behav Pers 38:561–570. CrossRefGoogle Scholar
  7. 7.
    Friedman KE, Reichmann SK, Costanzo PR, Musante GJ (2002) Body image partially mediates the relationship between obesity and psychological distress. Obes Res 10:33–41. CrossRefPubMedGoogle Scholar
  8. 8.
    Harris SM (1995) Body image attitudes and the psychosocial development of college women. J Psychol 129:315–330. CrossRefGoogle Scholar
  9. 9.
    Lowery SE, Kurpius SE, Befort KC, Blanks EH, Sollenberger S, Nicpon MF, Huser L (2005) Body image, self-esteem, and health-related behaviors among male and female first year college students. J Coll Stud Dev 46:612–623. CrossRefGoogle Scholar
  10. 10.
    Groesz LM, Levine MP, Musned SK (2002) The experimental presentation of thin media images on body dissatisfaction: a meta-analytic review. Int J Eat Disord 31:1–16. CrossRefPubMedGoogle Scholar
  11. 11.
    Furnham A, Badmin N, Sneade I (2002) Body image dissatisfaction: gender differences in eating attitudes, self-esteem, and reasons for exercise. J Psychol 136:581–596. CrossRefPubMedGoogle Scholar
  12. 12.
    Latner JD, Knight T, Illingworth K (2011) Body image and self-esteem among Asian, Pacific Islander, and White college students in Hawaii and Australia. Eat Disord 19:355–368. CrossRefPubMedGoogle Scholar
  13. 13.
    Harris SM (1994) Racial differences in predictors of college women’s body image attitudes. Women Health 21:89–104. CrossRefPubMedGoogle Scholar
  14. 14.
    Witherspoon D, Latta L, Wang Y, Black MM (2013) Do depression, self-esteem, body-esteem, and eating attitudes vary by BMI among African American adolescents? J Pediatr Psychol 38:1112–1120. CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Afifi-Soweid RA, Ktelig MBN, Schediac-Rizkallah MC (2002) Preoccupation with weight and disordered eating behaviors of entering students at a university in Lebanon. Int J Eat Disord 32:52–57. CrossRefPubMedGoogle Scholar
  16. 16.
    Al Sabbah H, Vereecken C, Abdeen Z, Coats E, Maes L (2009) Associations of overweight and of weight dissatisfaction among Palestinian adolescents: findings from the national study of Palestinian schoolchildren (HBSC-WBG2004). J Hum Nutr Diet 22:40–49. CrossRefPubMedGoogle Scholar
  17. 17.
    Mousa TY, Al-Domi HA, Mashal RH, Jibri MA (2010) Eating disturbances among adolescent school girls in Jordan. Appetite 54:196–201. CrossRefPubMedGoogle Scholar
  18. 18.
    Musaiger A (2015) Body weight concern among female university students in five Arab countries—a preliminary cross-cultural study. Ann Agric Environ Med 22:349–352. CrossRefPubMedGoogle Scholar
  19. 19.
    Musaiger AO, Al-Mannai M (2013) Role of obesity and media in body weight concern among female university students in Kuwait. Eat Behav 14:229–232. CrossRefPubMedGoogle Scholar
  20. 20.
    BenAmmar AA, Murad Ahmad Al-Holy MA (2013) Body image and lifestyle attitudes of female gymnasium users in Saudi Arabia. Nutr Food Sci 43:365–373. CrossRefGoogle Scholar
  21. 21.
    Khalaf A, Westergren A, Berggren V, Ekblom Ö, Al-Hazzaa HM (2015) Perceived and ideal body image in young women in south western Saudi Arabia. J Obes 2015:697163. CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Rasheed P (1999) Overweight status: body image and weight control beliefs and practices among female college students. Ann Saudi Med 19:365–369. CrossRefPubMedGoogle Scholar
  23. 23.
    Aldaqal SM, Sehlo MG (2013) Self-esteem and quality of life in adolescents with extreme obesity in Saudi Arabia: the effect of weight loss after laparoscopic sleeve gastrectomy. Gen Hosp Psychiatry 35:259–264. CrossRefPubMedGoogle Scholar
  24. 24.
    Rosenberg M (1965) Society and the adolescent self-image. Princeton University Press, PrincetonCrossRefGoogle Scholar
  25. 25.
    The Betsi Cadwaladr University Health Board Rosenberg self-esteem scale. Accessed 14 Sept 2017
  26. 26.
    Stunkard AJ, Sorenson TI, Schulsinger F (1983) Use of the Danish adoption register for the study of obesity and thinness. In: Kety S, Rowland LP, Sidman RL, Matthysse SW (eds) The genetics of neurological and psychiatric disorders. Raven Press, New York, pp 115–120Google Scholar
  27. 27.
    Bulik CM, Wade TD, Heath AC, Martin NG, Stunkard AJ, Eaves LJ (2001) Relating body mass index to figural stimuli: population-based normative data for Caucasians. Int J Obes Relat Metab Disord 25:1517–1524. CrossRefPubMedGoogle Scholar
  28. 28.
    Huang JS, Norman GJ, Zabinski MF, Calfas K, Patrick K (2007) Body image and self-esteem among adolescents undergoing an intervention targeting dietary and physical activity behaviors. J Adolesc Health 40:245–251. CrossRefPubMedPubMedCentralGoogle Scholar
  29. 29.
    Marsh HW, Abduljabbar AS, Parker PD, Morin AJ, Abdelfattah F, Nagengast B (2014) The big-fish-little-pond effect in mathematics—a cross-cultural comparison of U.S. and Saudi Arabian TIMSS responses. J Cross Cult Psychol 45:777–804. CrossRefGoogle Scholar
  30. 30.
    Ruby TF (2006) Listening to the voices of hijab. Women’s Stud Int Forum 29:54–66. CrossRefGoogle Scholar
  31. 31.
    Waseem F, Anila K (2014) Practicing hijab (veil): a source of autonomy and self-esteem for modern Muslim women. J Hum Soc Sci 22:19–34Google Scholar
  32. 32.
    Mussap AJ (2009) Acculturation, body image, and eating behaviours in Muslim-Australian women. Health Place 15:532–539. CrossRefPubMedGoogle Scholar
  33. 33.
    Goodman E, Must A (2011) Depressive symptoms in severely obese compared with normal weight adolescents: results from a community-based longitudinal study. J Adolesc Health 49:64–69. CrossRefPubMedPubMedCentralGoogle Scholar
  34. 34.
    Wardle J, Cooke L (2005) The impact of obesity on psychological well-being. Best Pract Res Clin Endocrinol Metab 19:421–440. CrossRefPubMedGoogle Scholar
  35. 35.
    Flament MF, Hill EM, Buchholz A, Henderson K, Tasca GA, Goldfield G (2012) Internalization of the thin and muscular body ideal and disordered eating in adolescence: the mediation effects of body esteem. Body Image 9:68–75. CrossRefPubMedGoogle Scholar
  36. 36.
    Baumeister RF, Campbell JD, Krueger JI, Vohs KD (2003) Does high self-esteem cause better performance, interpersonal success, happiness, or healthier lifestyles? Psychol Sci Public Interest 4:1–44. CrossRefPubMedGoogle Scholar
  37. 37.
    Murray M, Dordevic AL, Bonham MP (2017) Systematic review and meta-analysis: the impact of multicomponent weight management interventions on self-esteem in overweight and obese adolescents. J Pediatr Psychol 42:379–394. CrossRefPubMedGoogle Scholar
  38. 38.
    Perrin EM, Boone-Heinonen J, Field AE, Coyne-Beasley T, Penny Gordon-Larsen P (2010) Perception of overweight and self-esteem during adolescence. Int J Eat Disord 43:447–454. CrossRefPubMedPubMedCentralGoogle Scholar
  39. 39.
    van den Berg PA, Mond J, Eisenberg M, Ackard D, Neumark-Sztainer D (2010) The link between body dissatisfaction and self-esteem in adolescents: similarities across gender, age, weight status, race/ethnicity, and socioeconomic status. J Adolesc Health 47:290–296. CrossRefPubMedPubMedCentralGoogle Scholar
  40. 40.
    Gleason JH, Alexander AM, Somers CL (2000) Later adolescents’ reactions to three types of childhood teasing: relations with self-esteem and body image. J Soc Behav Pers 28:472–480. CrossRefGoogle Scholar
  41. 41.
    Jung J, Lee SH (2006) Cross-cultural comparisons of appearance self-schema, body Image, self-esteem, and dieting behavior between Korean and U.S. women. Fam Consum Sci Res J 34:350–365. CrossRefGoogle Scholar
  42. 42.
    Kiviruusu O, Konttinen H, Huurre T, Aro H, Marttunen M, Haukkala A (2016) Self-esteem and body mass index from adolescence to mid-adulthood. A 26-year follow-up. Int J Behav Med 23:355–363. CrossRefPubMedGoogle Scholar
  43. 43.
    Biro FM, Striegel-Moore RH, Franko DL, Padgett J, Bean JA (2006) Self-esteem in adolescent females. J Adolesc Health 39:501–507. CrossRefPubMedGoogle Scholar
  44. 44.
    Pila E, Sabiston CM, Brunet J, Castonguay AL, O’Loughlin J (2015) Do body-related shame and guilt mediate the association between weight status and self-esteem? J Health Psychol 20:659–669. CrossRefPubMedGoogle Scholar
  45. 45.
    Memish ZA, El Bcheraoui C, Tuffaha M, Robinson M, Daoud F, Jaber S et al (2014) Obesity and associated factors—Kingdom of Saudi Arabia, 2013. Prev Chronic Dis 11:E174. CrossRefPubMedPubMedCentralGoogle Scholar
  46. 46.
    Anderson CB, Bulik CM (2004) Gender differences in compensatory behaviors, weight and shape salience, and drive for thinness. Eat Behav 5:1–11. CrossRefPubMedGoogle Scholar
  47. 47.
    Pritchard ME (2010) Does self-esteem moderate the relation between gender and weight preoccupation in undergraduates? Pers Individ Differ 48:224–227. CrossRefGoogle Scholar
  48. 48.
    Sira N, White CP (2010) Individual and familial correlates of body satisfaction in male and female college students. J Am Coll Health 58:507–514. CrossRefPubMedGoogle Scholar
  49. 49.
    Krueger J (1998) Enhancement bias in the description of self and others. Pers Soc Psychol Bull 24:505–516. CrossRefGoogle Scholar
  50. 50.
    Brown JD (1986) Evaluations of self and others: self-enhancement biases in social judgment. Soc Cognit 4:353–376. CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2017

Authors and Affiliations

  1. 1.College of MedicineKing Saud UniversityRiyadhSaudi Arabia
  2. 2.Department of Orthopedics, King Saud University Medical CityKing Saud UniversityRiyadhSaudi Arabia
  3. 3.Professor Emeritus, Pediatric Exercise Physiology Research LaboratoryKing Saud UniversityRiyadhSaudi Arabia

Personalised recommendations