NATIONAL

HEALTH BEHAVIOUR IN SCHOOL-AGED CHILDREN:
WHO COLLABORATIVE CROSS-NATIONAL STUDY (HBSC)
2014 SURVEY IN SCOTLAND NATIONAL REPORT
BODY IMAGE AND BODY MASS INDEX
INTRODUCTION
Adolescence is a time of significant and rapid physical development, and an individual’s weight and body shape can change
quite dramatically. It is also a time of heightened scrutiny and evaluation of these physical attributes – both by the individual
themselves and by others 1 . The HBSC survey asks about both height and weight (from which age appropriate Body Mass
Index (BMI) is derived as an indicator of fatness), and perceptions of body size and appearance. Perceived and actual body
weights are associated: those with a higher BMI are more likely to report dissatisfaction with their body image 2 . Body
weight dissatisfaction is more common in girls than boys with many normal-weight girls perceiving themselves to be
overweight 3 , and is more common in older than younger adolescents 4,5 .
Body image plays a strong role in young people’s mental well-being including their self-esteem. 6,7 Negative body image has
also been linked to eating disturbances, depression, mood disorders and self-harming, as well as affecting general eating
behaviour and physical activity 8,9 .
In Scotland, the percentage of children with a BMI outside the healthy range has remained at around 30% since the turn
of the century. It is consistently, but only slightly, lower for girls than boys and not strongly different among age groups 10 .
A number of health policies, including Overweight and Obesity in Scotland: A Route Map Towards Healthy Weight (2010),
are focussed on reducing childhood obesity 11 . Current Scottish Government initiatives include the Child Healthy Weight
Intervention Programme (including HEAT targets set in conjunction with NHS Boards and schools 12 ), The Healthier Scotland
Cooking Bus and Good Places, Better Health (2011) 13 . Because of the link between healthy body weight and positive body
image, policy measures generally address both.
HBSC FINDINGS
The HBSC survey asks young people questions relating to perceived body size and looks, both of which have been collected
since 1990. Data on self-reported good looks were collected from 13- and 15-year olds only, in 2014. Body mass index (BMI)
is calculated based on self-reported height and weight (kg/m2).
BODY SIZE
Twenty-five percent (25%) of boys and 41% of girls report that they are ‘too fat’. There are large differences between 11
and 13-year olds, particularly among girls, with higher proportions of older adolescents describing themselves as too fat
(Figure 9.1). At all ages, girls are more likely than boys to report that they are too fat.
The prevalence of overweight perceptions among girls in 2014 (41%) is equivalent to that in 1990 (42%), following a peak in
1998 (48%). Boys have gradually become more likely to report that their body is overweight since 1990 (from 20% in 1990
to 25% in 2014) (Figure 9.2).
REPORTING GOOD LOOKS
Boys are approximately three times more likely than girls to report that they are ‘quite’ or ‘very’ good looking (32% and
33% of 13- and 15- year old boys, respectively, compared with 13% and 10% of girls at these ages; Figure 9.3). There is little
difference between 13- and 15-year olds for either boys or girls.
Across all seven surveys between 1990 and 2014, boys reported their looks more favourably than girls (Figure 9.4).
Since 2006, the proportion of boys reporting good looks has remained consistent; however girls have become increasingly
less likely to report good looks over this period. As such, the gender gap in perceived looks is now at its widest in the past
24 years.
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