Research Article | | Peer-Reviewed

Body Image Perceptions and Prevalence of Eating Disorders Among Adolescents in Private Schools in Surulere LGA, Lagos State, Nigeria

Received: 11 July 2025     Accepted: 22 July 2025     Published: 21 August 2025
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Abstract

Body image perceptions describe a person’s thoughts, feelings, and actions toward their body. They can be positive or negative and play a pivotal role in an individual’s overall health and productivity. In adolescents, body image is of utmost importance, as having a negative one can put them at risk for mental illnesses. This study investigated the body image perceptions and prevalence of eating disorders among adolescents in secondary schools in Surulere Local Government Area of Lagos State. This was a descriptive, cross-sectional study carried out among 330 in-school adolescents aged between 10-19 years. A multistage sampling method was used, and the questionnaire was semi-structured and self-administered. It was developed from the Stunkard Figure Rating Scale and the Eating Attitudes Test (EAT-26). Data were analyzed with Epi-Info version 7.1. The level of significance was set at p<0.05. The prevalence of body image dissatisfaction was 57.0%, with a higher percentage among females (52.8%). The prevalence of eating disorders was 17.0%, and 59.6% occurred among females. There was a statistically significant association between the prevalence of eating disorders and family loss or trauma (p=0.041), feelings of stress (p=0.010), and being informed by people to lose weight (p=0.043). This study revealed a high rate of body dissatisfaction and eating disorders. There is a need for positive body image promotion and the creation of awareness of eating disorders among adolescents in secondary schools. These would be useful in reducing the prevalence of body dissatisfaction and eating disorders.

Published in World Journal of Public Health (Volume 10, Issue 3)
DOI 10.11648/j.wjph.20251003.27
Page(s) 366-372
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2025. Published by Science Publishing Group

Keywords

Adolescents, Body Image, Body Dissatisfaction, Eating Disorders, Mental Health, Nigeria, Secondary Schools

1. Introduction
In recent times, there has been an increased awareness of body image perceptions among adolescents, and engagement in weight-changing practices, to achieve a perfect body . This can be largely attributed to society’s ideals of beauty . The ideal beauty standard is defined as having a slim or muscular body or both. Many adolescents often compare themselves to images of men and women presented by the media and perceive themselves differently, often negatively . In trying to fit in with society’s beauty standards, they become susceptible to developing body image dissatisfaction . Body image is a multi-dimensional concept that describes how an individual thinks, feels, or acts concerning his or her body. Body image dissatisfaction (BID) is a negative subjective evaluation of one’s figure or body part and has been shown to play a key role in body image disturbance . This dissatisfaction may deepen as the adolescent grows older, with the greatest dissatisfaction peaking during young adulthood . It is usually accompanied by abnormal eating behaviors known as eating disorders (EDs).
Eating disorders are psychological illnesses defined by abnormal eating habits that may involve either insufficient or excessive food intake, which impacts an individual’s physical and mental health negatively . In the most recent DSM-5 classification, the best-characterized eating disorders are anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED). These three are referred to as the typical EDs . Other EDs, which are atypical, are referred to as other specified feeding or eating disorders (OSFEDs). An OSFED is defined as an eating disorder that causes clinically significant distress or impairment in social life but does not meet the full criteria for typical eating disorders. Examples include purging and night eating syndrome . BID appears to be a potent force behind adolescents’ dieting and weight control behaviors. These behaviors are related to adverse physical and psychological changes and can precipitate health conditions such as eating disorders. With rapid economic development and affluence, a progressive shift toward thinness as the ideal body shape has been observed. This has led to increased body weight concerns and dissatisfaction among adolescents .
Eating disorders are one of the most common psychiatric conditions among young people and pose a major public health challenge, having the greatest mortality rate of all mental disorders . They may increase a person’s risk of becoming obese, developing deficiency diseases, anxiety disorders, chronic fatigue and pain, infectious diseases, insomnia, and neurological symptoms . Studies have also revealed their association with increased risk of depression, substance abuse, suicide, decreased quality of life, and significant disease burden . Like any other illness, a loved one’s affectation by an eating disorder may cause anguish, discomfort, or distraction, putting the family under perpetual pressure . Eating disorders tremendously impact the affected individual and their family and can lead to high levels of psychological distress and conflict in a family . Caregivers of people suffering from eating disorders also face major financial and opportunity costs. There may be loss of income due to treatment costs, taking time off work to cater for the care-dependent, and impacted educational or professional development .
In recent decades, body image dissatisfaction and eating disorders have become increasingly prevalent globally . Although our global access to food has improved, our relationship with food seems to have become even more complicated as EDs are on the rise . Adolescence represents a critical period for the development of a healthy or unhealthy body image . This is because the human body undergoes many changes during this period. The way the adolescent perceives these changes has a significant influence on the level of body satisfaction and the development of body image . Studies have shown that young people are particularly vulnerable to developing a negative body image . The generalized acceptance of thinness as the beauty ideal standard puts a lot of young people under pressure to make abnormal weight changes and have an unhealthy preoccupation with their body sizes . This could lead to the onset of body dissatisfaction and, subsequently, eating disorders . Although some studies have been done on body image perceptions of adolescents and on the prevalence of eating disorders among adolescents, there is a paucity of research associating both in this local context . In addition, previous studies focused majorly on young adults and not on in-school adolescents . The present study determined the body image perceptions, prevalence of eating disorders, and their association among in-school adolescents in secondary schools.
2. Methodology
This was a descriptive, cross-sectional study carried out among 330 in-school adolescents, aged between 10-19 years, in private secondary schools in Surulere LGA. A list of all the private secondary schools in Surulere LGA was obtained from District IV, the education district with Surulere LGA under its jurisdiction. The list had a total of 24 private secondary schools. Six schools were chosen by simple random sampling using balloting method. A minimum of 60 respondents was estimated for each of the schools. Using a cluster sampling method, three arms (science, art, and commercial) of each class of the selected schools were selected. Convenient sampling method was used to attain the selected sample size from each school. Both male and female adolescents participated in this study. Respondents who were acutely ill were excluded from the study.
2.1. Data Collection
Data collected were manually checked for corrections, completion after collection, and thereafter coded for data entry. Body image perceptions were obtained with the use of the Stunkard figure rating scale. The silhouette figures of the figure rating scale were assigned body weight status as follows: Underweight (silhouette 1), Normal weight (silhouette 2, 3 and 4), Overweight (silhouette 5), and Obese (silhouette 6, 7, 8, and 9). The BMI of each respondent was calculated and compared to the perceived body images of the respondents. The prevalence of eating disorders was determined using the EAT-26 questionnaire. Each item from questions 1-25 was scored as Always=3, Usually=2, Often=1, Sometimes=0, Rarely=0, Never=0. For question 26 only, the scoring for the items are Always=1, Usually=0, Often=0, Sometimes=1, Rarely=2 and Never=3. Item scores from all questions were added together. An EAT-26 score of 20 or more is indicative of a prevalence of an eating disorder.
2.2. Data Analysis
Data collected was analyzed electronically using Epi-Info 7.1 software program. Results are represented in a frequency table. Chi-square test was used to test for the association between body image perceptions, the prevalence of eating disorders, and factors influencing eating disorders. The level of significance (p) was set at (< 0.05).
3. Results
265 (84.4%) of the respondents were between the ages of 12-14 years, the highest frequency of all the age groups. The mean age was 14 ± 1. Of the respondents, 50.3% were females, and 49.7% were males. 42.7% of the respondents were in SS1 class, while 37.9% and 19.4% were in SS2 and SS3 respectively. The predominant ethnic group was Yoruba (43.0%), 36.3% were Igbo, 3.5% were Hausa and 17.2% belonged to other ethnic groups like Efik, Itsekiri and Tiv. Christians made up 81.9% of the respondents, while Muslims made up 18.2%. Table 2 shows the psychosocial factors related to the development of eating disorders. A greater proportion of respondents (78.7%) hadn’t suffered any family loss or trauma recently, however, 21.3% of them had. Of the affected respondents, 88.1% had experienced a recent family member loss, while 11.9% had experienced trauma. Majority of the respondents (72.9%) reported feeling stressed out lately; 50.6% experienced it 1-3 times a week, 30.6% experienced these feelings every day, and 18.8% of the respondents experienced this 4-6 times a week. From Table 3, a significant association between development of eating disorders and feeling stressed out lately (p=0.02), how often they have been feeling stressed out lately (p=0.01) and people informing them to lose weight (p=0.04), was shown. There was however no significant association between the prevalence of eating disorders and being in a low mood lately (p=0.10) or how often they had been in a low mood lately (p=0.10). Table 4 represents the association between eating disorders and body dissatisfaction of the respondents. The association was significant (p=0.013).
Table 1. Socio-Demographic Characteristics of The Respondents.

Socio-demographic characteristics

Frequency (n= 314)

Percentage (%)

Age (years)

12-15

265

84.4

16-19

49

15.6

Mean ± SD = 14.4 ± 1.

Sex

Female

158

50.3

Male

156

49.7

Class

SS1

134

42.7

SS2

119

37.9

SS3

61

19.4

Religion

Christianity

257

81.8

Islam

57

18.2

Tribe

Yoruba

135

43.0

Igbo

114

36.3

Hausa

11

3.5

Others

54

17.2

Table 2. Psychosocial Factors Related to Eating Disorders Among Respondents.

Variable

Frequency (n= 314)

Percentage (%)

Suffered a family loss or trauma recently

Yes

67

21.3

No

247

78.7

Kind of loss or trauma (n=67)

Family member loss

59

88.1

Trauma

8

11.9

Feeling stressed out lately

Yes

229

72.9

No

85

27.1

Feeling stressed out lately (How often) (n=229)

1-3 times a week

116

50.6

4-6 times a week

43

18.8

Everyday

70

30.6

Table 3. Association Between Psychosocial Factors and Eating Disorder.

Variable

Prevalence of eating disorder

Total (n=314)

Chi-square

P-value

No N (%)

Yes N (%)

Feeling stressed out lately

Yes

184(70.2)

45(86.5)

229(79.2)

5.84

0.010*

No

78(29.8)

7(13.5)

85 20.8)

19.09

0.000*

Feeling stressed out lately (How often) (n=229)

1-3 times a week

109(41.6)

18(34.6)

127(40.4)

2.74

0.100

4-6 times a week

32(12.2)

5(9.6)

37(11.8)

6.18

0.101

Everyday

43(16.4)

22(42.3)

65(20.7)

4.82

0.042*

Been in a low mood lately

Yes

128(48.9)

32(61.5)

160(51.0)

No

134(51.2)

20(38.5)

154(49.0)

Been in a low mood lately (How often) (n=160)

1-3 times a week

85(32.4)

17(32.7)

102(63.8)

4-6 times a week

23(8.8)

6(11.5)

29(18.1)

Everyday

20(7.6)

9(17.3)

29(18.1)

People inform you to lose weight

Yes

54(20.6)

18(34.6)

72(22.9)

No

208(79.4)

34(65.4)

242(77.1)

Table 4. Association Between Body Dissatisfaction and Eating Disorders Among Respondents.

Body Image Perceptions

Eating disorders (EAT-26)

Total (n=314)

X2

P-value

No

Yes

Dissatisfied

135(79.0)

44(21.0)

179(57.0)

6.30

0.013*

Satisfied

121(89.6)

14(10.4)

135(43.0)

Total

256(87.0)

58(13.0)

314(100.0)

4. Discussion
The mean age of the respondents was 14.4 ± 1.2 years and is consistent with a similar study done in Benin, Nigeria, where the mean age was 15.6 years . A little over half of the respondents were female (50.3%), which is in keeping with the findings of a study done in India which showed that 52% were females . In the present study, over half of the respondents had normal body weight (52.5%), while 33.2% were underweight and 14.3% were overweight. This is consistent with the findings of a study done in Malaysia which showed a majority of respondents (49.4%) were of normal weight, followed by underweight and overweight (30.3% and 20.3%, respectively) . These findings may be majorly attributed to the socio-demographics of the respondents, such as age and gender. Eating patterns, family history, and level of physical activity could have also played a significant role.
The present study showed that over half of the respondents (55.4%) perceived themselves to be normal weight. This is consistent with the findings of a study carried out in India . The similarities in these studies could be as a result of prevalent body image perceptions in the individual countries, as well as socio-demographic factors and psychosocial factors. The present study found the rate of body image dissatisfaction to be 57.0%. This lends support to a study carried out in Malaysia, which showed a body image dissatisfaction rate of 60.1% . A study in Brazil showed the rate of body image dissatisfaction to be 69.5% while another in Peru showed a rate of 11.5%. The varying rates among the different countries could be attributed to factors such as cultural beauty standards, the role of family and peers, and social media influence.
In the present study, the rate of body image dissatisfaction was higher among females (52.8%) than males (47.2%). This is in keeping with the findings of studies carried out in Brazil (46.4%) and China (41.2%) . This may result from the fact that, in general, society places a greater emphasis on how females should look than it does on males. This pressure often leads to a higher prevalence among females. To determine the prevalence of eating disorders, the present study used the EAT-26 scoring system and found the prevalence rate to be 17%. This is consistent with the findings of another study in Lagos, Nigeria which showed the prevalence rate of eating disorders to be 16% . In a study carried out in Iran, the prevalence rate was shown to be 24.3% , while studies carried out in Nepal and India showed prevalence rates of 27.2% and 26.7% respectively. These prevalence rates are higher than that of the present study and may be due to different cultural norms of attractiveness and eating practices.
In contrast, a study in Egypt revealed a prevalence rate of 3.3% while in Ethiopia, it was 8.6% . These rates are low in comparison to that of the present study. They may be as a result of an increased level of awareness of eating disorders, an adequate number of specialists in the field, quality comprehensive healthcare services, and sufficient research. A study done in Malaysia showed a significant association between eating disorders and depressive symptoms, low self-esteem, and body dissatisfaction . Although the present study did not assess self-esteem levels, it did assess respondents’ feelings of low mood. This was found not to be significant with eating disorders prevalence. The difference in these findings may be due to psychosocial and environmental factors.
This study found a significant association between body image perceptions and the prevalence of eating disorders. Body dissatisfaction, a form of body image perception, was significantly associated with the prevalence of eating disorders. This is consistent with the findings of a study done in Iran which showed a significant association between eating disorders and body dissatisfaction . Studies in Malaysia have also shown significant associations between eating disorders and body image perceptions . These findings may be resultant of the negative perceptions of body image which precipitated abnormal eating patterns, compensatory behaviors, and consequently, eating disorders.
5. Conclusion
The study showed that the prevalence of body image dissatisfaction in the study group was 57.0%. The prevalence rate of eating disorders was 17%. The factors significantly associated with the prevalence of eating disorders were recent family loss or trauma, feelings of stress, and being informed by people to lose weight.
Abbreviations

LGA

Local Government Area

EAT-26

Eating Attitudes Test-26

BMI

Body Mass Index

EDs

Eating Disorders

DSM-5

Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition

AN

Anorexia Nervosa

BN

Bulimia Nervosa

BED

Binge Eating Disorder

OSFEDs

Other Specified Feeding or Eating Disorders

SS1, SS2, SS3

Senior Secondary School Year 1, 2, and 3 Respectively

Epi-Info

Epidemiological Information (Software by CDC)

Acknowledgments
The authors express their sincere gratitude to the study participants for sharing their time and experiences. Appreciation is also extended to the field data collectors and research assistants for their dedication during data collection. Special thanks to the Lagos University Teaching Hospital and the Lagos State Ministry of Health for their support and collaboration throughout the study.
Author Contributions
Oluwatosin Mary Olawoyin: Software, Visualization, Writing - original draft
Adedoyin Ogunyemi: Conceptualization, Software, Visualization, Writing - original draft
Blossom Adaeze Maduafokwa: Conceptualization, Investigation, Software
Brenda Isikekpei: Conceptualization, Funding acquisition, Investigation
Samuel Okerinde: Conceptualization, Writing - original draft, X Writing - review & editing
Funding
This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
Ethical Clearance
Ethical approval was obtained from the Health Research and Ethics Committee of Lagos University Teaching Hospital. Written informed consent was obtained from each respondent before administering the questionnaire.
Conflicts of Interest
The authors declare no conflicts of interest.
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Cite This Article
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    Olawoyin, O. M., Ogunyemi, A., Maduafokwa, B. A., Isikekpei, B., Otokpa, E., et al. (2025). Body Image Perceptions and Prevalence of Eating Disorders Among Adolescents in Private Schools in Surulere LGA, Lagos State, Nigeria. World Journal of Public Health, 10(3), 366-372. https://doi.org/10.11648/j.wjph.20251003.27

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    ACS Style

    Olawoyin, O. M.; Ogunyemi, A.; Maduafokwa, B. A.; Isikekpei, B.; Otokpa, E., et al. Body Image Perceptions and Prevalence of Eating Disorders Among Adolescents in Private Schools in Surulere LGA, Lagos State, Nigeria. World J. Public Health 2025, 10(3), 366-372. doi: 10.11648/j.wjph.20251003.27

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    AMA Style

    Olawoyin OM, Ogunyemi A, Maduafokwa BA, Isikekpei B, Otokpa E, et al. Body Image Perceptions and Prevalence of Eating Disorders Among Adolescents in Private Schools in Surulere LGA, Lagos State, Nigeria. World J Public Health. 2025;10(3):366-372. doi: 10.11648/j.wjph.20251003.27

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  • @article{10.11648/j.wjph.20251003.27,
      author = {Oluwatosin Mary Olawoyin and Adedoyin Ogunyemi and Blossom Adaeze Maduafokwa and Brenda Isikekpei and Ejiro Otokpa and Samuel Okerinde},
      title = {Body Image Perceptions and Prevalence of Eating Disorders Among Adolescents in Private Schools in Surulere LGA, Lagos State, Nigeria
    },
      journal = {World Journal of Public Health},
      volume = {10},
      number = {3},
      pages = {366-372},
      doi = {10.11648/j.wjph.20251003.27},
      url = {https://doi.org/10.11648/j.wjph.20251003.27},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.wjph.20251003.27},
      abstract = {Body image perceptions describe a person’s thoughts, feelings, and actions toward their body. They can be positive or negative and play a pivotal role in an individual’s overall health and productivity. In adolescents, body image is of utmost importance, as having a negative one can put them at risk for mental illnesses. This study investigated the body image perceptions and prevalence of eating disorders among adolescents in secondary schools in Surulere Local Government Area of Lagos State. This was a descriptive, cross-sectional study carried out among 330 in-school adolescents aged between 10-19 years. A multistage sampling method was used, and the questionnaire was semi-structured and self-administered. It was developed from the Stunkard Figure Rating Scale and the Eating Attitudes Test (EAT-26). Data were analyzed with Epi-Info version 7.1. The level of significance was set at p The prevalence of body image dissatisfaction was 57.0%, with a higher percentage among females (52.8%). The prevalence of eating disorders was 17.0%, and 59.6% occurred among females. There was a statistically significant association between the prevalence of eating disorders and family loss or trauma (p=0.041), feelings of stress (p=0.010), and being informed by people to lose weight (p=0.043). This study revealed a high rate of body dissatisfaction and eating disorders. There is a need for positive body image promotion and the creation of awareness of eating disorders among adolescents in secondary schools. These would be useful in reducing the prevalence of body dissatisfaction and eating disorders.},
     year = {2025}
    }
    

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  • TY  - JOUR
    T1  - Body Image Perceptions and Prevalence of Eating Disorders Among Adolescents in Private Schools in Surulere LGA, Lagos State, Nigeria
    
    AU  - Oluwatosin Mary Olawoyin
    AU  - Adedoyin Ogunyemi
    AU  - Blossom Adaeze Maduafokwa
    AU  - Brenda Isikekpei
    AU  - Ejiro Otokpa
    AU  - Samuel Okerinde
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    JO  - World Journal of Public Health
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    PB  - Science Publishing Group
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    AB  - Body image perceptions describe a person’s thoughts, feelings, and actions toward their body. They can be positive or negative and play a pivotal role in an individual’s overall health and productivity. In adolescents, body image is of utmost importance, as having a negative one can put them at risk for mental illnesses. This study investigated the body image perceptions and prevalence of eating disorders among adolescents in secondary schools in Surulere Local Government Area of Lagos State. This was a descriptive, cross-sectional study carried out among 330 in-school adolescents aged between 10-19 years. A multistage sampling method was used, and the questionnaire was semi-structured and self-administered. It was developed from the Stunkard Figure Rating Scale and the Eating Attitudes Test (EAT-26). Data were analyzed with Epi-Info version 7.1. The level of significance was set at p The prevalence of body image dissatisfaction was 57.0%, with a higher percentage among females (52.8%). The prevalence of eating disorders was 17.0%, and 59.6% occurred among females. There was a statistically significant association between the prevalence of eating disorders and family loss or trauma (p=0.041), feelings of stress (p=0.010), and being informed by people to lose weight (p=0.043). This study revealed a high rate of body dissatisfaction and eating disorders. There is a need for positive body image promotion and the creation of awareness of eating disorders among adolescents in secondary schools. These would be useful in reducing the prevalence of body dissatisfaction and eating disorders.
    VL  - 10
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