Body size preferences for women and adolescent girls living in Africa: a mixed-methods systematic review

• Published in: Public health nutrition Vol. 25; no. 3; pp. 738 - 759
• Main Authors: Pradeilles, Rebecca, Holdsworth, Michelle, Olaitan, Oluwabukola, Irache, Ana, Osei-Kwasi, Hibbah A, Ngandu, Christian B, Cohen, Emmanuel
• Format: Journal Article
• Language: English
• Published: Cambridge, UK Cambridge University Press 01.03.2022; Cambridge University Press (CUP)
• Subjects: Adolescent; Adolescents; Africa; Body image; Body Mass Index; Body Size; Body weight; Community Nutrition; Demographics; Design factors; Education; Female; Females; Food and Nutrition; Girls; HIV; Human immunodeficiency virus; Humans; Life Sciences; Low income groups; Male; Males; Malnutrition; Mixed methods research; Norms; Obesity; Overweight; Overweight - epidemiology; Preferences; Pregnancy; Public health; Santé publique et épidémiologie; Self image; Sexually transmitted diseases; Socioeconomics; STD; Systematic review; Systemic Review; Teenagers; Thinness - epidemiology; Underweight; Weight control; Women; Womens health; Africa; Women; Adolescent girls; Review; Body size preferences; Africa; Preferences; Body size
• ISSN: 1368-9800; 1475-2727; 1475-2727
• DOI: 10.1017/S1368980021000768

To synthesise evidence on body size preferences for females living in Africa and the factors influencing these. Mixed-methods systematic review including searches on Medline, CINHAL, ASSIA, Web of Science and PsycINFO (PROSPERO CRD42015020509). A sequential-explanatory approach was used to integrate quantitative and qualitative findings. Urban and rural Africa. Studies of both sexes providing data on body size preferences for adolescent girls and women aged ≥10 years. Seventy-three articles from twenty-one countries were included: fifty quantitative, fifteen qualitative and eight mixed methods. Most studies reported a preference for normal or overweight body sizes. Some studies of adolescent girls/young women indicated a preference for underweight. Factors influencing preferences for large(r) body sizes included: socio-demographic (e.g. education, rural residency), health-related (e.g. current BMI, pubertal status), psycho-social (e.g. avoiding HIV stigma) and socio-cultural factors (e.g. spouse's preference, social standing, cultural norms). Factors influencing preferences for slim(mer) body sizes included: socio-demographic (e.g. higher socioeconomic status, urban residency, younger age), health-related (e.g. health knowledge, being nulliparous), psycho-social (e.g. appearance, body size perception as overweight/obese) and socio-cultural factors (e.g. peer pressure, media). Preference for overweight (not obese) body sizes among some African females means that interventions need to account for the array of factors that maintain these preferences. The widespread preference for normal weight is positive in public health terms, but the valorisation of underweight in adolescent girls/young women may lead to an increase in body dissatisfaction. Emphasis needs to be placed on education to prevent all forms of malnutrition.