Fatness, Thinness, Social Pressures and Health: Boys’ and Girls’ Perceptions

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The purpose of the study and problem identification

The study by Dixey, Sahota, Atwal and Turner (2001) is a study about the views held by young boys and girls about body size, health and pressure from society concerning body image. The study aims to provide health educators with information about weight issues, health matters and eating problems. The study was motivated by several issues which include: the response of children to social pressures, the perceptions of children to fatness or thinness, the consciousness of children to eating disorders, the perceptions of big children to their own body size, the treatment of big children by others in school, and the perception of children about the connection between healthy eating and the amount of fat in their diets or bodies.

The literature review

A number of qualitative studies have previously been carried out by other researchers to examine the perceptions of children about body size and health. Dixey, Sahota, Atwal and Turner (2001) used several past studies in their study. The first study was done by Richardson et al. in 1961 using ten and eleven-year-old children. Richardson et al. found that the children in the study viewed fatness as the worst physical disability among the disabilities listed by the researchers. Other studies done by Staffieri (1967), DeJong and Kreck (1986) and Cramer and Steinwert (1998) replicated the findings of Richardson et al. For instance, the study by Staffieri (1967) found that fat children are perceived by their peers as least liked and often get teased by their peers. Studies by Hill and Silver (1995) and Wardle et al. (1995) also found out that fat children are associated with negative perceptions such as laziness, stupidity, unfitness, dirt and unpopularity. A different angle was brought in by Lawson (1980) who found out that the stereotypes attached to fat children are done by peers with whom they do not have close associations.

The perceptions of children concerning their own weight have also been investigated by several researchers. These include Toro et al. (1989), Davies and Furnham (1986), Moses et al. (1989), Hill et al. (1992), Hill et al. (1994) and Tiggemann and Wilson-Barrett (1998). These studies found out that young children, particularly girls as young as nine years of age have great concerns about their body size and will even limit the number of food intakes to avoid getting fat. The perception of girls about their body image is actually related to perceived weight rather than their real weight. Children who perceive themselves as fat would also prefer to be thinner. Perceptions and knowledge about eating disorders have also been studied by a number of researchers such as Mumford et al. (1991), Ahmad et al. (1994a), Hill and Bhatti (1995), Barker and Cooke (1992) and Dixey (1996). These researchers found out that concerns about body image often occur amongst girls and women rather than boys and men. The majority of girls and women in westernized countries are not satisfied with their body image and weight.

Closely linked to this is the effect of the mass media on the perceptions of women about their body images. This effect was studied by Levine and Smolak (1996), Berel and Irving (1998), and Martin and Gentry (1997). These researchers found that the mass media play a very crucial role in the perceptions of girls towards their own body images. Besides the mass media, other social pressures come from families and peers. The influence of peers and family on perceptions of body size and body image was studied by Pike and Rodin (1991), Paxton (1996), Taylor et al. (1998), Thelen and Cormier (1995) and Hill and Franklin (1998) among others. The knowledge gap in the literature review concerns the effect of obesity on the self-esteem of young people (French et al., 1995) as well as the personal qualities of the children who hold negative perceptions towards fat children (Crandall and Biernat, 1990). Therefore, more research needs to be done on these matters.

It is clear from the literature review that the articles used are relevant to the study. Dixey, Sahota, Atwal and Turner (2001) used a combination of articles from different decades. Two of the articles were published in the 1960s and seven of them were published between 1980 and 1989. The rest of the articles used (thirty-six) were published between 1990 and 1999. The majority of the articles used were therefore current because the study was undertaken in 2000.

Research objectives, questions or hypotheses

The researchers stated the research questions pertinent to the study but did not state any objectives or hypotheses. The researchers were forced to first question the participants of the study about their knowledge of healthy eating and the factors that influence their adoption of a healthy diet. Questions that were developed by the researchers include:

  • Do you think it matters whether someone is fat or thin?
  • Do you think she/he will make many friends?
  • What problems do you think s/he will have?
  • What do you think she/he should do about their size?
  • Is there pressure to be a particular shape?
  • Do you think that fat people are always healthy?
  • Do you think that thin people are always healthy?
  • Do you exercise to get thin or to get fit?

Identification of attributes/demographic variables

The major attributes studied by Dixey, Sahota, Atwal and Turner (2001) include the perceptions of children towards thinness/fatness; the perception of children towards the relationship between body size and health; eating disorders; influence from social factors; and advice that can be given to fat children.

Research design and data collection technique

The research design used was ethnography. Ethnography entails the study of what is happening as it is lived by the people (Manen, 1990, p.67). It helps to identify the existence (or lack thereof) of certain attributes. It also helps to investigate the phenomenon that is not widely understood.

Focus groups were used as the preferred data collection technique. The total number of children used in the study was 300 from ten Leeds primary schools. The schools varied from low to high socioeconomic statuses. One of the schools was a Jewish school while the rest were white. The children were grouped into 60 focus groups each group consisting of five children. Each of the focus groups had members of the same sex, and all the members of each group belonged to the same year of study (that is, either year 5 or year 6). However, the members of the focus groups had varying intellectual and academic abilities. In each of the 10 schools, 6 focus groups were studied, three groups from year 5 and three from year 6 (Dixey, Sahota, Atwal and Turner, 2001, p.208). Details pertaining to the sampling technique and the inclusion and exclusion criteria have not been indicated by the researchers. The purpose of the use of the focus groups is to learn and comprehend the experiences and views of the participants rather than to measure them (Strauss, 1987, p.31). The tools used to collect data include questionnaires, tape recording and note-taking. The questions were developed by two of the researchers who had to be present in all the focus groups. The task of the other two researchers was to check for the consistency and style of the data collection procedure.

Researchers’ interpretation of findings

The findings from the focus groups’ discussions were categorized into four groups by the researchers. These groups include: whether it matters if a person is fat or thin; the advice is given by children to their peers who have a problem with their weight; the pressures put on children’s perception of body image by the society; and the correlation between body size and health. In the first category, all the focus groups agreed that being fat should not matter but it matters. The children in the focus groups pointed out that children who are fat are more likely to be bullied, picked upon by others and lacked as many friends as their counterparts. In the second category, the advice given to others differed on the lines of gender. Boys argued that children who are fat need not diet unless they are truly unhappy with their body size. The majority of the girls argued that fat children should diet, stop eating fatty foods and should be supported in their quest to adopt a healthy lifestyle. In the third category, the researchers found out that girls were more likely than boys to experience pressure on their body sizes from the mass media, family members and peers (Berel and Irving, 1998, p.422). In the last category, all the focus groups argued that being fat does not necessarily mean that one is unhealthy, and vice versa. Some of the children were aware of eating disorders while others were not. The groups also recognized the correlation between body size and health.

Implications of the findings to nursing

The findings of the study can be useful in the development of programs for school children that would help them to cope with their negative perceptions about body image that result from social pressures. These programs can include counseling on eating disorders and awareness creation (Smolak and Levine, 1994, p.304). Besides educational programs, the study can help to further develop media literacy programs. Much of the pressure on children results from the mass media. The media literacy programs can assist children in resisting unhealthy advertised foods and the elimination of negative body images (Austin and Meili, 1994, p.429). Most importantly, the study can be used in the development of nursing education programs through which children can be taught the significance of being healthy irrespective of one’s body image.

Suggestions for further study

The researchers of the study propose that more studies should be carried out about the meanings attached by children on the term “dieting”. This is because studies show that the meaning of dieting differs significantly from one child to another, and also the research technique used in questioning children about dieting will yield different results from the use of a different technique (Dixey, Sahota, Atwal and Turner, 2001, p.214).

Replication of the study

The description of the study was not sufficiently clear. For instance, the researchers did not mention the sampling technique used, the measurement instrument used, the level of measurement used, and the development of the measurement instrument. It would therefore be difficult for other researchers to replicate this study without such important details (Lofland and Lofland, 1995, p.27).

References

  1. Austin, E.W. and Meili, H. (1994). Effects of interpretations of televised alcohol portrayals on children’s alcohol beliefs. Journal of Broadcasting and Electronic Media, Fall, 418-435.
  2. Berel, S. and Irving, L. (1998). Media and disturbed eating: An analysis of media influence and implications for prevention. The Journal of Primary Prevention, 18.4, 415-430.
  3. Crandall, C.S. and Biernat, M. (1990). The ideology of anti-fat attitudes. Journal of Applied Social Psychology, 20.3, 227-243.
  4. Dixey, R., Sahota, P., Atwal, S., and Turner, A. (2001). A qualitative study of boys’ and girls’ perceptions of fatness, thinness, social pressures and health using focus groups. Health Education, 101.5, 206-216.
  5. Hill, A.J., Draper, E. and Stack, J. (1994). A weight on children’s minds: body shape dissatisfactions at 9-years old. International Journal of Obesity, 18, 383-389.
  6. Lawson, M.C. (1980). Development of body build stereotypes, peer ratings, and self-esteem in Australian children. Journal of Psychology, 104, 111-118.
  7. Lofland, J. and Lofland, L.H. (1995). Analyzing social settings (3rd ed.). Belmont: Wadsworth.
  8. Manen, M.V. (1990). Researching lived experience. New York: State University of New York.
  9. Smolak, L. and Levine, M.P. (1994). Toward an empirical basis for primary prevention of eating problems with elementary school-children. Eating Disorders: The Journal of Treatment and Prevention, 2.4, 293-307.
  10. Strauss, A.L. (1987). Qualitative analysis for social scientists. New York: Cambridge University Press.
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