Body Image in Hispanic/Latino vs.

European American
Adolescents: Implications for Treatment and Prevention of
Obesity in Underserved Populations

Natalie Ceballos, Maria Czyzewska

Journal of Health Care for the Poor and Underserved, Volume 21, Number
3, August 2010, pp. 823-838 (Article)

Published by Johns Hopkins University Press

DOI: https://doi.org/10.1353/hpu.0.0333

For additional information about this article

https://muse.jhu.edu/article/389040

Access provided by University of California , Santa Barbara (20 Sep 2018 09:11 GMT)
Part 1: Original Paper

Body Image in Hispanic/Latino vs.

European American Adolescents:
Implications for Treatment and Prevention
of Obesity in Underserved Populations
Natalie Ceballos, PhD
Maria Czyzewska, PhD

Abstract: Hispanic/Latino (H/L) vs. European American (EA) perceptions of current and
ideal body image as well as body dissatisfaction were examined in 416 adolescents aged
12–15 years. Gender, culture, and body mass index (BMI) were hypothesized to affect mea-
sures of self-perceived body image and dissatisfaction differentially. Participants completed
a computerized survey with gender-specific versions of applicable test items. Overall, body
dissatisfaction (BD) was higher among EAs vs. H/Ls, females vs. males, and unhealthy BMI
vs. healthy BMI (p.01). A gender 3 ethnicity interaction trend was also noted (p.06),
in which BD was highest among EA females, followed by H/L females, EA males, and H/L
males. Results suggest that gender and cultural differences in body image among adolescents
are significant. This study is an important step toward clarifying the nature of weight-related
health risks facing the understudied population of Hispanic/Latino teens.
Key words: Obesity, adolescents, body image, Latinos.

O besity has become a nationwide epidemic. Prevalence rates for obesity in the United
States have increased over time from 19.4% in 1997 to 27.6% in 2009.1 Hispanics/
Latinos in the Texas-Mexico border region constitute one of the most strongly affected
groups.2 This is an issue of increasing importance as the Hispanic/Latino population
is projected to constitute approximately 18% of the total U.S. population in 2020 and
approximately 25% in 2050.3,4 Although much is known about the health consequences
of increased obesity,5 the literature remains sparse with regard to the risk factors associ-
ated with obesity among Hispanics/Latinos.
The rapid rise in obesity among Hispanics/Latinos stands in contrast to the high value
often placed on being thin in the U.S., a valuation that may lead many adolescents to
feel dissatisfied with their bodies and to engage in risk behaviors such as cycles of binge
eating and compensatory dieting.6 Current literature, although collected primarily in
European American female populations, identifies thin body ideal internalization and
body dissatisfaction as major risk factors for dieting and eating pathology.7 Furthermore,

The authors are in the Department of Psychology, Texas State University, San Marcos. Please address
correspondence to Dr. Natalie Ceballos, Dept. of Psychology, Texas State University, 601 University Drive,
San Marcos, TX 78666; (512) 245-2526; nc18@txstate.edu.

Journal of Health Care for the Poor and Underserved  21 (2010): 823–838.
824 Body image and Hispanic/Latino adolescents

researchers suggest a bidirectional relationship between the aforementioned health risk

behaviors and the development of overweight or obesity.8,9
Whereas studies focusing on European Americans have emphasized restrictive eating
pathology or cycles of binging and purging, the relatively few studies conducted in the
Hispanic/Latino community have revealed that in this population unhealthy practices
such as binge eating are more prevalent than disorders such as anorexia or bulimia.10
Furthermore, this pattern is particularly significant for less acculturated Latinas.10
The literature remains unsettled with regard to studies of health risk behaviors
and body dissatisfaction among Hispanics/Latinos. Some studies indicate no signifi-
cant difference between Hispanics/Latinos and European Americans with regard to
self-perceived body image.11,12 Other studies indicate that Hispanics/Latinos do not
endorse the view of the ultra-thin body as positive, preferring a larger body type.11,13
Considering additional factors such as gender, age, acculturation, and socioeconomic
status may help clarify this inconsistent literature. For example, Ayala and colleagues14
found that a strong identification with Mexican culture was a significant predictor of
body dissatisfaction during the earlier stages of childhood, whereas, among teens, indi-
viduals who identified more strongly with body ideals portrayed in the popular media
were more likely to experience body dissatisfaction. Although a number of studies
have reported that the relationship between body image, unhealthy eating practices,
and obesity may be similar for males and females,15 other researchers have suggested
that these effects are weaker in males and have postulated the need for more gender-
comparative studies.16,17
A number of studies have examined adolescents’ endorsement of body stereotypes
while viewing silhouettes of same-sex peers. Such studies have found that obesity is
highly stigmatized relative to other physical disabilities,18 and that children are more
likely than adults to stigmatize obese people.18 Among adolescents, overweight body
shape is associated with negative stereotypes such as poor social functioning, impaired
academic success, and low perceived health, healthy eating, and fitness.19 A number of
studies have shown that participants’ own weight does not affect their stigmatization
of obesity.18,19 Gender differences in these measures have been noted in studies focus-
ing on mixed-age populations.18 However, among adolescents, Hill and Silver19 noted
that gender had only limited impact on these stereotypical judgments. Research on the
endorsement of body stereotypes within the Hispanic/Latino community is limited;
nevertheless, some studies have noted instances in which obese silhouettes evoke nega-
tive responses from adolescents and adults alike.20
A better understanding of the relationship between body dissatisfaction and attitudes
about overweight/obesity within the Hispanic/Latino community could lead to the
development of better treatment and prevention programs. Various intervention models
have suggested that approaches that address socio-cultural attitudes toward appearance
may be effective at reducing both the prevalence of body image dissatisfaction and
related obesity.14 Adolescents are a particularly relevant target for this work, as child-
hood and adolescent obesity have a significant impact on mortality and morbidity in
adulthood.21 To address this issue, the authors extracted the current data from a larger,
online survey of Hispanic/Latino and European American male and female adolescents
in the middle school setting. The authors hypothesized that gender, culture, and body
 Ceballos and Czyzewska 825

mass index (BMI) would differentially affect participants’ responses regarding current
and ideal body image, body stereotypes, and related factors.

Methods
Participants and procedures. Four hundred sixteen participants (177 male), aged 12
to 15, were recruited from junior high schools and after school programs throughout
Central Texas. The participant sample was 3.6% African American, 3.6% Asian Ameri-
can, 24.0% European American, 60.6% Hispanic/Latino, 2.6% Native-American, and
3.4% Other. Approximately 2.2% of participants declined to endorse a race/ethnicity
category. Only data from self-identified European American and Hispanic/Latino
participants were included in further statistical analysis due to small sizes of other
racial/ethnic groups. Data from 33 participants were removed due to a high degree of
missing data across variables. The final sample consisted of 319 adolescents (190 male),
28.5% European American (n91) and 71.5% Hispanic/Latino (n228). The study was
approved by the Texas State University Institutional Review Board. Written consent
was not required due to the anonymous nature of the data collection. The survey was
administered in English. Monitored testing sessions were conducted in the computer
labs of participating schools/programs, and groups of participants simultaneously
completed an online survey of approximately 30 minutes duration. Gender-specific ver-
sions of test items were presented where this was suitable. Although participants were
not directly surveyed regarding their proficiency/comfort level with computer-based
surveys, assistance with the survey (provided by teachers and research assistants) was
equally available to all students.
Survey instruments. Background variables. Self-reported demographic informa-
tion included age, current height and weight, ethnicity, city of residence, and familial
country of origin.
Acculturation was assessed using an instrument developed by the authors and their
collaborators. As an index of acculturation, Hispanic/Latino participants were asked to
indicate various characteristics of their Spanish language abilities. These items included
self-rating (four-point scale) of ability to understand Spanish and ability to speak Span-
ish. In addition, the frequency of using Spanish was assessed by asking participants
to indicate with whom they communicate in Spanish, using a list of descriptors and a
10-point scale. Similar methods have been employed successfully by other researchers.6,22
Individuals with a greater degree of acculturation were expected to exhibit lower levels
of Spanish language ability and frequency of use than less acculturated individuals.
Familial socioeconomic status (SES) was estimated based on the highest level of
schooling completed by the participants’ parents.23
Body image. Gender-specific adolescent silhouette drawings based on the Figure Rat-
ing Scale (FRS) were used to assess body image.24 Silhouette drawings are recognized
as a standard assessment technique for perceived body size.25,26 Nine different figures,
ranging from underweight to obese, were presented for females,27 and seven figures were
presented for males.28 Reliability and validity values for the FRS have been reported as
0.89 to 0.92 and 0.63 to 0.92, respectively.27 Participants were asked to think about the
silhouette as a whole rather than focusing on any individual body parts and to choose
826 Body image and Hispanic/Latino adolescents

the silhouette drawing that 1) represented their current appearance, 2) represented

their ideal appearance.
Kaufer-Horwitz and colleagues25 report a positive correlation (r0.702 in males,
r0.766 in females) between objective BMI measurements and self-perceived body
shape silhouettes among Mexican American male and female participants. This work
suggests that body shape silhouettes may be a useful method for defining overweight
and obesity in settings where scales might not be available.25 Further, the discrepancy
between current and ideal body silhouette figures has frequently been used as an index
of body dissatisfaction.29,30
Additional questions included two items regarding body-thinness preoccupation
derived from the Children’s Eating Attitudes Test (ChEAT-2631), and three items cre-
ated by the authors: one item assessing participants’ desire (or lack of desire) to add
more muscles to his/her body, and two items addressing pressure from parents to gain
weight (one item) and lose weight (one item). Research has shown that concerns about
body muscularity may also be relevant for body satisfaction among males.11,32 However,
it is important to note that an additional body of literature exists that suggests that
body dissatisfaction and drive for muscularity are not completely parallel constructs.33
Parental expectation items were included to reflect cultural norms for a desirable body
size in the adolescents’ familial environments.
Body stereotypes. This assessment was based on the Siperstein Adjective Checklist
(ACL).34,35 Participants completed two test trials: one in which they were presented with
a thin silhouette target figure and one in which they were presented with an overweight
silhouette target figure. In each trial, participants selected words from a checklist of 16
positive and 16 negative adjectives that they felt best described the personality traits
of the target figure.
Body mass index. Self-reported height and weight information was used to compute
a body mass index (BMI; weight kg/height m2) based on Centers for Disease Control
and Prevention guidelines.36 Adolescents’ BMI values were then used to identify the
gender and age-specific percentile for each participant.37 Participants with BMI percen-
tiles below 85 were classified as non-overweight (healthy weight). Individuals with BMI
percentiles equal to or higher than 85, but lower than 95, were classified as overweight;
those with BMI percentiles equal to or higher than 95 were classified as obese.
Data analysis. Differences between genders, ethnicities, and BMI groups on demo-
graphic, body image, and weight-stereotype variables were examined by a series of
analyses of variance (ANOVAs) for independent samples and analyses of covariance
(ANCOVAs) using SES and acculturation level (if applicable) as covariates. The Tukey’s
HSD test was used for all reported pairwise comparisons.

Results
Background variables. Mexico was listed as the country of origin for 67% of Hispanic/
Latino families. Females represented 59.6 % (n190) of the sample. The age range of
participants was 12–15 years (M13.30, SD0.78); 13.8% of the sample was 12 years of
age at the time of testing, 48.6% of the sample was 13 years of age, 31.3% of the sample
was 14 years of age, and 6.3% of the sample was 15 years of age. The Hispanic/Latino
 Ceballos and Czyzewska 827

teens were significantly older than the European Americans (F(1, 315)7.29, p.01;
H/L M13.40, SE0.05, EA M13.13, SE0.09). There was also a trend in which
males were older than females (F(1, 315)3.31, p.07; males: M13.35, SE (standard
errors)  0.08; females: M13.17, SE0.06). There was no significant interaction effect
of ethnicity and gender on age (p.54).
Body mass index. Participants of healthy weight constituted 61.4% of the sample,
while 14.1% were overweight, and 24.5% were obese. Gender was distributed unequally
across weight categories (χ2 (2, n319)  19.52, p.001). A higher percentage of males
than of females were identified as obese (35.7% vs. 16.8%). Similar results were noted
for overweight (17.1% of males vs. 12.1% of females). A lower percentage of males vs.
females were classified as having a healthy weight (47.3% vs. 71.1% respectively).
Across ethnic groups, 57% of Hispanic/Latinos were in a healthy weight category,
15.8% were overweight, and 27.2 % were obese, compared with 72.5%, 9.9.%, and 17.6%,
respectively, among European Americans (χ2(2, n319)6.61, p.04).
Acculturation. An acculturation index was computed as a sum of self-ratings reflect-
ing understanding and speaking abilities multiplied by frequency of use of Spanish
in communication with others. The resulting acculturation scores ranged from 0 to
54 (M11.66, SD12.61).] A two-factor ANOVA for independent samples revealed
no significant differences in the acculturation index between gender or BMI groups

Table 1.
DISTRIBUTION OF BODY MASS INDEX (BMI) STATUS ACROSS
GENDER AND ETHNIC GROUPS OF ADOLESCENTS.

European Hispanic/
Americans Latinos
(n=91) (n=228)
Total Girls Boys Girls Boys
N=319 (n59) (n32) (n131) (n97)

BMIa
  Mean 22.41 20.81 21.53 22.23 23.91
  SD 5.05 3.65 3.65 4.49 6.39
Weight statusb
  Non-overweight 61.4% 81.4% 56.3% 66.4% 44.3%
  At risk of overweight 14.1% 8.5% 12.5% 13.8% 18.6%
  Overweight 24.5% 10.1% 31.2% 19.8% 37.1%
a
BMI based on age/gender specific percentile.
b
Distribution of BMI status within each ethnic and gender group; Non-overweight  BMI percentile
less then 85, At Risk of Overweight  BMI equal to or higher than 85 but less than 95, Overweight 
higher than 95 percentile.
BMI  body mass index
SD  standard deviation
828 Body image and Hispanic/Latino adolescents

among Hispanic/Latino teens and no significant gender 3 BMI interaction (p.05

for all effects).
Socioeconomic status. The composite index of parental education level was created
by summing responses to both items regarding parental education (i.e., mother and
father). Missing or partial responses (i.e., only one parent’s education provided) were
replaced by a median education level computed separately for each ethnic group. The
amount of missing data for this variable ranged from approximately 12% for European
Americans to 20% and 30% for Hispanic/Latino mothers and fathers, respectively.
The parental education level of Hispanic/Latino adolescents’ was the same for both,
mothers and fathers, and ranged from 6th grade or less to completed graduate school
with completed high school as the median response. In contrast, the maternal educa-
tion level of European American teens ranged from completed high school to completed
graduate school with completed college as the median. The father’s education reported
by European American teens ranged from completed some high school to completed
graduate school with completed college as a median.
The effects of ethnicity, gender, and BMI status on SES were also examined. The
participants’ BMI statuses were entered to analysis at two levels: healthy vs. unhealthy
body weight (overweight and obese groups combined). The two BMI groups were col-
lapsed in order to achieve sufficient group size for comparisons. The 2 (ethnicity) 
2(gender)  2(BMI status) ANOVA conducted on SES revealed significant effects of
ethnicity (F(1,311)123.04 p.001, η2.28), BMI (F(1, 311)9.23, p.01, η2.03),
and ethnicity 3 BMI interaction (F(1,311)6.78, p.01, η2.02). Overall, Hispanic/
Latino SES was lower than that of European Americans (M8.35, SE.20 vs. M12.89,
SE.36). Among European Americans, participants with unhealthy BMI reported lower
SES than those with healthy BMI (M11.74, SE.60 vs. M14.05, SE.39). However,
among Hispanics/Latinos, SES did not significantly differ by BMI status (Healthy:
M8.44, SE.27 vs. Unhealthy: M8.26, SE.30).
Body dissatisfaction. The body dissatisfaction index was computed as a difference in
the ideal vs. actual body shape endorsed by adolescents (e.g., a lower score indicated
more body dissatisfaction). A three-factor ANCOVA was performed on dissatisfaction
scores with ethnicity, gender and BMI status (healthy vs. unhealthy) as independent
factors and SES as a covariate.
Females were more dissatisfied with their bodies than males (F(1, 310)30.16
p.001, η2.09). Body dissatisfaction was also significantly increased among par-
ticipants with an unhealthy BMI, compared with participants with a healthy BMI
(F(1,  310)15.12, p.001, η2.05). Further, body dissatisfaction was higher among
European Americans than among Hispanics/Latinos (F(1, 310)6.97, p.01, η2.02).
Analyses showed a trend toward an interaction between ethnicity and gender (p.06),
in which body dissatisfaction (BD) was highest among European American females,
followed by Hispanic/Latino females, European American males, and Hispanic/Latino
males, consecutively (see Figure 1).
Body dissatisfaction among Hispanic/Latino participants appeared to be unrelated to
acculturation level. The partial correlation between body dissatisfaction and accultura-
tion index while controlling for SES was not significant (r.02, p.84, n224).
 Ceballos and Czyzewska 829

0.5

0.5

1

1.5
E-A-F E-A-M HF HM

Figure 1. Body dissatisfaction by ethnicity and gender (p.06).

E-A F  Euro-Am. females
E-A M  Euro-Am males
HF  Hispanic females
HM  Hispanic males
BMI 5 body mass index

In order to examine body dissatisfaction in our sample further, ethnicity, gender,

and BMI status groups were compared on the desire to be thinner (two survey items)
and dissatisfaction with body muscularity (one item).
The participants’ answers to two survey items related to the desire to be thinner were
averaged prior to analysis. A three-factor ANCOVA performed on average scores with
ethnicity, gender, and BMI status as independent variables and SES as the covariate
confirmed previously revealed gender differences in preferences for a thinner body.
Female adolescents expressed a significantly stronger desire to be thinner than did the
male participants (F(1, 310)23.08, p.001, η2.07). In addition, there was a statistical
trend for adolescents with an unhealthy vs. healthy BMI to express a stronger desire to
become thinner (F(1,310)3.29, p.07, η2.01). There were no significant differences
between ethnic groups, and no significant interactions were observed.
The same analysis was performed on responses to a question related to dissatisfaction
with body muscularity. Results indicated no significant main effects or interactions.
To understand better the roots of the body dissatisfaction findings reported above,
830 Body image and Hispanic/Latino adolescents

additional analyses were conducted on measures of current and ideal body image, and
other factors such as parental expectations regarding adolescents’ weight gain, and
adolescents’ body weight stereotypes.
Body image perception. Ethnicity, gender, and BMI status differences in self-perception
of actual and ideal body size were examine by a series of ANCOVAs (covarying for
SES) performed on responses to the visual body image scales. Prior to analyses, all
participants’ ratings obtained from the visual body image scales were transformed to
correct for differences in the assessment instruments used for males vs. females (i.e.,
seven-point visual body image scales for males and nine-point scales for females). All
females’ scores were multiplied by a coefficient reflecting the scaling difference (i.e., a
ratio 7/9) resulting in a new scale ranging from .77 to 7.0.
Analyses revealed significant differences between BMI groups. Participants with an
unhealthy BMI selected larger body figures than did participants with a healthy BMI
(F(1,310)62.79, p.001, η2.17). In addition, females endorsed significantly larger
body figures than males endorsed (F(1, 310)56.48, p.001, η2.15). The effects of
ethnicity and interactions between variables were not statistically significant.
When the same statistical analysis was repeated for ideal body figure ratings, in
addition to the significant BMI status effect (p.001), results also indicated a signifi-

4.5

3.5

2.5

2
F
1.5
M
1

0.5

0
BMI Healthy BMI UnHealthy

Figure 2. Parental preference for adolescents to loose weight by gender and BMI status
(healthy vs. unhealthy), p.03.
Unhealthy BMI female vs. unhealthy BMI male, p.01
Healthy BMI female vs. healthy BMI male, p.26
 Ceballos and Czyzewska 831

cant difference between ethnicity and gender groups (F(1,310)6.52, p.01 and F(1,
310)4.06, p.05, respectively). Hispanic/Latino adolescents indicated larger body
figures as their ideal body image than did European American adolescents (M3.04,
SE.07 vs. M2.72, SE.10), and females selected larger figures than did males
(M2.99, SE.07 vs. M2.78, SE.08). Interaction effects were not statistically sig-
nificant. It is important to note that, on average, body figures chosen by both groups
were within a healthy range. Any differences between ethnic groups were due to subtle
differences in selected body figures.
Parental expectations. The results of an ANCOVA performed on responses to the
item My parents would like me to lose some weight showed a significant effect of BMI
status (F(1,299)24.05, p.001, η2.07). Further, analyses revealed a higher parental
preference for females to lose weight compared with males (F(1,299)3.90, p.05,
η2.01), and a significant interaction of gender and BMI status (F(1,299)4.70, p.03,
η2.02). Female adolescents with an unhealthy BMI reported the highest parental
preference for them to lose weight. This preference was significantly higher than the
parental preference to be thinner reported by males in the same BMI group (p.01).
This gender difference was not significant for healthy BMI status (p.05). There were
no significant differences between ethnic groups in reported parental expectations.
Parental expectation results are shown in Figures 2 and 3.

2.5

Female
1.5
Male

0.5

0
Hispanic/Latinos European-American

Figure 3. Parental preference for adolescents to gain weight by gender and ethnicity
(p.05).
Males Euro-Am. vs. Hispanic, p.01
Females Euro-Am. vs. Hispanic, p.77
832 Body image and Hispanic/Latino adolescents

The same analyses were conducted on responses to the survey item about parental
preferences for adolescents to gain weight. Results revealed a significant effect of BMI
status (F(1, 305)16.72, p.001, η2.05), and an additional significant main effect
of ethnicity (F(1, 305)4.12, p.05, η2.01). An interaction of ethnicity and gender
was also noted (F(1, 305)3.88, p.05, η2.01). The reported parental preference for
adolescents to gain weight was higher overall among Hispanic/Latino participants, but
within this ethnic group, the parental preference for adolescents’ weight gain showed
a tendency to be higher for males than for females (p.08). Compared with the par-
ents of European American males, the parents of Hispanic/Latino males appeared to
express more concerns about their child’s body being too thin. A trend in the opposite
direction was revealed among European American adolescents, but pair-wise tests of
corresponding differences showed they were not significant (p.05).
Body stereotypes. For analyses of body image stereotypes, an index of positive atti-
tude was computed as a total number negative traits subtracted from a total number
of positive traits ascribed by participants to obese and thin body figures. Lower scores
indicated a more negative attitude toward the body drawing. Separate ANCOVAs were
used to examine differences between ethnicity, gender, and BMI status groups covary-
ing for SES. Body stereotypes results are shown in Figure 4.
Obese silhouette. Results indicated significant interactions between ethnicity and
gender (F(1, 303)3.85, p.05, η2.01) and ethnicity and BMI (F(1, 305)3.73, p.05,
η2.01) with respect to responses to the obese silhouette drawing. A trend toward a
gender difference in response to the obese silhouette was also noted (F(1,305)3.55,
p.06, η2.01). European American male participants showed a significantly more
negative attitude toward the obese male body silhouette than did Hispanic/Latino
male participants (p.02), but this ethnic difference was not significant among females
(p.05). Moreover, among adolescents identified as having an unhealthy BMI, European
American adolescents exhibited a tendency to increased negativity toward the obese
body shape compared with Hispanics/Latinos (p.06). However, the corresponding dif-
ference was not significant among adolescents with a healthy body weight (p.05).
Thin silhouette. Compared with male participants, females expressed significantly
more negative stereotypes in response to the same-sex thin body figure (F(1, 304)31.00,
p.001, η2.09; females: M1.38, SE.64; males: M3.84, SE.70). No other
significant findings were noted.

Discussion
Recent research suggests that Hispanic/Latino male and female adolescents of the
Texas-Mexico border region may be at particular risk of developing obesity and co-
morbid medical conditions.2 The current study examined trends in body image by
gender, culture, and body mass index in a large group of Hispanic/Latino and European
American adolescents from this region. Several interesting trends emerged.
Overall, many survey results supported the BMI and gender differences reported in
previous studies. For instance, females were found to be more dissatisfied with their
bodies and expressed a significantly stronger desire to be thinner than males, and
individuals with an unhealthy BMI reported significantly more body dissatisfaction
overall than others. In addition, Hispanics/Latinos identified larger ideal body sizes than
 Ceballos and Czyzewska 833

2

4

6

8

10
HF HM E-A-F E-A-M

Figure 4. Obese body stereotype by ethnicity and gender (p.05).

Euro-Am. males vs. Hispanic males, p.02
Euro-Am. females vs. Hispanic females, p.90
HF  Hispanic females
HM  Hispanic males
E-A F  Euro-Am. females
E-A M  Euro-Am males

European Americans. These findings are consistent with previous work,11,38 although
the literature remains unsettled overall.35
In one of the most interesting findings of the current study, body dissatisfaction was
higher among European Americans than among Hispanics/Latinos, and a trend was
noted for an interaction between gender and ethnicity (p.06). Body dissatisfaction
was highest among European American females, followed by Hispanic/Latino females,
European American males, and Hispanic/Latino males, in that order. Thus, although
European American adolescents report greater body dissatisfaction overall, the pattern
of body dissatisfaction within Hispanic/Latino and European American groups appears
to be similar in that females report greater body dissatisfaction than males.
As reviewed in Caballero and Tenzer,39 Hispanic/Latino views regarding body image
tend to endorse the toleration or even celebration of individuals who are slightly over-
weight or plump. This body type is considered to reflect a state of being “well cared
for and healthy”; this preference for a body type corresponding to the Spanish term
gordito is particularly apparent in reference to children and adolescents.39 Taken together,
these attitudes may lessen the social pressure to lose weight; thus, contributing to the
834 Body image and Hispanic/Latino adolescents

approval of larger body types in the Hispanic/Latino populations.39 However, it is also

important to note that research studies have also failed to find significant ethnic dif-
ferences in preferred body image.40
As a possible explanation for the differences in body dissatisfaction between gen-
ders and between ethnic groups, a number of additional variables were examined,
including parental preferences for adolescents’ body sizes and adolescents’ positive and
negative stereotypes associated with thin and obese silhouettes. For responses to the
obese silhouette drawing, ethnicity significantly interacted with both gender and BMI.
European American male participants showed a significantly more negative attitude
toward the presentation of an obese male body silhouette than Hispanic/Latino males
showed. The corresponding difference was not significant among females. Interest-
ingly, an effect of ethnicity was also noted within the group of participants identified
as having an unhealthy BMI. European American adolescents with an unhealthy BMI
reported a significantly more negative response to the obese silhouette than Hispanic/
Latino adolescents reported. This effect could be related to Hispanic/Latino adolescent’s
preference for a larger ideal body size overall and was consistent with our finding that
Hispanic parents prefer their children, particularly males, to gain weight.
Female participants exhibited significantly more negative stereotypes than the male
participants exhibited in response to thin same-sex figures. No other significant find-
ings were noted.
These findings stand in contrast to previous reports in which gender19 and current
BMI18 were not significant predictors of the association of negative stereotypes with the
obese silhouette. However, as Hill and Silver19 studied younger adolescents, and Latner
et al.18 included older participants, it is possible that our findings may be more specific
to our pubertal sample ranging in age from 12 to 15. Previous work has suggested that
this range may be a particularly sensitive time for youngsters around matters of body
image.41 Further, few studies have included Hispanic/Latino adolescent populations.
In a notable exception, Greenleaf and colleagues35 compared 157 European Ameri-
can and 117 Hispanic/Latino middle school students with regard to their responses to
obese and thin body silhouettes, among other measures. Few differences were noted
between Hispanic/Latino and European American participants. In comparison, the
results of the current study suggest that racial/ethnic differences in responding to the
body weight stereotypes instrument may be influenced significantly by other factors,
such as gender and BMI. This finding is particularly interesting, as a number of previ-
ous studies have shown that Hispanic/Latino males typically prefer a larger body type
and may be more likely to engage in extreme weight/muscle-building strategies such
as the use of steroids.11,38
Given the pattern of gender and ethnicity differences in parental preferences for
adolescent weight/body size, as well as individual responses to obese and thin body
silhouettes, it appears that these additional factors (e.g., ethnicity and individual body
type preferences) may contribute to the body dissatisfaction levels and motivations
regarding body size preferences among male and female adolescents.
Although the results of the current study are thought-provoking, a number of limi-
tations should be corrected in future investigations. First, the current findings were
obtained via online survey from a limited sample of adolescents in Central Texas; thus,
 Ceballos and Czyzewska 835

results may have been influenced by the collection method and also may not directly
generalize to other geographical regions. In addition, these findings should be inter-
preted with caution due to the limitations of self-reported anthropometric data. It is
important to note that BMI indices calculated based on self-reported height and weight
estimates are commonly used by researchers and large scope national surveys.42,43 While
some data indicate self-reported height/weight as an adequately accurate measure of
actual height/weight,44,45 other researchers warn about systematic bias that might be
introduced to anthropometric estimates based on participants’ reports.46,47
Specifically, self-reported weight and height values are often thought to underesti-
mate a participant’s true BMI,48,49 although gender appears to be an important factor
in such misperceptions. Kuchler and Variyam50 have noted that men who are obese or
overweight are more likely than obese or overweight women to underestimate their
weight status, whereas women who are healthy weight/underweight are more likely than
men to believe they are overweight. Further, those who underestimated their weight
frequently reported low levels of education and income, and those who overestimated
their weight were frequently of a higher socioeconomic status.50 However, it is important
to note that much of the work on weight misperception has focused on adults.48,49
Further, gender differences in responses to the obese and thin silhouettes might at least
partially reflect responses to specific details of the body drawings, which were different
for males and females and were originally designed for use in predominantly European
American populations. Future studies should focus on the development and use of
more culturally-relevant body drawings for Hispanic/Latino populations. In addition,
research utilizing direct body height/weight assessment (i.e., objective BMI) is needed to
examine more closely the nature of the potential discrepancy between actual, perceived,
and ideal body size among Hispanic/Latino female adolescents. This promising line
of investigation may lead to a better understanding of the psychological mechanisms
contributing to increased body dissatisfaction among female adolescents.
Additional limitations and areas for further study include the assessment of accul-
turation and socioeconomic status within health research. To assess acculturation, the
current study used an instrument developed by the authors and their collaborators,
which focused on Spanish communication skills as an index of acculturation among
Hispanic/Latino adolescents. Despite the relevance of language as an index of accultura-
tion among adolescents, future studies employing more specific surveys of acculturation
level are needed to substantiate the findings of the current study.
Further, the assessment of socioeconomic status in health research studies remains
somewhat controversial, with recent publications calling for more extensive measures
and better acknowledgment of the limitations of existing methods.33 The current
study utilized parental education as an index of socioeconomic status in a popula-
tion of adolescents. The authors acknowledge that the use of parental schooling as a
proxy is not the ideal method for assessing socioeconomic status. However, given the
age and experience level of the current sample, a more extensive measure including
income, wealth, occupation, neighborhood characteristics and/or past socioeconomic
­experiences, as recommended by Braveman and colleagues,33 was not feasible. Future
work should include age-appropriate adaptations of the recommendations made by
Braveman and colleagues.33
836 Body image and Hispanic/Latino adolescents

Conclusion. Body dissatisfaction and related traits are influenced by gender, cul-
ture, and their interaction. The results of the current study suggest that among both
European American and Hispanic/Latino adolescents, females exhibit greater body
dissatisfaction than males; however, European Americans reported greater body dis-
satisfaction overall than Hispanics/Latinos. This study represents an important step
toward a better understanding of weight-related health risks facing the understudied
population of Hispanic/Latino teens and an important contribution to the ongoing
literature addressing socio-cultural attitudes toward appearance as an effective means
of reducing body image satisfaction and co-morbid conditions such as obesity and
disordered eating.14

Acknowledgments
The authors wish to express their sincere appreciation to the San Marcos Consolidated
Independent School District, particularly Principal John Orozco and campus technolo-
gist Lisa Jones, as well as the staff and volunteers of Latinitas.org for their assistance
with recruitment. In addition we wish to thank G. Marc Turner, PhD for his assistance
with the design of the web-based survey and Ms. Jade Lovera for her help with data
collection.
Earlier versions of the survey were piloted in a small focus group of adolescent
females who commented on the suitability of the assessment and provided suggestions
for wording changes. The authors wish to thank these volunteers for their contribu-
tions to the project.

Notes
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