Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

Users Online : 124016

AbstractMaterial and MethodsResultsDiscussionConclusionReferencesDOI and Others
Article in PDF How to Cite Citation Manager Readers' Comments (0) Audio Visual Article Statistics Link to PUBMED Print this Article Send to a Friend
Advertisers Access Statistics Resources

Dr Mohan Z Mani

"Thank you very much for having published my article in record time.I would like to compliment you and your entire staff for your promptness, courtesy, and willingness to be customer friendly, which is quite unusual.I was given your reference by a colleague in pathology,and was able to directly phone your editorial office for clarifications.I would particularly like to thank the publication managers and the Assistant Editor who were following up my article. I would also like to thank you for adjusting the money I paid initially into payment for my modified article,and refunding the balance.
I wish all success to your journal and look forward to sending you any suitable similar article in future"

Dr Mohan Z Mani,
Professor & Head,
Department of Dermatolgy,
Believers Church Medical College,
Thiruvalla, Kerala
On Sep 2018

Prof. Somashekhar Nimbalkar

"Over the last few years, we have published our research regularly in Journal of Clinical and Diagnostic Research. Having published in more than 20 high impact journals over the last five years including several high impact ones and reviewing articles for even more journals across my fields of interest, we value our published work in JCDR for their high standards in publishing scientific articles. The ease of submission, the rapid reviews in under a month, the high quality of their reviewers and keen attention to the final process of proofs and publication, ensure that there are no mistakes in the final article. We have been asked clarifications on several occasions and have been happy to provide them and it exemplifies the commitment to quality of the team at JCDR."

Prof. Somashekhar Nimbalkar
Head, Department of Pediatrics, Pramukhswami Medical College, Karamsad
Chairman, Research Group, Charutar Arogya Mandal, Karamsad
National Joint Coordinator - Advanced IAP NNF NRP Program
Ex-Member, Governing Body, National Neonatology Forum, New Delhi
Ex-President - National Neonatology Forum Gujarat State Chapter
Department of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat.
On Sep 2018

Dr. Kalyani R

"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."

Dr Kalyani R
Professor and Head
Department of Pathology
Sri Devaraj Urs Medical College
Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
On Sep 2018

Dr. Saumya Navit

"As a peer-reviewed journal, the Journal of Clinical and Diagnostic Research provides an opportunity to researchers, scientists and budding professionals to explore the developments in the field of medicine and dentistry and their varied specialities, thus extending our view on biological diversities of living species in relation to medicine.
‘Knowledge is treasure of a wise man.’ The free access of this journal provides an immense scope of learning for the both the old and the young in field of medicine and dentistry as well. The multidisciplinary nature of the journal makes it a better platform to absorb all that is being researched and developed. The publication process is systematic and professional. Online submission, publication and peer reviewing makes it a user-friendly journal.
As an experienced dentist and an academician, I proudly recommend this journal to the dental fraternity as a good quality open access platform for rapid communication of their cutting-edge research progress and discovery.
I wish JCDR a great success and I hope that journal will soar higher with the passing time."

Dr Saumya Navit
Professor and Head
Department of Pediatric Dentistry
Saraswati Dental College
On Sep 2018

Dr. Arunava Biswas

"My sincere attachment with JCDR as an author as well as reviewer is a learning experience . Their systematic approach in publication of article in various categories is really praiseworthy.
Their prompt and timely response to review's query and the manner in which they have set the reviewing process helps in extracting the best possible scientific writings for publication.
It's a honour and pride to be a part of the JCDR team. My very best wishes to JCDR and hope it will sparkle up above the sky as a high indexed journal in near future."

Dr. Arunava Biswas
MD, DM (Clinical Pharmacology)
Assistant Professor
Department of Pharmacology
Calcutta National Medical College & Hospital , Kolkata

Dr. C.S. Ramesh Babu
" Journal of Clinical and Diagnostic Research (JCDR) is a multi-specialty medical and dental journal publishing high quality research articles in almost all branches of medicine. The quality of printing of figures and tables is excellent and comparable to any International journal. An added advantage is nominal publication charges and monthly issue of the journal and more chances of an article being accepted for publication. Moreover being a multi-specialty journal an article concerning a particular specialty has a wider reach of readers of other related specialties also. As an author and reviewer for several years I find this Journal most suitable and highly recommend this Journal."
Best regards,
C.S. Ramesh Babu,
Associate Professor of Anatomy,
Muzaffarnagar Medical College,
On Aug 2018

Dr. Arundhathi. S
"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".

Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
On Aug 2018

Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
The journal has a monthly publication and the articles are published quite fast. In time compared to other journals. The on-line first publication is also a great advantage and facility to review one's own articles before going to print. The response to any query and permission if required, is quite fast; this is quite commendable. I have a very good experience about seeking quick permission for quoting a photograph (Fig.) from a JCDR article for my chapter authored in an E book. I never thought it would be so easy. No hassles.
Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".

Dr. Mamta Gupta
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018

Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.

Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."

Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
On May 11,2011

Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."

Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
On April 2011

Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.

Dr. Anuradha
On Jan 2020

Important Notice

Original article / research
Year : 2023 | Month : November | Volume : 17 | Issue : 11 | Page : LC11 - LC14 Full Version

A Cross-sectional Study on Body Image Perception and Self-Esteem among Adolescent Girls in Urban and Rural Areas of Kolkata, West Bengal, India

Published: November 1, 2023 | DOI:
Baishakhi Paria, Malvika Dwivedi, Sunetra Kaviraj Roy

1. Assistant Professor, Department of Community Medicine, Jalpaiguri Government Medical College and Hospital, Jalpaiguri, West Bengal, India. 2. Assistant Professor, Department of Community Medicine, Calcutta National Medical College, Kolkata, West Bengal, India. 3. Assistant Professor, Department of Community Medicine, Calcutta National Medical College, Kolkata, West Bengal, India.

Correspondence Address :
Dr. Malvika Dwivedi,
Assistant Professor, Department of Community Medicine, Government Housing Estate, 44 Ironside Road, Ballygunge Park, Kolkata-700019, West Bengal, India.


Introduction: Adolescence is one of the most important and crucial phases of learning and individual development. Adolescents are particularly vulnerable due to the physiological, social, and psychological changes they undergo. Understanding the factors responsible for the development of body image perception and self-esteem is crucial for adolescent health and well-being.

Aim: To estimate the prevalence of body image dissatisfaction among urban and rural girls and its impact on self-esteem.

Materials and Methods: A cross-sectional study was conducted in two Government schools located in urban and rural areas of Calcutta National Medical College, Kolkata, West Bengal, India. The sample size of the study was 397, with 206 girls from urban areas and 191 girls from rural areas. The Rosenberg Self-esteem Scale was used to measure self-esteem. The Stunkard Silhouettes Figure Rating Scale (FRS) was used to measure adolescents’ body image dissatisfaction. The height and weight of the participants were measured, and Body Mass Index (BMI) was calculated. Data was compiled, presented in tabular form, and analysed using Statistical Package for Social Sciences (SPSS) version 23.0.

Results: A total of 206 (51.89%) study subjects in the present study resided in urban areas, with a mean age of 15±3.32 years. Among the study population, 242 adolescent girls (60.95%) were dissatisfied with their body image. Body image dissatisfaction was higher among urban girls (57.85%) compared to adolescent girls in rural areas. A significant association between self-esteem and body image perception was found. Among the girls in the study population, 126 (52.1%) were both dissatisfied with their body image and had low self-esteem.

Conclusion: The present study shows that the majority of adolescent females were dissatisfied with their body image, and a significant association between low self-esteem and body image perception was established.


Adolescence, Body image dissatisfaction, Body weight, Low self-esteem

In India, the adolescent population constitutes 20% of the total population, reaching nearly 30 crores. Therefore, gathering information about their health needs, both physical and mental, is a national imperative with global implications (1). Adolescence is a crucial phase of growth and development, as many health-related behaviours that arise during this time have long-lasting implications. The mental health of adolescents not only affects their present well-being but also influences their personality, attitude, and behaviour as adults (2). During this period, rapid and simultaneous physiological changes occur in the body (3), making it a critical stage for the development of positive or negative body image perceptions (4),(5).

Body image is a multidimensional construct that encompasses a person’s perceptions, feelings, actions, and thoughts about their body. It is typically perceived as including body size estimation, evaluation of body attractiveness, and emotions associated with body shape and size (6). The struggle with body image is prevalent across all adolescent age groups but is experienced more by adolescent girls than boys, as shown by a study conducted by Van den Berg PA et al., in 2010 (7). The rapid physical changes in shape and weight during adolescence, along with socio-cultural influences, play a significant role in shaping body image perceptions and contribute to the emotional and social development of adolescents (8).

According to a study by Paxton SJ et al., although there are many factors that influence an adolescent’s self-esteem, body image is a critical factor. Self-esteem, which refers to a sense of self-respect and personal appraisal, is an important aspect of an individual’s identity (9). Self-esteem arises automatically from within based on a person’s beliefs and consciousness. Self-esteem and body image perceptions are terms that are often used interchangeably. Evaluative perceptions of oneself and one’s physical appearance are crucial for the development of self-confidence in adolescents. These self-evaluations impact emotional experiences, future behaviour, and long-term psychological adjustment and achievements in life (10).

Stress, developmental changes, and social adjustment problems are concerning issues for adolescents, especially rural teens. Overvaluing body image as a determinant of one’s self-worth is a crucial risk factor that can make individuals more susceptible to eating disorders. Adolescence represents a critical stage in the development of positive or negative body image. Therefore, although screening for psychosocial problems by teachers and other school personnel is infrequent, it can be a useful health promotion strategy (11).

With growing public health concerns regarding weight status, physical inactivity, obesity, eating disorders, and their associated spectrum of health consequences, the topic of body image has attracted significant attention worldwide, particularly in psychological sciences and philosophy. However, it has not been extensively studied in India, especially in terms of comparative urban-rural studies focusing on self-esteem and body image perception. The aim of the present study was to estimate the prevalence of body image dissatisfaction among urban and rural adolescent girls and explore any potential association, if any, between body image dissatisfaction and self-esteem within the study population.

Material and Methods

A cross-sectional study was conducted over a period of six months (June 2022 to November 2022) in two government schools located in urban and rural areas associated with Calcutta National Medical College. Permission was obtained from the school authorities, and ethical clearance was granted by the Institutional Ethical Committee (CM/CNMC/2467).

The details and necessity of the study were explained to the students and teachers. School records obtained from both schools revealed a total of 452 adolescent girls enrolled in middle, secondary, and higher secondary classes. Among them, 206 adolescent girls were from the urban area school, and 191 were from the rural area school. For the study sample, purposive sampling was used, including all girls in the age group of 10-19 years who were willing to participate and available during the data collection period.

Inclusion and Exclusion criteria: Girls who were absent, unwilling, or had confirmed mental or physical disabilities were excluded. After obtaining verbal assent from the students and informed consent from their parents/guardians, a total of 397 students were included in the study.

Study Procedure

A predesigned, pretested self-administered questionnaire was used for data collection after translation into the local language, Bengali. The validation of the questionnaire was done with the assistance of three public health experts. Standardised and reliable tools were used to assess body image perception and self-esteem.

Section I: Demographic Profile: This section includes items related to the demographic data of the study subjects, such as age, education, religion, type of family, and residency.

Anthropometric measurements of height and weight were taken, and BMI was calculated.

Section II : Rosenberg Self-esteem Rating Scale: This section consists of 10 items that assess the self-esteem of the participants. The scoring of the items was based on a 4-point Likert Scale, ranging from strongly agree (score 1) to strongly disagree (score 4). Out of the 10 items, five negative statements were scored as given below, and five positive statements were reverse-scored. The scale ranges from 0 to 30, with scores between 15 and 25 falling within the normal range, while scores below 15 suggest low self-esteem (12).

Section lll: Body Image Dissatisfaction: The Stunkard Silhouettes FRS was used to measure body image dissatisfaction in adolescents. It includes drawings of nine silhouettes ranging from very thin (1) to very heavy (9). Students were given the FRS (female version) and asked to indicate the figure that they currently identified themselves with the most. Body image dissatisfaction was assessed by examining the difference between perceived body image and actual body size based on BMI categories. The numbers on the body image perception scale (perceived or ideal) were classified into four groups using standard procedures: 1 and 2 for underweight, 3 and 4 for normal weight, 5-7 for overweight, and 8 and 9 for obese shape (13),[ 14]. Hence, participants who showed discrepancies in the chosen figures were identified as having body image dissatisfaction.

Statistical Analysis

The collected data were entered into Microsoft excel and analysed using SPSS Inc., version 16.0, for Windows (Chicago, USA, SPSS Inc.). Descriptive analysis was conducted using frequencies, means, standard deviations, and proportions. Chi-square (X2)statistical tests were performed to explore further associations.


The mean age of the study population was 15±3.32 years. The youngest study subject was 11 years old, and the oldest study subject was 19 years old. Among the population, 153 (38.54%) belonged to the early adolescent group, i.e., from 10 to 14 years (Table/Fig 1). The majority 241 (60.71%) belonged to nuclear families. In the present study, most of the participants (172) were in middle school (43.32%). A total of 206 (51.89%) study subjects resided in urban areas, while 191 (48.11%) were from rural areas. Among the study population, 126 (31.73%) were classified as underweight according to the World Health Organisation (WHO) BMI classification, and 95 (23.93%) were overweight (Table/Fig 2).

(Table/Fig 2) showed that the majority, 242 adolescent girls (60.95%), in the study population were not satisfied with their body image. Among those not satisfied, 140 (57.89%) were from urban areas. A significant association was found between residence and body image perception. (Table/Fig 3) suggests that among underweight school girls with body image dissatisfaction, the majority (54; 56.25%) were from urban areas, while among overweight adolescent girls with body image dissatisfaction, the majority (66.67%) were also from urban areas. (Table/Fig 4) shows that 59.78% of adolescent girls with low self-esteem resided in urban areas, whereas 40.21% of adolescent girls with low self-esteem were from rural areas.

Finally, the study suggests that 52.1% of the study population had both low self-esteem and dissatisfaction regarding body image, and 47.93% of adolescent girls with normal self-esteem had body image dissatisfaction, as shown in (Table/Fig 5).


Adolescence represents a crucial time for building a healthy body image as it is a period of physical and psychological changes influenced by social surroundings. Importantly, body image development has developmental significance as it is a dynamic aspect that changes over the lifespan (4). The present study aimed to estimate the prevalence of body image dissatisfaction among urban and rural school girls and understand the factors significantly influencing it.

The findings of the present study showed that 60.95% of the study population were dissatisfied with their body image perception. These results were similar to a study conducted in Chennai by Sasi RV and Maran K among adolescents above the age of 12, which revealed a prevalence of 81% (15). According to the present study, 42.15% of adolescent girls from rural areas and 57.85% of girls from urban areas were dissatisfied with their body image. These findings correlate with a study done by Dixit S et al., wherein dissatisfaction was higher in urban areas (30.20%) compared to rural areas (22.3%) (16).

A study by Ganesan S et al., showed that 77.6% of the adolescents were dissatisfied with their body image, and 56.25% of them were from urban areas (17). Mishra S et al., reported that urban girls outnumbered rural girls in following a weight reduction diet, and significant differences in perceptions of their own body weight and shape were noticed among girls from different residential areas, which corroborates the present study results (18).

Musaiger A in their study, concluded that approximately 32-39% of females were dissatisfied with their body weight (19). The study findings by Kaur S and Thakur K revealed that 12% of adolescent girls were dissatisfied, 73% were partially dissatisfied, and 15% were highly satisfied, supporting the results presented in (Table/Fig 2) (20). A study done by Srivastava R and Joshi S suggests that no significant association exists with regard to self-esteem in urban and rural adolescents (21). No significant differences were found in the prevalence of mild underweight girls and overweight girls in the urban and rural groups (26.5% vs 22.3% and 7.5% vs 5.2%, respectively), as reported in a study by Moshago Berheto T et al., (22). Lata S and Devi A reported in their study that 86% of female adolescent college students desired to be slim (23).

A study by Ganesan S et al., showed that in their study, 71% of the study population with normal BMI were dissatisfied, while among the underweight category, 23.3% were satisfied and 7% wanted to lose further weight, which corroborates with our study where 47.3% of school girls with normal BMI were dissatisfied with their body image perception (17).

The present study shows that among underweight school girls, 43.75% of girls were dissatisfied with their body image in rural areas, while 56.25% had body image dissatisfaction in urban areas. Among overweight girls, 66.67% had body image dissatisfaction in urban areas, whereas 33.33% of rural overweight girls were dissatisfied. The findings of research by Divya V and Mayuri K show an effective relationship between body image perceptions and self-esteem of adolescents (24). According to Adrian Furnham’s study, girls had a higher prevalence of body image-associated low self-esteem than boys, and it was concluded that body image dissatisfaction is strongly influenced by self-esteem (25). Similarly, the present study findings also show a significant association between self-esteem and body image perception. 52.1% of the study population had both body image dissatisfaction and low self-esteem. A study conducted by Paxton SJ et al., shows that body image dissatisfaction is a risk factor for low self-esteem, affirming the present findings (9).

There should be better awareness of a nutritious diet and regular physical activity for maintaining a normal body weight. Special interventions must be taken to explain the media propaganda on unnatural images of perfect body figures and the side-effects of unnatural fad diets. School administration, teachers, and students were made aware of the Adolescent Friendly Health Services delivered through trained service providers-Mobile Originated (MO), Auxillary Nursing Midwifery (ANM), and Counsellors at Adolescent Friendly Health Clinics located at Primary Health Centres (PHCs), Community Health Centres (CHCs), District Hospitals (DHs), and Medical Colleges.


Although the study was conducted in large Government schools that included adolescents from varied socio-economic and cultural backgrounds, it is important to note that only a single school was selected from urban and rural areas for inclusion in the study. This restriction may limit the generalisability of the findings.


The present study establishes the fact that body image dissatis-faction is no longer solely a Western concept and significantly affects both rural and urban Indian adolescent girls. A substantial portion of girls were dissatisfied with their body image regardless of their BMI. On further exploration, a significant association was found between low self-esteem and dissatisfaction with body image. Therefore, there should be proper planning for interventions to educate adolescents on proper nutrition and the concept of BMI in order to protect these young adults. Negative perception of one’s body image has the effect of lowering self-esteem, which in turn increases psychological distress and negatively impacts overall well-being of individuals.


Samir KC, Wurzer M, Speringer M, Lutz W. Future population and human capital in heterogeneous India. Proc Natl Acad Sci USA. 2018;115(33):8328-33. [crossref][PubMed]
Singh G, Agarwal S. A comparative study on attitude of adolescent and adult towards Yoga. Asian J Home Sci. 2013;8(1):324-26.
Pinho L, Brito MFSF, Silva RRV, Messias RB, Silva CSOE, Barbosa DA, et al. Perception of body image and nutritional status in adolescents of public schools. Rev Bras Enferm. 2019;72:229-35. [crossref][PubMed]
Voelker DK, Reel JJ, Greenleaf C. Weight status and body image perceptions in adolescents: Current perspectives. Adolescent Health Med. 2015;6:149-58. [crossref][PubMed]
Elia C, Karamanos A, Silva MJ, O’Connor M, Lu Y, Dregan A . Weight misperception and psychological symptoms from adolescence to young adulthood: Longitudinal study of an ethnically diverse UK cohort. BMC Public Health. 2020;20(1):712.[crossref][PubMed]
Grogan S. Body image: Understanding body dissatisfaction in men, women and children. London: Routledge; 1999. [Last accessed on 2019 Oct 15].
Van Den Berg PA, Mond J, Eisenberg M, Ackard D, Neumark-Sztainer D. The link between body dissatisfaction and self-esteem in adolescents: Similarities across gender, age, weight status, race/ethnicity, and socio-economic status. Journal of Adolescent Health. 2010;47(3):290-96. [crossref][PubMed]
National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Division of Behavioral and Social Sciences and Education; Board on Children, Youth, and Families; Committee on the Neurobiological and Socio-behavioral Science of Adolescent Development and Its Applications; Backes EP, Bonnie RJ, editors. The Promise of Adolescence: Realizing Opportunity for All Youth. Washington (DC): National Academies Press (US); 2019 May 16. 2, Adolescent Development.
Paxton SJ, Neumark-Sztainer D, Hannan PJ, Eisenberg ME. Body dissatisfaction prospectively predicts depressive mood and low self-esteem in adolescent girls and boys. Journal of Clinical Child & Adolescent Psychology. 2010;35(4):539-49. [crossref][PubMed]
Beck. Development through the life span; Boston: Allyn2Bacon. (2nd Ed.)
Duchesne AP, Dion J, Lalande D, Bégin C, Émond C, Lalande G, et al. Body dissatisfaction and psychological distress in adolescents: Is self-esteem a mediator. Journal of Health Psychology. 2017;22(12):1563-69. [crossref][PubMed]
Rosenberg, Morris. 1989. Society and the Adolescent Self-Image. Revised edition Rosenberg’s Self-esteem Scale. Available from: https://www.wwnorton. com/college/psych/psychsci/media/rosenberg.htm. [Last accessed on 2022 Jun 21].
Bhuiyan AR, Gustat J, Srinivasan SR, Berenson GS. Differences in body shape representations among young adults from a biracial (Black-white), semirural community: The Bogalusa heart study. Am J Epidemiol. 2003;158:792-97. [crossref][PubMed]
Lo WS, Ho SY, Mak KK, Lam TH. The use of Stunkard’s figure rating scale to identify underweight and overweight in Chinese adolescents. PLoS One. 2012;7:e50017. [crossref][PubMed]
Sasi RV, Maran K. Advertisement pressure and its impact on body dissatisfaction and body image perception of women in India. Glob Med J Indian Ed. 2012;3:01-09.
Dixit S, Agarwal G, Singh J, Kant S, Singh N. A study on consciousness of adolescent girls about their body image. Indian J Community Med. 2011;36(3):197-202. [crossref][PubMed]
Ganesan S, Ravishankar SL, Ramalingam S. Are body image issues affecting our adolescents? A cross-sectional study among college going adolescent girls. Indian J Community Med. 2018;43:S42-46. [crossref][PubMed]
Mishra S, Mukhopadhyay S. Eating and weight concerns among Sikkimese adolescent girls and their biocultural correlates: An exploratory study. Public Health Nutrition. 2011;14(5):853-59. [crossref][PubMed]
Musaiger A. Body weight concern among female university students in five Arab countries--a preliminary cross-cultural study. Ann Agric Environ Med. 2015;22(2):349-52. [crossref][PubMed]
Kaur S, Thakur K. A descriptive study to assess the perceived impact of body image on self-esteem among adolescent girls in Baru Sahib, district Sirmour, Himachal Pradesh. Journal of Indian Public Health Association (ipha) Chandigarh state branch, Chandigarh (u.t.) 2018;3(9).
Srivastava R, Joshi S. Relationship between self-concept and self- esteem in adolescents. International Journal of Advanced Research. 2014;2(2):36-43.
Moshago Berheto T, Mikitie WK, Argaw A. Urban-rural disparities in the nutritional status of school Adolescent girls in the Mizan district, south-western Ethiopia. Rural and Remote Health. 2015;15:3012. [crossref]
Lata S, Devi A. Problems and challenges during adolescence. International Journal of Education and Management Studies. 2016;6(2):205.
Divya V, Mayuri K. Body image perceptions and its correlation with self-esteem of adolescents studying in engineering Colleges of Hyderabad. International Journal of Indian Psychology. 2015;3(1). [crossref]
Furnham A, Cheng H. Childhood intelligence, self-esteem, early trait neuroticism and behaviour adjustment as predictors of locus of control in teenagers. Personality and Individual Differences. 2016;95:178-82.[crossref]

DOI and Others

DOI: 10.7860/JCDR/2023/62667.18697

Date of Submission: Jan 24, 2023
Date of Peer Review: Apr 15, 2023
Date of Acceptance: Sep 18, 2023
Date of Publishing: Nov 01, 2023

• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. Yes

• Plagiarism X-checker: Jan 27, 2023
• Manual Googling: Apr 20, 2023
• iThenticate Software: Sep 15, 2023 (20%)

ETYMOLOGY: Author Origin


JCDR is now Monthly and more widely Indexed .
  • Emerging Sources Citation Index (Web of Science, thomsonreuters)
  • Index Copernicus ICV 2017: 134.54
  • Academic Search Complete Database
  • Directory of Open Access Journals (DOAJ)
  • Embase
  • EBSCOhost
  • Google Scholar
  • HINARI Access to Research in Health Programme
  • Indian Science Abstracts (ISA)
  • Journal seek Database
  • Google
  • Popline (reproductive health literature)