Body dissatisfaction, drug use, and associated factors among adolescents in three Brazilian cities

Rocha, Ryvanne Paulino; Galvão, Patrícia Paiva de Oliveira; Sanchez, Zila van der Meer; Rebouças, Lidiane Nogueira; Castro Júnior, André Ribeiro de; Santos, Luís Eduardo Soares dos; Martins, Mariana Cavalcante; Pinheiro, Patrícia Neyva Da Costa; Vieira, Neiva Francenely Cunha; Gubert, Fabiane do Amaral

doi:10.1590/1518-8345.6163.3663

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Revista Latino-Americana de Enfermagem

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Original Article • Rev. Latino-Am. Enfermagem 30 (spe) • 2022 • https://doi.org/10.1590/1518-8345.6163.3663 copy

Body dissatisfaction, drug use, and associated factors among adolescents in three Brazilian cities^* * This article refers to the call “Adolescent health and the role of nurses”. Edited by Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil. Publication of this supplement was supported by the Pan American Health Organization (PAHO/WHO). Articles have undergone the journal’s standard peer-review process for supplements. The views expressed in this supplement are those of the authors alone and do not represent the views of PAHO/WHO. Paper extracted from master’s thesis “Avaliação da percepção e satisfação com a imagem corporal entre adolescentes brasileiros”, presented to Universidade Federal do Ceará, CE, Brazil. Supported by Ministério da Saúde (TED # 176/2017), Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective:

analyze the association between drug use and body dissatisfaction among adolescents in three Brazilian cities.

Method:

cross-sectional study, using a nested randomized controlled trial to evaluate the drug use prevention program #TamoJunto2.0 of the Ministry of Health in Brazilian schools. The sample consisted of 5,213 students from 73 schools in three Brazilian cities. The outcome body satisfaction was analyzed using the Stunkard scale and the explanatory variables were drug use and sociodemographic data.

Results:

the adolescents were between 12 and 14 years old; about 69.9% of them reported body dissatisfaction, and 35.67% used alcohol in the previous year. Dissatisfaction due to overweight was higher among girls (41.5%) and dissatisfaction due to underweight was higher among boys (33.1%). Adolescents who used marijuana were 39% (OR=1.39) more likely to feel dissatisfied due to underweight and being a girl increased the chances of feeling dissatisfied due to overweight by 24% (OR=1.24).

Conclusion:

the levels of body dissatisfaction deserve attention in hebiatric nursing care and reinforce the importance of educational strategies addressing body image and drug use, relating them to the various subjective attributes that can affect the health of adolescents, whether in the community or at school.

Descriptors:
Body Dissatisfaction; Adolescent; Alcohol Drinking; Drug Abuse, Health Promotion; Students

Highlights:

(1) High prevalence of body dissatisfaction related to overweight.

(2) Girls presented 24% more chances of feeling body dissatisfaction due to overweight.

(3) Marijuana use in adolescence can increase by 39% body dissatisfaction due to underweight.

(4) Last year, about 35.7% of adolescents had already consumed alcohol.

(5) Health promotion and stimulation of positive perceptions of self-image.

VARIABLES		N	%	95%CI^*
City
	São Paulo	2376	58.53	[54.78; 62.19]
	Fortaleza	2051	30.37	[27.53; 33.36]
	Eusébio	786	11.10	[10.08; 12.22]
Sex
	Male	2578	50.06	[49.04; 51.08]
	Female	2573	49.94	[48.92; 50.96]
Age (years)
	Mean ± SD^†	13.23±0.85
	12-14	4648	89.27	[88.22; 90.23]
	15-17	565	10.73	[9.77; 11.78]
SES ^‡
	Mean ± SD^†	24.75±9.19
	A (45-100)	179	3.91	[3.41; 4.48]
	B (29-44)	1282	27.19	[25.08; 29.40]
	C (17-28)	2809	54.03	[52.50; 55.55]
	D/E (1-16)	884	14.87	[13.45; 16.42]
Real self-image (How do you see yourself?) ^§
	Silhouettes 1 to 3	2093	50.03	[48.88; 51.18]
	Silhouettes 4 to 6	2029	48.42	[47.27; 49.57]
	Silhouettes 7 to 9	71	1.55	[1.30; 1.86]
Ideal self-image (How would you like to look?) ^§
	Silhouettes 1 to 3	2086	51.65	[50.61; 52.69]
	Silhouettes 4 to 6	1940	48.10	[47.05; 49.15]
	Silhouettes 7 to 9	10	0.25	[0.16; 0.38]
Body satisfaction ^§
	Satisfied	1146	30.11	[29.11; 31.13]
	Dissatisfied due to underweight	1226	31.45	[30.25; 32.67]
	Dissatisfied due to overweight	1493	38.44	[37.51; 39.38]
Drug use in previous year
	Alcohol	1758	35.67	[34.63; 36.73]
	Binge drinking	987	19.28	[18.45; 20.15]
	Smoking	320	5.98	[5.43; 6.59]
	Inhalants	478	9.34	[8.69; 10.02]
	Marihuana	281	5.67	[5.12; 6.27]
	Cocaine	19	0.35	[0.26; 0.47]
	Weight-loss drugs	48	1.03	[0.82; 1.28]

VARIABLE		Body satisfaction
		Satisfied		Dissatisfied due to underweight		Dissatisfied due to overweight		P*
		%	95%CI^†	%	95%CI^†	%	95%CI^†	P*
SEX
	Male	31.2	[29.8;32.6]	33.1	[31.4;0.34.9]	35.7	[34.3;37.1]	<0.001
	Female	28.6	[27.4;29.9]	29.9	[28.4;31.5]	41.5	[40.0;43.0]	<0.001
AGE
	12-14	29.9	[28.8; 31.0]	31.1	[29.9; 32.4]	39.0	[38.0; 39.9]	0.097
	15-17	31.9	[28.1; 36.0]	33.7	[29.9; 37.3]	34.4	[30.6; 38.4]	0.097
ABEP ^‡
	A	34.1	[28.6; 40.1]	21.7	[15.1; 30.2]	44.2	[38.8; 49.7]	<0.001
	B	29.0	[27.1; 31.3]	28.4	[26.4; 30.4]	42.6	[40.2; 45.0]
	C	30.8	[29.5; 32.1]	32.5	[31.2; 33.7]	36.8	[35.5; 38.0]
	D/E	29.3	[27.0; 32.0]	35.1	[32.5; 37.7]	35.6	[33.5; 37.8]
CITY
	Eusébio	26.9	[25.3; 28.6]	31.5	[30.0; 33.2]	41.6	[39.7; 43.5]	<0.001
	Fortaleza	29.6	[28.1; 31.1]	33.4	[31.9; 35.0]	37.0	[35.6; 38.4]
	São Paulo	31.5	[29.5; 32.7]	30.4	[28.5; 32.3]	38.5	[37.1; 40.0]
DRUG USE
Alcohol
	No	31.2	[29.9; 32.5]	30.9	[29.5; 32.3]	37.9	[36.8; 39.1]	0.031
	Yes	28.2	[26.4; 30.1]	32.1	[30.5; 33.9]	39.7	[37.9; 41.4]	0.031
Binge drinking
	No	30.8	[29.6; 32.0]	30.9	[29.5; 32.4]	38.3	[37.2; 39.4]	0.036
	Yes	27.1	[24.7; 29.7]	33.6	[31.2; 36.0]	39.3	[36.9; 41.7]	0.036
Smoking
	No	30.3	[29.3; 31.3]	31.0	[29.7; 32.3]	38.7	[37.7; 39.7]	0.053
	Yes	26.9	[22.6; 31.6]	36.3	[32.8; 40.0]	36.8	[32.7; 41.2]	0.053
Inhalants
	No	30.8	[29.8; 31.9]	30.8	[29.5; 32.1]	38.4	[37.4; 39.3]	<0.001
	Yes	23.1	[20.8; 25.5]	35.5	[32.7; 38.4]	41.4	[38.1; 44.7]	<0.001
Marijuana
	No	30.2	[29.2; 31.3]	31.0	[29.7; 32.3]	38.8	[37.8; 39.8]	0.007
	Yes	26.1	[22.2; 30.4]	37.7	[33.9; 41.5]	36.2	[32.4; 40.2]	0.007
Cocaine
	No	29.9	[28.9; 31.0]	31.6	[30.3; 32.8]	38.5	[37.5; 39.4]	0.725
	Yes	33.8	---	25.1	---	41.1	---	0.725
Weight-loss drugs
	No	30.2	[29.2; 31.2]	31.4	[30.2; 32.6]	38.4	[37.3; 39.4]	0.013
	Yes	14.4	[8.6; 23.0]	38.2	[26.5; 51.5]	47.4	[35.7; 59.4]	0.013

VARIABLE	Ideal self-image*
	Boys
	Underweight		Eutrophy		Overweight		Total
Real self-image^†	n	%	n	%	n	%	n	%	Kappa	p^‡
Underweight	500	55,43	397	44,01	5	0,55	902	100	0,234	<0,001
Eutrophy	293	31,57	634	68,32	1	0,11	928	100
Overweight	14	32,56	26	60,47	3	6,98	43	100
Total	807	43,09	1057	56,43	9	0,48	1873	100
VARIABLE	Ideal self-image ^*
	Girls
	Underweight		Eutrophy		Overweight		Total
Real self-image ^†	n	%	n	%	n	%	n	%	Kappa	p ^‡
Underweight	635	63,44	366	36,56	0	0,00	1001	100	0,072	<0,001
Eutrophy	521	56,08	407	43,81	1	0,11	929	100
Overweight	15	60,00	10	40,00	0	0,00	25	100
Total	1171	59.90	783	40,05	1	0,05	1955	100

		Univariate regression						Multivariate regression
		Dissatisfaction due to underweight versus satisfied			Dissatisfaction due to overweight versus satisfied			Dissatisfaction due to underweight versus satisfied			Dissatisfaction due to overweight vrsus satisfied
		cOR^*	95%CI^†	P^‡	cOR^*	95%CI^†	P^‡	aOR^§	95%CI^†	P^‡	aOR^§	95%CI^†	P^‡
Sex									.
	Girls	0.89	[0.77; 1.74]	0.138	1.23	[1.07; 1.40]	0.002	0.88	[0.75; 1.02]	0.095	1.24	[1.09; 1.41]	0.001
	Boys	ref			ref
Age
		1.06	[0.98; 1.15]	0.156	0.93	[0.86; 0.99]	0.032	----	----	----	----	----	----
ABEP ^\|\|
		0.99	[0.98; 1.00]	0.006	1.00	[1.00; 1.01]	0.081	0.99	[0.98; 1.00]	0.003	1.01	[1.00; 1.01]	0.043
City
	Eusébio	1.06	[0.89; 1.27]	0.492	1.12	[0.99; 1.31]	0.188	----	----	----	----	----	----
	Fortaleza	1.16	[0.99; 1.36]	0.071	0.97	[0.84; 110]	0.593	----	----	----	----	----	----
	São Paulo	ref			ref
Drug use
	Alcohol	1.06	[0.92; 0.12]	0.390	1.07	[0.95; 1.21]	0.262	----	----	----	----	----	----
	Binge drinking	1.15	[0.97; 1.37]	0.105	1.02	[0.87; 1.19]	0.809	----	----	----	----	----	----
	Smoking	1.27	[0.98; 1.65]	0.067	0.91	[0.72; 1.14]	0.406	----	----	----	----	----	----
	Inhalants	1.24	[1.00; 1.53]	0.047	1.07	[0.87; 1.32]	0.507	----	----	----	----	----	----
	Marijuana	1.36	[1.03; 1.78]	0.029	0.88	[0.68; 1.14]	0.338	1.39	[1.05; 1.81]	0.020	0.87	[0.67; 1.13]	0.236
	Cocaine	1.11	[0.34; 3.61]	0.868	0.93	[0.31; 2.11]	0.901	----	----	----	----	----	----
	Weight-loss drugs	1.15	[0.58; 2.31]	0.687	1.42	[0.76; 2.65]	0.267	----	----	----	----	----	----

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E-mail: rlae@eerp.usp.br

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[1] Corresponding author: Luís Eduardo Soares dos Santos E-mail: luisedu.edu19@gmail.com https://orcid.org/0000-0003-4771-3342