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Article

University Students’ Self-Image and Body Weight Gain During COVID-19: A Descriptive Study

by
Ana Beatriz Nogueira do Vale
1 and
Laisa Liane Paineiras-Domingos
2,3,*
1
Physiotherapy Course, Multidisciplinary Institute of Rehabilitation and Health, Federal University of Bahia (UFBA), Salvador 40110-100, BA, Brazil
2
Department of Physiotherapy, Multidisciplinary Institute of Rehabilitation and Health, Federal University of Bahia (UFBA), Salvador 40110-170, BA, Brazil
3
Post Graduate Program in Medicine and Health, Federal University of Bahia (UFBA), Salvador 40110-060, BA, Brazil
*
Author to whom correspondence should be addressed.
Adolescents 2024, 4(4), 512-524; https://doi.org/10.3390/adolescents4040036
Submission received: 18 September 2024 / Revised: 22 November 2024 / Accepted: 26 November 2024 / Published: 2 December 2024
Browse Figure
Figure 1
<p>Study flow diagram. Source: adapted from STROBE 2007 [<a href="#B14-adolescents-04-00036" class="html-bibr">14</a>].</p> ">
Versions Notes

Abstract

:
This study identified college students’ weight gain and body image during COVID-19. A descriptive cross-sectional study was carried out, with data collection occurring from January to May 2023, using an electronic form distributed via social networks or email. Students (+18 years) participated in the study and answered a semi-structured questionnaire, containing questions related to sociodemographic aspects, clinical aspects, and the silhouette scale. A comparison of several events and clinical conditions was made between the period before and during COVID-19. In total, 52 responses were given (86.3% female; 41.3% Black people). In total, 60% were diagnosed with obesity, and 20% were diagnosed with Diabetes Mellitus. Pain related to muscular and joint structures (34.3%) and anxiety (60%) were reported to have been concerns before COVID-19. During COVID-19, this scenario was maintained, in addition to symptoms related to fatigue/tiredness (52.3%) and body weight gain (61.4%). The existence of an active social life (54.3%) and the regular practice of physical activity (65.2%) were reported as occurring only before COVID-19.

1. Introduction

The COVID-19 pandemic, which erupted at the end of 2019, triggered a series of transformations in society, affecting not only physical health but also the mental and emotional health of individuals [1]. Among the various affected groups, university students faced unique challenges, including changes in living patterns, interruption of in-person academic activities, and increased stress related to the pandemic context [2,3]. University students from Jordan, Brazil, and Egypt presented consequences caused by COVID-19 far beyond physical health, like effects on mental health and educational outcomes [4,5,6].
Considering that bodily experiences and conditions bear close relations to social development and human well-being [7], authors have concluded that social isolation measures may have directly influenced students’ body image and body weight gain [8], as it has been indicated that the stress and anxiety related to COVID-19 might have contributed to a negative body image [9] (Swami et al., 2021) and bodily dissatisfaction [10] (Robertson et al., 2021).
Body image, defined as the subjective perception of one’s own body, plays a crucial role in individuals’ mental and emotional health. Previous studies have shown that dissatisfaction with body image is associated with a range of psychological problems, including low self-esteem, anxiety, and depression [11,12,13]. During COVID-19, restrictions on physical activities and changes in daily routines may have contributed to shifts in body perception, leading to significant impacts on the body image of university students [14,15].
Body weight gain is a common concern during periods of confinement due to changes in eating habits, reduced physical activity levels, and increased stress. Recent studies indicate that body weight gain may be related not only to physical health issues such as obesity and metabolic diseases but also to psychosocial consequences, including body dissatisfaction and low self-esteem [16,17].
In this context, this exploratory cross-sectional study seeks to analyze the relationship between body image and weight gain in university students before and during the COVID-19 pandemic. The findings of this study will not only contribute to understanding the effects of the pandemic on students’ mental and physical health but may also inform interventions and policies to support the overall health of young adults in similar contexts.

2. Materials and Methods

2.1. Study Design and Sample

This is a descriptive cross-sectional study that evaluated the body image changes and weight gain in university students before and during the COVID-19 pandemic. The sample consisted of university students of both genders, aged between 18 and 54 years, from the Federal University of Bahia (UFBA), selected randomly and voluntarily. The inclusion criteria for this study were being enrolled in one of the courses at the Federal University of Bahia throughout the pandemic period and being over 18 years old. Questionnaires with incomplete responses were excluded. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) protocol item guideline [18,19] was used to conduct this study and ensure a more accurate and complete description of the data.
The perceived body mass index (BMI) was considered based on the participants’ self-reported anthropometric measures (height and body mass), followed by the established calculation for the BMI [20]. For the complete Classification of Body Image Self-Perception presented by the Silhouette Test [21,22,23,24,25], all the participants provided additional information regarding their body image perception.

2.2. Ethical Aspects

This study is part of the project titled “Analysis of the repercussions of the COVID-19 pandemic on the health conditions of the Brazilian population and frontline healthcare professionals”, approved by the Research Ethics Committee (CAAE: 47770421.3.0000.5662—approval number: 4.925.580). It was conducted by the principles expressed in the Declaration of Helsinki.

2.3. Study Variables

This study adopted the variables body image and BMI at the time of questionnaire response as main outcomes. For this, a questionnaire was administered to characterize the sample with questions to identify gender/sex, age (years), height (meters), body mass (kilograms), BMI (kilograms per square meter), employment conditions, value in the study environment, favorable study conditions, risk factors for the exacerbation of symptoms caused by coronavirus contamination, race/ethnicity, and income.
The BMI is a function of height and mass (mass kg/height2 m), and the current criterion by which to distinguish “healthy” from “unhealthy” weight. According to Gutin, 2018 [26], the BMI is a biomarker, and a more flexible view of the measure should be utilized as a holistic appraisal of health.
Body image, according to the American Psychological Association [27], is defined as the mental picture one forms of one’s body, including its physical characteristics and one’s attitudes toward these characteristics.

2.4. General Health Conditions

Regarding general health conditions, participants were asked about their feeding habits, if they felt healthy, the main perceived symptoms associated with COVID-19, their lifestyle habits, their smoking status, and clinical or therapeutic assistance.

2.5. Subjective Perceptions of Body Image and Associated Factors

The perception of body image among female and male university students before and during COVID-19 was assessed using the adult silhouette scale [21,23,24,25]. It also evaluated the level of satisfaction regarding body image, whether participants were satisfied or dissatisfied and desired to increase or decrease their body mass, their perception of their health status, physical fitness, physical activity practice, and leisure activities.

2.6. Data Collection

Data collection took place from January to May 2023, during the ongoing COVID-19 pandemic. This period was marked by significant changes in behavior due to social distancing practices and activity restrictions. The research was publicized through WhatsApp groups. Additionally, some institutes of UFBA published the research access link on their website, inviting all students to participate in the study. Those interested in contributing to the research accessed the link, which redirected them to an online questionnaire hosted on Google Forms. Only those who consented to the Informed Consent Form, provided on the first page of the form as a mandatory field, were allowed to respond to the questionnaire. The students answered a semi-structured questionnaire, containing questions related to sociodemographic and clinical aspects, as well as a specific validated scale for this population (body image silhouette scale) that assesses self-reported body image [21,25].

2.7. Statistical Analysis

This study adopted a non-probability convenience sampling method, considering the pandemic context and according to the protocol designed by do Vale and Domingos [28], to avoid information bias in this study, from the choice and design of the instrument for data collection (electronic form) to the execution of data analysis with blinding.
Frequencies were presented in absolute values and percentages. The Shapiro–Wilk test was used to verify the normality of the data. To measure the correlation of explanatory variables on the primary outcome, the Spearman correlation coefficient was determined, considering the following ranges: 0 < r ≤ 0.1 (Null); 0.1 < r ≤ 0.3 (Weak); 0.3 < r ≤ 0.6 (Moderate); 0.6 < r ≤ 0.9 (Strong); 0.9 < r < 1 (Very Strong); and r = 1 (Perfect), as well as the Mann–Whitney test. The analyses were conducted using GraphPad Prism software version 6.0, with a confidence level of 95% and a significance level of p < 0.05. This methodology was designed to capture detailed data on body image and weight gain in university students, allowing for a comprehensive analysis of the changes that occurred during COVID-19.

3. Results

The results of this study revealed significant patterns related to body image and weight gain in university students before and during COVID-19. A total of 50 individuals participated in this study, including 43 females and 7 males (Figure 1).
Table 1 (Description of demographic data of study participants) provides a comprehensive analysis of various aspects. The data include information on gender/sex, age, height in meters, body mass in kilograms/grams, employment conditions, perceived value in the work environment, favorable study conditions, risk factors for worsening COVID-19 symptoms, color, race, ethnicity, and income. This wide range of variables allows for a holistic understanding of the demographic profile of the participants, which is essential to contextualize the research and identify possible patterns or correlations. The thorough analysis of these data will significantly contribute to achieving the study’s proposed objectives.
The results reveal that most participants were female, comprising 86% (43) of the sample. Most participants were Black, aged between 20 and 24 years, 50% (25), with an income in Class E, up to two minimum wages, an average height of 1.62 m, and an average body mass of 71.5 kg. Most participants also had a BMI in the eutrophic range, indicating an ideal weight of 52% (26). Regarding employment conditions, most of the sample consisted of students, only 60% (30), who considered themselves valued in their study environment, 60% (30). Among those with comorbidities, most indicated obesity, 60% (3), as a risk factor for worsening symptoms of COVID-19.
Table 2 (General health conditions) provides a comparative analysis between the pre-pandemic period and the period during COVID-19 regarding diet, overall health perception, the main perceived symptoms associated with COVID-19, lifestyle habits, and clinical and/or therapeutic assistance. This comparison offers valuable insights into how participants’ health conditions were affected during the pandemic, providing a crucial basis for a comprehensive understanding of the impact of COVID-19 on these variables.
The data in Table 2 reveal significant changes in perceptions and habits during the pandemic. The transition from a balanced diet to a more caloric one, the increase in the percentage of people who did not feel healthy (from 30% to 70%), and the replacement of symptoms like muscle pain with demotivation indicate complex impacts on mental and physical health. Furthermore, the shift from an active social life and physical activity to a sedentary lifestyle reflects the challenges faced during this period. The increased demand for psychotherapeutic services suggests a growing need for emotional support during the pandemic.
Regarding the subjective perceptions of body image and associated factors, a comparative analysis was conducted between the pre-pandemic period and the period during COVID-19. Examining specific data on satisfaction with body image, perception of health status, physical fitness, and physical and leisure activities reveals significant variations. This comparison sheds light on the possible influence of the pandemic on subjective perceptions of body image and associated factors, providing a deeper understanding of the psychosocial impact during this period.
Before COVID-19, the majority identified as dissatisfied and wanted to decrease body mass, which accounted for 31.91% of the sample. During COVID-19, the highest dissatisfaction rate was also among females, which increased to 57.45%. Regarding health perception, only 8% considered it negative before the pandemic, while 58% considered it regular. During COVID-19, the negative perception rose from 8% to 36%. In terms of physical fitness, 26.53% rated it as poor before COVID-19, which increased to 40% during the pandemic. As for physical activity and leisure, 58% were active before COVID-19, while 68% reported becoming inactive during COVID-19.
The substantial increase in body image dissatisfaction, especially among women, suggests possible psychological impacts related to the pandemic context. Additionally, the increase in negative health perceptions, deterioration in physical fitness, and the shift from a majority being active to a majority being inactive in physical activities during the pandemic indicate additional challenges for overall well-being. These changes may be influenced by factors such as stress, movement restrictions, and emotional impacts associated with the pandemic.
Table 3 provides an overview of body image perception among female students before and during COVID-19. Before COVID-19, the most frequently indicated number with the highest volume of people was number 4 on the silhouette scale. During COVID-19, it shifted to number 6, indicating a perception of increased body mass.
Table 4 presents an overview of the perception of body image among male students before and during COVID-19. Before COVID-19, none of the men indicated being overweight. The highest number, with the greatest volume of responses, was number 6. During the test, one participant became overweight, and the highest number indicated was number 9. In other words, there was a shift towards higher numbers during the pandemic, indicating a change in perceived body image among male students.
The data from Table 4 indicate a notable change in men’s body image perception during the pandemic. The increase in the number indicated by participants, especially the shift towards number 9 and the identification of one participant as being overweight, suggests a potential alteration in health standards and self-care during this challenging period. These changes may be related to various factors such as changes in dietary habits, levels of physical activity, or emotional impacts caused by the pandemic.

3.1. Correlation Between Diet and the BMI

The correlation between pre-pandemic diet and the BMI is weak (r = −0.13), indicating a lack of evidence for a significant relationship (p = 0.36). However, there is a statistically significant and moderate correlation (p = 0.003, r = 0.41) between diet during the pandemic and the BMI. While there is insufficient evidence for a significant link between pre-pandemic diet and the BMI, there is a notable positive association between diet quality during the pandemic and the BMI, indicating that an increase in caloric intake during this period is associated with an increase in the BMI.

3.2. Correlation Between Anxiety and the BMI

When analyzing the correlation between anxiety and the BMI before and during COVID-19, we observed that before the pandemic, the correlation was very weak (r = 0.098, 95% CI: −0.19 to 0.37, p = 0.50), and during the pandemic, it followed a similar trend with a coefficient of 0.13 (95% CI: −0.16 to 0.40, p = 0.35). Thus, there was no statistically significant association between anxiety and the BMI in either of the periods analyzed.

3.3. Feeling Healthy and the BMI

Analyzing the correlation between feeling healthy and the BMI before and during COVID-19, we observed that before the pandemic, the correlation was very weak (r = −0.10, 95% CI: −0.38 to 0.19, p = 0.47), and during COVID-19 it was similarly weak with a coefficient of 0.19 (95% CI: −0.10 to 0.45, p = 0.18). In both periods, there was no statistically significant association between feeling healthy and the BMI.

3.4. Correlation Between Sedentary Behavior and the BMI

The correlation between sedentary behavior pre-pandemic and the BMI is quite weak (r = −0.19), indicating a lack of evidence for a significant relationship (p = 0.18). However, when examining sedentary behavior during the pandemic, we identified a statistically significant and moderate correlation (p = 0.04, r = 0.29) with the BMI. The positive coefficient indicates that as sedentary behavior intensifies during this period, the BMI tends to increase. The data suggest, like the relationship between diet and the BMI, a positive connection between sedentary behavior levels during the pandemic and the BMI; an increase in physical inactivity is associated with an increase in the BMI. These observations highlight the importance of considering sedentary behaviors in assessing factors associated with BMI variations.

3.5. Correlation Between Silhouette Perception and the BMI

The correlation between silhouette perception and the BMI before the pandemic is notably strong (r = 0.79, CI = 0.64 to 0.88, p < 0.0001), indicating a significant and robust relationship between silhouette perception and the BMI. The correlation during the pandemic is slightly stronger (r = 0.82, CI = 0.70 to 0.90, p < 0.0001) compared to the pre-pandemic period. Both cases show an extremely strong and statistically significant correlation. These results suggest that individuals have an accurate perception of their silhouette regarding the BMI, indicating a robust relationship between these variables both before and during COVID-19.

4. Discussion

The COVID-19 pandemic brought different intolerable and uncomfortable situations for the students’ academic performance, career opportunities, and social lives through depression, anxiety, fear, uncertainty, and mental illness [5].
Chinese researchers indicated that body experiences and conditions bear close relations to social development and human well-being, and they emphasized the relevance of understanding body changes that resulted as consequences of COVID-19 [7]. According to these authors, the public was likely to accept their physical appearance during lockdown due to changes in lifestyle and the fear of mortality, with a dynamic transformation of negative body image under the influence of catastrophic public health events.
However, Keel et al., 2020 [29]; Goitia et al., 2022 [30]; and Eneli et al., 2022 [31], have pointed out that weight gain among young people also was a common consequence of the pandemic. Goitia et al., 2022 [30], suggested that being Black, living in low-income neighborhoods, and having depression were factors that caused patients to be disproportionately affected by an increase in body mass.
Changes in young people’s body weight during COVID-19 have also been associated with decreased physical activity, altered sleep routines and schedules, increased screen time, and non-nutritious food choices. Average weight gain was higher among young people with severe obesity. Younger, female, and ethnic-minority youth were more likely to switch to a higher/worse weight category. Significant weight gain occurred in the first 3–6 months of the pandemic among low-income youth, reflecting the short-term effects of the pandemic [31].
A study similar to ours documented perceived changes since COVID-19 and compared them to the longitudinal changes observed in reported weight, the BMI, and how college students described their weight from January to April 2020 [29]. Undergraduates, 88% female, completed online assessments before and after they were required to leave campus due to COVID-19. Time 1 and Time 2 surveys collected demographic information, height, weight, and a Likert-scale rating to describe perceived weight, ranging from 1 = very underweight to 5 = very overweight (weight description). Time 2 surveys added questions for perceived changes since COVID-19 in body weight, eating, physical activity, various forms of screen time, and concerns about weight, shape, and eating. Shifts in how body weight was experienced in the wake of COVID-19 that do not align with observed changes in reported weight may reflect cognitive distortions that could increase risk for disordered eating in some individuals.
As, here in Brazil, similar behavior was noticed among university students, we invested in this preliminary investigation, which was conducted over 2 years after the pandemic. The relevance of this investigation is the construction of evidence that serves as a warning and directs universities to the need for psychosocial care and reception policies for their students. Despite the limited representativeness of this current study, we consider it pertinent to point out the realities of each country and/or population.
Other Brazilian investigations [6] showed that 53.1% of university students (the majority were women and in the health field) considered online classes to be bad or terrible, but only 43.6% thought about giving up their studies during the period. Most participants spent between five and nine hours a day studying in front of screens, and 57.7% said they experienced a drop in academic performance. Students had problems sleeping (58.2%) and showed changes in weight during the period (75.4%).
The results of this current study indicated that feelings of anxiety, irritability, and demotivation were those most reported by the participants. These outcomes aligned closely with findings from a study conducted in June 2020 [32] on residents of Belo Horizonte aged 18 and older, which aimed to assess weight gain. It was observed that 54% of participants gained weight, correlating with feelings of anxiety, worry, distress, and fear, as reported in this study. Of the 44% of participants who remained in social isolation, 72.3% reported significant changes in their diet leading to excessive weight gain. The study noted an increase in the consumption of sweets and pasta, which may have contributed to this scenario.
A targeted interdisciplinary intervention was considered urgently needed and widely proposed to mitigate the high risk of mental disorders occurring during COVID-19 and promote an active and healthy lockdown lifestyle [33].
Most of the sample did not indicate having comorbidities that could have worsened COVID-19 outcomes, which corroborates with the findings of a study conducted on students enrolled in the Physical Education program at a federal university [34]. This cross-sectional study predominantly included male participants (60.8%) with a median age of 22 years, averaging the 6th period of their graduate studies (1st–9th). Additionally, it was observed that 1% of participants were diabetic, 1.9% were hypertensive, and 3.9% were dyslipidemic. The analysis of median time spent on physical activity revealed that while 68.6% of participants were classified as physically active, the average weekly sedentary behavior time was considerable, reaching 1253 min.
It is noteworthy that the use of electronic devices such as computers and mobile phones significantly contributed to this behavior, with 77.4% of participants dedicating between 2 and 6 h daily to these activities. The results of this study highlight that, despite being predominantly physically active, students faced challenges related to increased sedentary behavior. Despite the sample being predominantly male among Physical Education students and predominantly female in this study, it was possible to draw parallels between increased sedentarism and conditions posing risks for worsened COVID-19 outcomes without gender modifying the significance of the results.
There is little evidence linking increased social media use with the weight gain reported in numerous studies. But we can consider the negative effect of long exposure to screen time brought during COVID-19, as well as after the pandemic, and inappropriate behaviors that consequently contribute to poor eating habits and less healthy lifestyles, affecting self-image and body perception.
In a cross-sectional study, 725 Jordanian adults aged 18+ reported the changes that they had experienced in their daily life during the COVID-19 lockdown period [35]. Approximately two thirds of the sample (n ¼ 505, 69.7%) reported that their increased mobile phone use and checking and social media use had increased their levels of psychological distress.
Another cross-sectional, exploratory, and quantitative study [36] conducted between January and February 2017 on 324 university students from the fields of Health Sciences, the Exact Sciences, and Humanities evaluated self-perception of body image using the silhouette scale and nutritional status using the body mass index. The prevalence of overweight/obesity was 43.2% (n = 141), and dissatisfaction with body image was 76.5% (n = 248). The population with a higher likelihood of being overweight and obese (95% CI: 1.0–2.7; p 0.03) were university students. Married students (95% CI: 1.8–5.9; p 0.01), those employed (95% CI: 1.4–3.7; p 0.01), those with income equal to or greater than minimum wage (95% CI: 1.4–4.8; p 0.01) were more likely to be overweight. Regular health status was related to greater dissatisfaction with body image (95% CI: 1.4–5.7; p 0.01). As expected, individuals with better physical fitness were associated with a lower likelihood of body dissatisfaction (95% CI: 0.06–0.47; p 0.01). Thus, there is an association between excess weight and age, gender, marital status, employment, income, and eating habits, as well as between self-perception of body image and self-perception of health status, necessitating good physical and study habits. Additionally, there is a high prevalence of overweight/obesity and dissatisfaction with body image among university students.
An analytical and cross-sectional study [37] was conducted on a sample of nutrition center attendees, predominantly composed of women (76.6%) aged 40 to 50 years (45.7%), with university education (67.9%), residing in urban areas (86.4%), and classified in the highest income deciles (7 to 10) in 90.1% of cases. They self-reported weight gain ranging from 1 to 6 kg, with a nutritional state of malnutrition due to excess observed in 86.4% of participants. The most consumed foods belonged to the groups of eggs and meat (91.4%); potatoes, legumes, fruits, and vegetables (82.7%); and sodas, bakery products, and junk food (82.2%). Food consumption was reported to increase after dinner, with food delivery being a common practice associated with a low level of physical activity in 40.7% of participants. No statistically significant association was observed between nutritional status and food consumption or physical activity levels (p > 0.05). However, participants with excessive malnutrition predominantly exhibited a low or moderate level of physical activity. In this study, while there is insufficient evidence for a significant link between pre-pandemic diet and the BMI, there is a notable positive association between diet quality during the pandemic and the BMI, indicating an increase in caloric intake during this period associated with an increase in the BMI.
An integrative review of the literature on databases PubMed, Lilacs, Bireme, and SciELO [11], involving a population exclusively consisting of university students, presented data regarding the prevalence of body dissatisfaction and/or characterization of related factors. In total, 40 national studies and 36 international studies were selected, totaling 76. Body dissatisfaction ranged from 8.3% to 87% in national studies and from 5.2% to 85.5% in international studies, with evaluation instruments mainly being silhouette scales and questionnaires such as the Body Shape Questionnaire, the Eating Disorder Inventory, and the Body-Self Relationships Appearance Scales. Factors such as exposure to social media, menstrual period, and low self-esteem predominated. Body dissatisfaction is an increasingly common characteristic among university students. In this study, the results suggest that people have an accurate perception of their silhouette as concerns the BMI, indicating a robust relationship between these variables both before and during the pandemic.
A review elaborated by Souza, Sampaio, and Paineiras-Domingos [38] investigated conservative non-pharmacological intervention strategies in overweight and obese individuals during the pandemic caused by COVID-19. According to this systematic review, the presented conservative non-pharmacological interventions, in-person or remote, brought significant benefits regarding body weight loss, increased muscle strength and physical activity level, and improved eating habits in the investigated population. Sevilla et al. (2021) [39] used physical exercise and nutrition; Vitale et al. (2020) [40] used a resistance training protocol; Bailly and collaborators (2021) [41] used Nutritional Psycho-Behavioral rehabilitation; and Fraticelli, Nicola, and Vitacolonna (2020) [42] compared the supply of nutritional concepts via the web and through conventional nutritional guidelines.
According to Robertison et al. [10], ongoing research to explore individual differences in the trajectories of change in eating, exercise, and body image as lockdown measures ease will be important for understanding the full psychological impact of this pandemic and improve service and public health planning going forward. Nuttley et al. [43] added that future research is needed to assess the impact of the COVID-19 pandemic on disordered eating behavior and to evaluate the role of social media discussion forums in mental health treatment, especially during periods of limited treatment access.
One potential source of bias lies in the self-reported nature of the collected information, which is subject to participants providing socially desirable or inaccurate responses. Body image perception is a sensitive topic and may be influenced by subjective interpretations or influenced by factors such as social norms and cultural expectations.
Additionally, weight gain may be perceived differently by participants, potentially leading to underestimation or overestimation of reported data. To mitigate this risk, anonymized data collection techniques and strategies to encourage honesty in responses were employed. Despite these precautions, it is important to interpret the results cautiously, recognizing the possibility of bias in participant responses.
Some of those included might be considered obese or on the high side of body weight in some cultures, especially since most of the subjects were female. Thus, this study, while interesting and useful locally or nationally in Brazil, may not be generalizable beyond this area.
Finally, as our participants were recruited through social media platforms and the survey was hosted online, we declare that the sample of this study was likely to be biased towards individuals with internet access and who actively used social media.

5. Conclusions

COVID-19 changed university dynamics and generated negative impacts on the academic performance, social interaction, and physical activity and mental health of students, showing a need for urgent intervention.
The data from this study indicate that the students had an accurate perception of their silhouette as concerns the BMI, with a robust relationship between these variables both before and during the pandemic period, highlighting the considerable impact of COVID-19 on biopsychosocial issues. Therefore, it emphasizes the importance of universities developing actions and policies that encourage students to maintain good physical activity habits, maintain balanced nutrition, and seek assisted mental health, especially in critical situations such as a pandemic.

Author Contributions

Conceptualization, A.B.N.d.V. and L.L.P.-D.; methodology, A.B.N.d.V. and L.L.P.-D.; software, A.B.N.d.V. and L.L.P.-D.; validation, A.B.N.d.V. and L.L.P.-D.; formal analysis, A.B.N.d.V.; investigation, A.B.N.d.V.; resources, A.B.N.d.V.; data curation, A.B.N.d.V.; writing—original draft preparation, A.B.N.d.V. and L.L.P.-D.; writing—review and editing, A.B.N.d.V. and L.L.P.-D.; visualization, L.L.P.-D.; supervision, L.L.P.-D.; project administration, L.L.P.-D.; funding acquisition, L.L.P.-D. All authors have read and agreed to the published version of the manuscript.

Funding

This research received no external funding.

Institutional Review Board Statement

This study was conducted following the Declaration of Helsinki and approved by the Research Ethics Committee of the Federal University of Bahia (CAAE: 47770421.3.0000.5662—approval number: 4.925.580; date of approval: 23 August 2021).

Informed Consent Statement

Informed consent was obtained from all the subjects involved in this study. Written informed consent was obtained from the patient(s) to publish this paper.

Data Availability Statement

The datasets generated by the survey research analyzed during the current study are unavailable due to privacy or ethical restrictions.

Conflicts of Interest

The authors declare no conflicts of interest.

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Adolescents 04 00036 g001
Figure 1. Study flow diagram. Source: adapted from STROBE 2007 [14].
Figure 1. Study flow diagram. Source: adapted from STROBE 2007 [14].
Adolescents 04 00036 g001
Table 1. Description of demographic data of study participants.
Table 1. Description of demographic data of study participants.
% (n) or Media (SD)
GenderMale—14% (7)
Female—86% (43)
Age (Years)Up to 19—12% (6)
20 to 24—50% (25)
25 to 29—20% (10)
30 to 34—6% (3)
40 to 44—10% (5)
45 to 49—2% (1)
Stature (m)1.62 ± 0.50
Body mass (Kg)71.5 ± 13.46
BMI (kg/m2)Underweight—8% (4)
Eutrophic—52% (26)
Overweight—28% (14)
Obesity—12% (6)
Employability conditions
(n = 41)		Non-working/student only—60% (30)
Was already employed before the pandemic—8% (4)
I got a job during the pandemic—10% (5)
I was already unemployed before the pandemic—2% (1)
I became unemployed during the pandemic—2% (1)
Do you feel valued in the work and/or study environment?Yes 56% (28)
No 24% (22)
Do you consider the working and/or study conditions to be favorable?Yes 60% (30)
No 40% (20)
Comorbidity/risk factor for worsening of symptoms caused by contamination by the coronavirus (n = 5)Obesity 60% (3)
Diabetes Mellitus 20% (1)
Immunosuppression 20% (1)
Neurological Disease 20% (1)
Race/EthnicityBlack 42% (21)
Brown 34% (17)
White 22% (11)
Yellow 0% (0)
Indigenous 2% (1)
Income
(Brazilian social classes)		Class A 0% (0)
Class B 12% (6)
Class C 24% (12)
Class D 30% (15)
Class E 34% (17)
SD = standard deviation; BMI = body mass index. The data are presented in percentages [%] and absolute values (n). Class A: families with incomes above 20 minimum wages (per month). Class B: Income 10–20. Class C: Income 4–10. Class D: Income 2–4. Class E: Income of up to 2.
Table 2. General health conditions comparing the pre-pandemic period and the period during COVID-19.
Table 2. General health conditions comparing the pre-pandemic period and the period during COVID-19.
Pre-COVID-19 During COVID-19
FeedingHealthy
More caloric
Balanced		16% (8)
28% (14)
56% (28)		10% (5)
56% (28)
34% (17)
Feeling healthyYes
No		70% (35)
30% (15)		15% (30)
70% (35)
Main perceived symptoms
before COVID-19 (n = 35)
during COVID-19 (n = 44)		Symptoms of anxiety and irritability
Muscle pain
Tiredness and fatigue
Difficulty sleeping
Symptoms of depression and demotivation		60% (21)
34.3% (12)
34.3% (12)
31.4% (11)
28.6% (10)
22.9% (8)
20% (7)		72.7% (32)
54.5% (24)
36.4% (16)
52.3% (23)
43.2% (19)
36.4% (16)
54.5% (24)
Lifestyle habits
Before COVID-19 (n = 46)
During COVID-19 (n = 43)		Smoker
Alcoholism
Active social life
Physical activity
Sedentary lifestyle		2.2% (1)
6.5% (3)
54.3% (25)
65.2% (30)
34.4% (14)		2.3% (1)
7% (3)
11.6% (5)
30.2% (13)
67.4% (29)
Clinical and/or therapeutic assistance
before COVID-19 (n = 38)
during COVID-19 (n = 33)		Clinical/medical, pharmacological, physiotherapeutic, psychotherapeutic
Nutritional
Dental
Speech–language pathology
PICS		71.1% (21)
10.5% (4)
2.6% (1)
18.4% (7)
7.9% (3)
50% (19)
0% (0)
3.3% (2)		66.7% (22)
15.2% (5)
9.1% (3)
39.5% (13)
12.1% (4)
39.4% (13)
3% (1)
3% (1)
Clinical and/or therapeutic assistance (management)
Before COVID-19 (n = 40)
During COVID-19 (n = 34)		Public
Private		27.5% (11)
72.5% (29)		20.6% (7)
27% (79.4)
PICS: Integrative and complementary practices in health. The data are presented in percentage [%] and absolute value (n).
Table 3. Overview of body image perception among female students before and during COVID-19 (n = 43).
Table 3. Overview of body image perception among female students before and during COVID-19 (n = 43).
Adolescents 04 00036 i001Adolescents 04 00036 i002Adolescents 04 00036 i003Adolescents 04 00036 i004Adolescents 04 00036 i005Adolescents 04 00036 i006Adolescents 04 00036 i007Adolescents 04 00036 i008Adolescents 04 00036 i009Adolescents 04 00036 i010Adolescents 04 00036 i011Adolescents 04 00036 i012Adolescents 04 00036 i013Adolescents 04 00036 i014Adolescents 04 00036 i015
Before COVID-19%4.6516.39.318.64.654.65144.6511.64.652.3302.3302.33
n274822625210101
During%011.66.986.989.3149.34.6511.64.654.659.32.332.332.33
COVID-19n053346425224111
BMI perceived during COVID-19(Δ)−18.220.420.823.123.722.523.528.324.7293135.829.433.1
Nutritional statusBMI
Ideal		−EutEutEutEutEutEutEutOveEutOveObeObeOveObe
Eut: eutrophic; Obe: obesity; Ove: overweight. BMI ideal = 18 ≥ 25 < kg/m2. The data are presented in absolute value (n) and percentage (%). (Δ): BMI perceived during COVID-19.
Table 4. Overview of body image perception among male students before and during COVID-19 (n = 7).
Table 4. Overview of body image perception among male students before and during COVID-19 (n = 7).
Adolescents 04 00036 i016Adolescents 04 00036 i017Adolescents 04 00036 i018Adolescents 04 00036 i019Adolescents 04 00036 i020Adolescents 04 00036 i021Adolescents 04 00036 i022Adolescents 04 00036 i023Adolescents 04 00036 i024Adolescents 04 00036 i025Adolescents 04 00036 i026Adolescents 04 00036 i027Adolescents 04 00036 i028Adolescents 04 00036 i029Adolescents 04 00036 i030
Before COVID-19%14.2928.5714.29042.860000000000
n121030000000000
During COVID-19%14.2914.2914.2914.2914.2914.290014.29000000
n111111001000000
BMI perceived
during
COVID-19		(Δ)16.6121.8025.0624.2524.2224.020025.88000000
Nutritional status Ideal BMI UndEutOveEutEutEut------------Ove------------------------------------
Eut: eutrophic; Und: underweight; Ove: overweight. BMI ideal = 18 ≥ 25 < kg/m2. The data are presented in absolute value (n) and percentage (%). (Δ): BMI perceived during COVID-19.
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do Vale, A.B.N.; Paineiras-Domingos, L.L. University Students’ Self-Image and Body Weight Gain During COVID-19: A Descriptive Study. Adolescents 2024, 4, 512-524. https://doi.org/10.3390/adolescents4040036

AMA Style

do Vale ABN, Paineiras-Domingos LL. University Students’ Self-Image and Body Weight Gain During COVID-19: A Descriptive Study. Adolescents. 2024; 4(4):512-524. https://doi.org/10.3390/adolescents4040036

Chicago/Turabian Style

do Vale, Ana Beatriz Nogueira, and Laisa Liane Paineiras-Domingos. 2024. "University Students’ Self-Image and Body Weight Gain During COVID-19: A Descriptive Study" Adolescents 4, no. 4: 512-524. https://doi.org/10.3390/adolescents4040036

APA Style

do Vale, A. B. N., & Paineiras-Domingos, L. L. (2024). University Students’ Self-Image and Body Weight Gain During COVID-19: A Descriptive Study. Adolescents, 4(4), 512-524. https://doi.org/10.3390/adolescents4040036

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