Does Foster Care Influence Body Image and BMI?

 Background/Purpose:

Research has established relationships between body image and physical, mental, and sexual health.  For example, poor body image is related to eating disorders, depression, and sexual behaviors.  Thus, this is an important area of inquiry.  Foster youth experience extreme health disparities in the U.S., but have not been included in this area of scholarship to determine if body image may be one contributing factor. Given their health disparities and that there is reason to believe that foster youth experience disparities in body image and body size, an understanding of how body image and body mass index (BMI) vary among foster youth could have implications for health-related interventions.  As such, the goal of this study was to explore the relationship between foster care status, BMI, and body image among a sample of foster youth and non-foster youth.

 Methods:

The present study used data from the World Health Organization’s Health Behavior in School-Aged Children (HBSC) U.S. survey (N = 12,642). Approximately half (48.5%) were female, 52.1% identified as White, 20.3% as African American, and 26.9% as Hispanic/Latino. The average age was 13.0 years, and average BMI was 21.2. Only 56 youth identified as being in foster care. Measures included BMI, foster care status, and the following six dependent variables: frustrated with appearance, satisfied with my appearance, hate body, comfortable with body, anger toward body, and like appearance in spite of flaws. Foster care and non-foster care groups were significantly different on the covariates age, race, ethnicity, and affluence. Thus, we utilized propensity scores with Mahalanobis distance to create a matched sample of foster youth and non-foster youth. A chi-square test revealed that the two groups did not differ significantly by these factors. Six regression models were conducted using the matched sample to predict each of the dependent variables from BMI and foster care status.

 Results:

In the matched sample, youth in foster care had an average BMI of 24.6, compared to 22.4 for youth not in foster care. Though this was not statistically significant (t(70) = -1.79, p = .077), it does represent a potential trend. Two of the six regression models using BMI and foster care status to predict feelings about body image were significant (frustrated with appearance and hate my body). Foster care status was a significant predictor of more negative feelings related to frustrated with appearance, while BMI was the only significant predictor of hate my body.  

 Implications:

This research suggests that being in foster care may influence one’s body image. As the matched sample demonstrates, being in foster care is associated with a higher BMI when compared to non-foster youth. With previous studies suggesting a relationship between BMI and body image, this research affirms the BMI and body image relationship through the data collected on foster youth experience. With the knowledge that foster youth disproportionately experience extreme health disparities and being in foster care negatively influences body image, interventions can be updated or developed to address body image as a health concern within this population.