Gender Differences in Body Mass Index, Body Weight Perception, weight satisfaction, disordered eating and Weight control strategies among Indian Medical and Nursing Undergraduates

Student summary

Why This Research Matters

This study looked at how male and female nursing and medical students in India think about their bodies, their weight, and their eating habits — and it found some results that don't match the usual assumptions.

Researchers Poreddi Vijayalakshmi, Rohini Thimmaiah, and colleagues surveyed 454 undergraduate students in Bangalore, South India: 241 medical students and 213 nursing students. The study ran from August to October 2014, and 91.9% of eligible students agreed to participate. Most participants (78.6%) were women, and the average age was about 19 for women and 20 for men. Everyone filled out a self-administered survey that included questions about height, weight, and weight satisfaction, plus three standardized tools: the SCOFF questionnaire (a short 5-item screen for disordered eating, where a score of 2 or higher signals risk), the EAT-26 (a 26-item eating attitudes test where 20 or higher signals risk), and the PHQ-9 (a 9-item depression screen).

The clearest finding was that men had a significantly higher Body Mass Index than women (p<0.001) — which matches what most people would expect, since men on average carry more muscle and body mass. But what happened next is where the study gets interesting, and where it challenges assumptions students might carry into clinical practice.

Despite having a lower average BMI, women were far more likely to see themselves as overweight: 74.8% of women perceived themselves this way, compared to only 28.9% of men. Women were also much less satisfied with their weight overall (81.6% dissatisfied vs. 33% of men). In other words, women's body image did not track closely with their actual measured weight.

Now flip to the eating-disorder screening tools, and the pattern reverses. More men than women screened positive for disordered eating on the SCOFF (45.4% vs. 31.1%) and on the EAT-26 (16.5% vs. 8.7%). Binge eating was reported by close to half of both groups, but slightly more women (48.2%) than men (41.2%), and this difference was statistically significant. Men were also more likely to use vigorous exercise as a weight-control strategy, with 47.4% exercising more than 60 minutes to manage their weight compared to 25.4% of women — a significant difference. Purging behaviors, like vomiting or laxative use, were reported by fewer than 10% of either group. On the depression screen, men reported somewhat higher rates of severe depression (9.3% vs. 4.5%), though the researchers noted this difference was not statistically significant.

Put together, the authors describe a kind of paradox: women in the sample carried more body dissatisfaction and distorted self-perception, while men scored higher on the actual screening instruments for disordered eating behavior. The authors concluded that the gender differences found were modest overall, but real enough that they need to be considered when institutions design programs to prevent eating disorders among health science students.

For nursing students reading this study, there are two lessons worth sitting with. First, body dissatisfaction and formal disordered-eating risk are not the same thing, and they don't always move together — a person who feels fine about their weight might still screen positive on a validated tool, and a person distressed about their weight might not meet screening criteria at all. Second, health science students themselves are not immune to these pressures; in fact, some of the pressures (long clinical hours, body-focused training environments, appearance norms in healthcare work) may make future nurses and physicians a group worth screening rather than assuming they are protected by their professional knowledge.

Because this was a cross-sectional, convenience-sample study conducted in one city in South India, the numbers describe this specific group at one point in time — they should not be generalized to nursing students everywhere, but they do raise a legitimate question worth asking on any nursing program: are students routinely screened for disordered eating and body image concerns, or only assumed to be at low risk because of their profession?

Faculty notes

Educational Relevance

This descriptive cross-sectional study (Vijayalakshmi et al., 2017, Investigación y Educación en Enfermería) surveyed 454 undergraduate health science students — 241 medical and 213 nursing — at institutions in Bangalore, South India, between August and October 2014, with a 91.9% response rate. The sample skewed female (78.6%), with mean ages of 19 years (SD=1.32) for women and 20 years (SD=2.04) for men. Data were collected via a self-administered packet combining a socio-demographic questionnaire (self-reported height/weight, weight satisfaction) with three validated screening instruments: the SCOFF questionnaire (5 items, cutoff ≥2 for eating-disorder risk), the EAT-26 (26 items, cutoff ≥20 for at-risk status), and the PHQ-9 depression screen. Comparisons used chi-square tests for categorical variables and t-tests for continuous variables, with significance set at p<0.05.

The central finding is a dissociation between measured BMI, perceived body image, and validated disordered-eating risk. Men had significantly higher measured BMI than women (t=5.403, p<0.001) — an expected physiological difference. Yet women reported far greater perceived overweight status (74.8% vs. 28.9%) and weight dissatisfaction (81.6% vs. 33%), despite lower BMI. Conversely, men screened positive at higher rates on both the SCOFF (45.4% vs. 31.1%) and EAT-26 (16.5% vs. 8.7%), suggesting more objectively risky eating cognitions and behaviors than their self-perception or dissatisfaction rates would suggest. Binge eating was common in both groups (48.2% women, 41.2% men; p<0.004), and roughly equal small minorities of each gender (13.1%) misclassified their own weight status in either direction, indicating that body-image distortion is not a purely female phenomenon in this sample. Weight-control behavior also diverged by gender: men more often used prolonged exercise (>60 minutes; 47.4% vs. 25.4%, p<0.001) and reported higher rates of substantial recent weight loss (>10kg in six months; 9.3% vs. 3.4%), with 8.2% of men also reporting prior treatment for an eating problem; compensatory purging (vomiting, laxatives) stayed under 10% for both sexes. Depression screening showed a non-significant trend toward higher severe-depression rates among men (9.3% vs. 4.5%).

For classroom discussion, this study is a useful counter-example to the common teaching shorthand that "disordered eating is a women's issue" and that "body dissatisfaction predicts eating-disorder risk." Here the two constructs pull apart: the group with more distorted/dissatisfied body image (women) was not the group that screened at higher risk on standardized instruments (men). This is worth unpacking with students as a measurement issue as much as a clinical one — screening tools built and validated primarily on adolescent/young Western women populations may perform differently, or capture different behaviors, in male and cross-cultural samples.

Methodologically, faculty should flag the convenience sampling from a single city, the cross-sectional design (no causal or trajectory claims are possible), and reliance on self-reported height/weight and behaviors, all of which limit both internal and external validity. The authors themselves frame the gender differences as "small" but policy-relevant, recommending that eating-disorder prevention programming for health science students be designed with attention to these gendered patterns rather than defaulting to female-only outreach. A natural discussion extension for a Canadian nursing cohort is whether local screening practices for students and for patients assume the same gendered risk pattern this South Indian sample complicates.