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Original article
Body image: a survey of children in Caribbean Bonaire
  1. Joana Kist-van Holthe1,
  2. Laura Melchers1,
  3. Tirza Blom1,
  4. Teatske Altenburg1,
  5. Marian Luinstra-Passchier2,
  6. Alcira Janga-Jansen2,
  7. Tahirih van Kanten2,
  8. Aleid Wirix1,
  9. Remy Hirasing1,
  10. Mai Chinapaw1
  1. 1 Department of Public and Occupational Health, Amsterdam Public Health Research Institute, VU Medical Center, Amsterdam, The Netherlands
  2. 2 Department of Public Health, Openbaar Lichaam Bonaire, Bonaire, Netherlands Antilles
  1. Correspondence to and Dr Joana Kist-van Holthe; j.kist{at}


Background In Bonaire, the prevalence of overweight and obesity is twice as high compared with Northern Europe but similar to other Caribbean Islands and the USA. Having a realistic body image may be an important tool in the battle against childhood obesity. Previous studies have demonstrated associations between having a realistic body image and efforts to control weight. The aim of the study was to explore the body image of children in Bonaire.

Methods In a cross-sectional study from March to May 2015 in Bonaire, weight and height were measured in all children aged 10–14 years attending school. Body mass index (kg/m2) was classified according to the International Obesity Task Force. The children were asked about their body image using a validated questionnaire.

Results Body mass index was measured in 939 of 1029 (91.3%) children aged 10–14 years (51.5% boys) in Bonaire. Of all children, 9.7% was underweight, 57.6% was normal weight, 32.7% was overweight (including obesity) and 11.6% was obese. The question pertaining to body image was completed by 750 of 939 (79.9%) children. Having a realistic perception of body image varied per weight category from 65% in underweight girls to 13% in obese boys. The percentage of obese children who underestimate their weight is high (boys 87%, girls 77%).

Conclusions In many children in Caribbean Bonaire, perceived body image is not in agreement with actual weight status. This applies especially to obese children. Disagreement between perceived body image and actual weight status may prevent weight management in overweight children. Future research is needed to elucidate determinants of disagreement between body image and actual weight status.

  • adolescent health
  • child psychology
  • general paediatrics
  • obesity

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  • Contributors JKVH, MLP, AJJ, TVK, RH and MC designed the study. TB and LM carried out the study. JKVH, LM and TB wrote the manuscript. JKVH, TA and MC analysed the data. TVK, TA, MLP, AJJ, RH and MC critically reviewed the manuscript.

  • Competing interests None declared.

  • Ethics approval The study was approved by the VU University Medical Ethical Committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement All data are published and available upon request.

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