The perception of body image plays a crucial role in shaping an individual's psychosocial well-being, particularly during the transitional period of late adolescence. The period of early adulthood is called as youths (15- 24 years).^[1] It is a unique stage of human development and an important time for laying the foundations of good health.^[2] Body image refers to an individual's thoughts, feelings, and attitudes concerning their physical appearance, and it has a substantial impact on self-esteem, social relationships, and mental health consequences.^[3] As young people traverse the complicated transitions of late adolescence, including heightened social scrutiny and the internalization of conventional beauty standards, their body image beliefs can dramatically influence their general well-being.^[4]

Studies carried out in India reveal that between 10% and 30% of teenage girls and women enrolled in college worry about their bodies. It is crucial to assess body image within its cultural context, as it is founded on a social construct of the ideal body image.^[5] Previous studies have demonstrated that negative body image is linked to a variety of adverse psychological outcomes, including depression, anxiety, and eating disorders. Conversely, a positive body image is associated with higher self-esteem, better social relationships, and improved overall mental health.^[6]  Existing literature has primarily focussed on adolescent girls of early to mid-adolescence. There is a dearth of research pertaining to males and youths. To identify the research gap, this study was aimed to assess the body image perception among youths of both gender and its association with psychosocial well-being.

Objectives:

• To determine the prevalence of body image perception among Youths in Lucknow.
• To assess the various factors associated with body image perception among youths in Lucknow.

MATERIALS AND METHODS

Study design and setting: This facility based cross-sectional study was conducted in the various colleges in Lucknow. Lucknow is the largest city in northern India, capital of Uttar Pradesh. There are about 108 colleges in the Lucknow district. ^[7]

Study participants, sampling technique, and sample size: This study was conducted among Youths 15-24 years of age) studying in the selected colleges of Lucknow district. The sample size was calculated by taking the prevalence of body dissatisfaction as 77.6% among college students and the absolute precision (d) as 5% at a 95% confidence level.^[4] By using Epi tool software,^[8] the sample size was calculated to be 268. After applying the designing effect of 1.5 and non-response rate of 10% the final sample size considered for the study was 442. Cluster random sampling method was applied to select the colleges and from the Participants were recruited through simple random sampling using chit method among the selected clusters. Participants who were not willing to participate and those who were not able to conduct in three consecutive visits were excluded from the study

Data collection tool and technique: The study was started after obtaining the necessary permission from the institutional research and ethical committee (Serial Number: IEC/IIMSR/2025/29). All interviews were done face to face by a trained interviewer. The study was conducted after getting informed written consent from the participants in privacy without any family members accompanying them. We used a pretested, semi structured questionnaire which consisted of the sociodemographic details of the participants; Data were compiled, entered in Microsoft Excel software, and analyzed using SPSS Version 22 (SPSS Inc, Chicago IL, USA). All the categorical variables were presented as frequencies and percentages, and test of significance like the Chi square test was used to assess the level of significance of variables. Statistical significance was set at p-value < 0.05.

Operational definitions

Body Image: Body image is the internal representation of one's outward look. It includes one's attitudes toward one's body as well as thoughts, beliefs, feelings, and behaviors.^[9]

Psychological well-being: Presence of positive feelings (eg. Good self-esteem) or the absence of negative emotions (eg. Symptoms of depression or anxiety). It includes self-acceptance, personal growth, positive relationship with others, autonomy, and environmental mastery.^[10]

RESULTS

A total of 442 participants participated in the study and the results were described under the following headings:

• Sociodemographic details
• Body Image perception
• Self-esteem status

Sociodemographic details

The majority of the participants were female (68.3%), while males comprised 31.7%. Most participants were Hindu (60.4%), followed by Muslims (38.2%) and Christians (1.4%). Regarding family structure, 62.2% belonged to nuclear family. Socioeconomic classification revealed that 37.1% were from the upper class and upper-middle class respectively according to modified BG prasad classification. (Table 1)

Table 1: Demographic details of the study participants (n=442)

Body Image Perception

Figure 1 depicted the body image perception of the study participants. Major proportion of the study participants were having poor body image perception (87%). 66.5% of the females were having poor perception whereas 33.5% of males reported poor perception

Figure 1: Body image perception among the study participants (N=442)

Self-Esteem Status

Figure 2 shows the distribution of self-esteem levels among the participants. Nearly half of the study participants 55% were having poor self-esteem whereas 45% were having good self-esteem. Poor self-esteem was comparatively higher among female with 62.1%.

Figure 2: Self-esteem among the study participants (n=442)

Association Between Demographic variables and Body Image Perception

Among gender females were having poor body image perception (66.5%) when compared with males, which is statistically significant (p=0.002). However, no significant association was observed between socioeconomic status and body image perception (p=0.45). (Table 2)

Table 2: Association of demographic variable with body image perception (n=442)

Association of gender and Body image perception with self-esteem

The association of gender and body image perception with self-esteem is shown in Table 3. A significant relationship was found between gender and self-esteem (p=0.002), with a higher proportion of females experiencing poor self-esteem. In addition, body image perception showed a highly significant association with self-esteem (p<0.001). Participants with poor body image perception were more likely to report poor self-esteem (92.6%) compared to those with good perception (7.4%).

Table 3: Association of gender and Body image perception with self-esteem (n=442)

DISCUSSION

The current study cross sectional conducted among youths studying selected college in Lucknow district. In the present study, majority of the study participants were females (68.3%) belonging to nuclear family (62.2%) and belongs to upper and upper middle class based on modified BG prasad classification.

In the current study, major proportion of the study participants were having poor body image perception (87%). Similar to our study, many studies shows that females were having more body image dissatisfaction when compared with males.^[11,12] A larger proportion of females (40.4%) compared to males (23.4%) was dissatisfied by their body size in the study conducted by kartha et al.,^[13] In contrast, chae et al., reported that 26.5% participants were having under perception about their body image.^[14]

A significant association was observed between body image perception and self esteem in the current study (p<0.001). similar findings were reported in previous research indicating the negative correlation between body image disturbance and self-esteem. Concurrent findings were reported by the study conducted by Mishra et al. found that the higher body image dissatisfaction was significantly associated with lower self- esteem among Indian adults.^[15] Similarly Tewatia reported positive correlation between body image satisfaction and self esteem among male undergraduate students in Delhi. ^[16]

The Present study found that females were having more poor body image perception and lower self- esteem compared to males (=<0.002). A study conducted by the Bedi and Javed highlighted that women often experience greater body image dissatisfaction and lower self- esteem than men.^[17] In addition, increase in media exposure has been shown significant impact on girls mental health which lead to body dissatisfaction and poor self- esteem.

The findings form the research underscore the need for targeted interventions to address body image concern and self-esteem particularly among young females. Educational programs promoting body positivity and media literacy could help to mitigate the negative impact. Mental health professionals should also be aware of the influence of body image on self-esteem to provide appropriate support.

Limitations:

Being a cross sectional study, the temporality of the findings could not be established. Qualitative research could explore the underlying reasons for body dissatisfaction and low self-esteem in different socioeconomic and cultural contexts.

CONCLUSION

The study shows that higher prevalence of poor body image perception among the study participants. The poor body image perception is associated with low self- esteem. This research highlights the significant role of body image perception in shaping self- esteem.  Implementation of various health education programs and counselling session can be done to improve the mental health of the participants.

Acknowledgement:

We acknowledge the cooperation of the participants for conducting the study and Department of Community health nursing, Department of pediatrics and Department of Community Medicine for the smooth conduct of the study.

Financial support and sponsorship: Nil.

Conflicts of interest: There are no conflicts of interest

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