Sixth form students' attitudes toward obesity in Malta

Abstract

The aim of this study is to assess Maltese adolescent sixth form students' current attitudes towards overweight and obesity, and analyse the effect of actual weight status on perceived weight bias. This data will be compared to attitudes elicited twenty years ago in a cross sectional study of a similar student population, and discuss reasons for any observed change. Data collection for this cross-sectional survey was conducted between January and April 2010 in a government, church, and independent sixth form institution. A validated tool- the Attitudes Toward Obese Persons questionnaire - was used to obtain a score measuring such attitudes. Body mass index values were also derived from selfreported height and weight. A number of statistical analyses were carried out to elicit differences in self-reported BMI and attitudes towards obesity between schools, by geographical region and socioeconomic status. Results were compared to unpublished survey data collected circa 1989 by Cacciotolo, Mamo and Stivala from Polytechnic (now Junior College) students. Results showed that ATOP score is not related to BMI in Maltese adolescents. Nor is there a significant difference in either BMI or ATOP score between schools. However, maternal education and geographical region independently influence adolescents' attitudes towards obese persons. A higher socioeconomic status as suggested by a higher level of maternal education is associated with more discriminatory attitudes toward obesity, whereas living in the Southern Harbour area is associated with increased tolerance compared to students originating from the Norther Harbour area. Additionally, there has also been a change in attitudes over the past two decades: a gradual mellowing of perceptions appears to have taken place. Notably, attitudes toward career success and marriage seem to be less influenced than previously by perceived self- weight status and that of long term partners respectively. The study concludes that increasing overweight and obesity in adolescents over the past two decades, together with their tendency towards normative behaviour, has resulted in increased tolerance and acceptance of obesity. This effect is seen across all strata of society, although matemal education appears to play a role in modulating these attitudes. Recommendations are given together with suggestions for further research.