Perception of body size in the Tongan community: differences from and similarities to an Australian sample

OBJECTIVE: The prevalence of obesity in Tonga is high and increasing. Attempts to address this major health issue would be assisted by a realistic concept of current and preferred body sizes. In this study, body size perception in Tongans was compared with that of Australians. DESIGN: Cross-sectional comparative study. SUBJECTS: 542 Tongans, 89 of whom were enrolled in a weight-loss programme (WLP); 481 Australians. Measurements: Subjects were weighed and measured. Two series of photographs tone female, one male), representing specific body mass indexes (BMIs) were used to assess body perception. RESULTS: The BMIs of the Tongans were higher than those of the Australians (Tongans: female 32.6+/-0.35 (mean +/- s.e.m); male, 30.4+/-0.33; Australians: female, 25.6+/-0.33; male 26.3+/-0.26 kg/m(2)). Tongan women underestimated their body size; Tongan men and Australians overestimated. WLP and younger Tongan women preferred smaller body sizes for themselves and for men and women in general. There were gender differences in preferred healthy and attractive female sizes (men: 27 kg/m(2); non-WLP women: 25 kg/m(2); WLP women: 23 kg/m(2)) and male sizes (men: 29 30kg/m(2); women: 26-27kg/m(2)) chosen by Tongans. Preferred, attractive and healthy body sizes chosen by Australian men and women were similar; about 24 kg/m(2) for males and 21 -22 kg/m(2) for females. CONCLUSION: Tongans preferred larger body sizes than did Australians, particularly the men, but WLP women's preferences were similar to those of Australians. There is evidence that preferences are changing in Tonga with time, and probably with increasing Western influence.