Is health behavior among university students determined by actual body shape or by body image? A European study

BACKGROUND: Appropriate body image self-perceptions provide a good help to increase the feeling of personal well-being, thus having an important impact on health. Universities, having an important role in shaping of the future workers, represent an important setting to approach health issues. OBJECTIVE: This study determined to what extent different types of students in higher education (four categories of students were created: "self-secure", "perfect", "destructive" and "apologetic") are likely to adopt different health risk behaviors. METHODS: A cross-sectional study in a sample of students from five European Universities in the 2016/2017 academic year was conducted. Based on the combination of body image perception and body mass index, four types of students were identified: "self-secure" (overweight students with a good self-esteem); "perfect" (underweight students with a good self-esteem); "destructive" (overweight students with a poor self-esteem); "apologetic" (underweight students with a poor self-esteem). RESULTS: The study reveals that the defined types of students differed in terms of risk behavior. When the control was included, the "self-secure" student type had a reduced likelihood of being on a diet (22.3%) and physically active (17.8%) than other students (p