Associations between body image changes and modifiable behavioral variables among university students in the context of COVID-19 pandemic

Although previous studies have already examined pandemic-era behavior changes, there are still unanswered questions related to complex and sensitive topics such as body image, that can be answered by exploratory contextual analysis. The aim of this study was to evaluate changes in body image and explore its associations with modifiable behavioral variables among university students in the context of COVID-19 pandemic, controlling by sex and age. This cross-sectional study assessed body image perception both retrospectively (before the pandemic) and during the pandemic, as well as behavioral factors, in a sample of 252 university students of both sexes (77.4% female), aged 25.22±6.73 years. The Body Silhouette Scale measured the difference between participants perceived current and desired body image. Walking time, sedentary behaviour, and diet changes were considered modifiable behaviours and were assessed using a specific question about walking time, the short-form of the International Physical Activity Questionnaire (IPAQ-short) and a specific question about diet, respectively. Including those who became dissatisfied during the pandemic, 77.4% of the sample reported dissatisfaction with their body image. Sedentary behaviour and diet changes were significantly associated with body image changes. Low levels of sedentary behaviour reduced the odds of remaining dissatisfied by approximately 53% (OR = 0.47; 95% CI: 0.23-0.94; p = 0.03), while diet changes reduced the odds of becoming dissatisfied by 82% (OR = 0.18; 95% CI: 0.06-0.51; p < 0.01) to 83% (OR=0.17; 95% CI: 0.06-0.49; p < 0.001), and the odds of remaining dissatisfied by 69% (OR = 0.31; 95% CI: 0.15-0.64; p < 0.01) to 70% (OR = 0.30; 95% CI: 0.15-0.60; p < 0.001). Lower sitting time and diet changes acted as positive associated factors among university students during pandemic, with diet changes showing a strong association.