TY - JOUR
T1 - Association of Smartphone Use with Body Image Distortion and Weight Loss Behaviors in Korean Adolescents
AU - Kwon, Sohyeon
AU - Kim, Rockli
AU - Lee, Jong Tae
AU - Kim, Jinho
AU - Song, Sunmi
AU - Kim, Seongcheol
AU - Oh, Hannah
N1 - Funding Information:
Funding/Support: This work was supported by grant 2019S1A3A2099973 from the National Research Foundation of Korea (Ms Kwon and Drs S. Kim Oh).
Publisher Copyright:
© 2022 Acoustical Society of America. All rights reserved.
PY - 2022/5/20
Y1 - 2022/5/20
N2 - Importance: Despite high use of smartphones among adolescents, little is known about the association of smartphone use with body image and related behaviors. Objective: To examine the associations of duration of smartphone use and types of content most frequently accessed via smartphone with body image distortion and weight loss behaviors in adolescents. Design, Setting, and Participants: This cross-sectional study used data from the population-based Korea Youth Risk Behavior Web-Based Survey 2017. Participants comprised a nationally representative sample of 53 133 Korean adolescents aged 12 to 18 years. Data were collected from June 1 to July 18, 2017. The analysis was performed from February 7, 2020, to March 30, 2022. Exposures: Self-reported duration of smartphone use (min/d) and types of content (educational or informational searches; chatting, messaging, or email; social networking services or forums; games; videos, movies, or music; webtoons or web novels; and shopping or other activities) most frequently accessed during smartphone use. Main Outcomes and Measures: Body image distortion (overperception of body weight), weight loss attempt, use of inappropriate weight loss strategies (skipping meals, eating only 1 food at a time, vomiting, or using laxatives), and healthy weight loss behaviors (muscle-strengthening and aerobic physical activity). Multivariable logistic regression analysis was performed to estimate odds ratios (ORs) and 95% CIs, accounting for survey sampling and adjusting for potential confounders. Results: Among 53133 participants, the mean (SD) age was 15.0 (1.8) years; 50.7% of participants were female, and 49.3% were male. After adjusting for types of content accessed, prolonged smartphone use (≥301 min/d) was positively associated with body image distortion (boys: OR, 1.17; 95% CI, 1.07-1.28; girls: OR, 1.20; 95% CI, 1.10-1.30) and inappropriate weight loss strategies (boys: OR, 1.54; 95% CI, 1.25-1.90; girls: OR, 2.45; 95% CI, 2.14-2.79) in both sexes compared with minimal smartphone use (1-120 min/d). After adjusting for duration of smartphone use, the use of smartphones mainly for videos, movies, or music (OR, 1.15; 95% CI, 1.02-1.29), webtoons or web novels (OR, 1.28; 95% CI, 1.10-1.48), and games (OR, 1.17; 95% CI, 1.03-1.32) was positively associated with body image distortion in boys compared with the use of smartphones mainly for educational or informational content. Among boys, the use of smartphones mainly for chatting, messaging, or email was positively associated with muscle-strengthening activity (OR, 1.31; 95% CI, 1.18-1.44) and aerobic physical activity (OR, 1.41; 95% CI, 1.29-1.55), as was the use of smartphones mainly for social networking services or forums (muscle-strengthening activity: OR, 1.27; 95% CI, 1.13-1.42; aerobic physical activity: OR, 1.28; 95% CI, 1.15-1.43). Among girls, the use of smartphones mainly for chatting, messaging, or email was positively associated with weight loss attempts (OR, 1.34; 95% CI, 1.19-1.51) and the use of inappropriate weight loss strategies (OR, 1.57; 95% CI, 1.25-1.99), as was the use of smartphones mainly for social networking services or forums (weight loss attempts: OR, 1.20; 95% CI, 1.07-1.36; use of inappropriate weight loss strategies: OR, 1.37; 95% CI, 1.08-1.73). Conclusions and Relevance: In this cross-sectional study, both the duration of smartphone use and the types of content most frequently accessed via smartphone were associated with body image distortion and weight loss behaviors in adolescents. These findings suggest a need for the identification of strategies to help adolescents develop healthy smartphone use behaviors..
AB - Importance: Despite high use of smartphones among adolescents, little is known about the association of smartphone use with body image and related behaviors. Objective: To examine the associations of duration of smartphone use and types of content most frequently accessed via smartphone with body image distortion and weight loss behaviors in adolescents. Design, Setting, and Participants: This cross-sectional study used data from the population-based Korea Youth Risk Behavior Web-Based Survey 2017. Participants comprised a nationally representative sample of 53 133 Korean adolescents aged 12 to 18 years. Data were collected from June 1 to July 18, 2017. The analysis was performed from February 7, 2020, to March 30, 2022. Exposures: Self-reported duration of smartphone use (min/d) and types of content (educational or informational searches; chatting, messaging, or email; social networking services or forums; games; videos, movies, or music; webtoons or web novels; and shopping or other activities) most frequently accessed during smartphone use. Main Outcomes and Measures: Body image distortion (overperception of body weight), weight loss attempt, use of inappropriate weight loss strategies (skipping meals, eating only 1 food at a time, vomiting, or using laxatives), and healthy weight loss behaviors (muscle-strengthening and aerobic physical activity). Multivariable logistic regression analysis was performed to estimate odds ratios (ORs) and 95% CIs, accounting for survey sampling and adjusting for potential confounders. Results: Among 53133 participants, the mean (SD) age was 15.0 (1.8) years; 50.7% of participants were female, and 49.3% were male. After adjusting for types of content accessed, prolonged smartphone use (≥301 min/d) was positively associated with body image distortion (boys: OR, 1.17; 95% CI, 1.07-1.28; girls: OR, 1.20; 95% CI, 1.10-1.30) and inappropriate weight loss strategies (boys: OR, 1.54; 95% CI, 1.25-1.90; girls: OR, 2.45; 95% CI, 2.14-2.79) in both sexes compared with minimal smartphone use (1-120 min/d). After adjusting for duration of smartphone use, the use of smartphones mainly for videos, movies, or music (OR, 1.15; 95% CI, 1.02-1.29), webtoons or web novels (OR, 1.28; 95% CI, 1.10-1.48), and games (OR, 1.17; 95% CI, 1.03-1.32) was positively associated with body image distortion in boys compared with the use of smartphones mainly for educational or informational content. Among boys, the use of smartphones mainly for chatting, messaging, or email was positively associated with muscle-strengthening activity (OR, 1.31; 95% CI, 1.18-1.44) and aerobic physical activity (OR, 1.41; 95% CI, 1.29-1.55), as was the use of smartphones mainly for social networking services or forums (muscle-strengthening activity: OR, 1.27; 95% CI, 1.13-1.42; aerobic physical activity: OR, 1.28; 95% CI, 1.15-1.43). Among girls, the use of smartphones mainly for chatting, messaging, or email was positively associated with weight loss attempts (OR, 1.34; 95% CI, 1.19-1.51) and the use of inappropriate weight loss strategies (OR, 1.57; 95% CI, 1.25-1.99), as was the use of smartphones mainly for social networking services or forums (weight loss attempts: OR, 1.20; 95% CI, 1.07-1.36; use of inappropriate weight loss strategies: OR, 1.37; 95% CI, 1.08-1.73). Conclusions and Relevance: In this cross-sectional study, both the duration of smartphone use and the types of content most frequently accessed via smartphone were associated with body image distortion and weight loss behaviors in adolescents. These findings suggest a need for the identification of strategies to help adolescents develop healthy smartphone use behaviors..
UR - http://www.scopus.com/inward/record.url?scp=85130704333&partnerID=8YFLogxK
U2 - 10.1001/jamanetworkopen.2022.13237
DO - 10.1001/jamanetworkopen.2022.13237
M3 - Article
C2 - 35594044
AN - SCOPUS:85130704333
SN - 2574-3805
VL - 5
SP - E2213237
JO - JAMA network open
JF - JAMA network open
IS - 5
ER -