Document Type : Original Article


1 Department of Exercise Physiology, Faculty of Sport Sciences, University of Isfahan, Isfahan, Iran / Department of Sport Sciences, Shahrekord University, Shahrekord, Iran

2 Department of Sport Sciences, Shahrekord University, Shahrekord, Iran

3 Department of Sport Sciences, Shahrekord University, Shahrekord, Iran / Department of Sport Sciences, Faculty of Education and Psychology, Ardakan University, Ardakan, Iran

4 Department of Physical Education, Islamic Azad University of Tehran, Tehran, Iran

5 Center for Health and Exercise Science Research, Hong Kong Baptist University, Hong Kong, China


Background and aims: Decreased levels of physical activity (PA) during the coronavirus disease 2019 (COVID-19) pandemic can cause physical and psychological problems for individuals. Therefore, the aim of this study was to investigate the relationship between PA, body image, and eating disorders (EDs) during the COVID-19 pandemic among high school girls in Farsan, Iran.
Methods: This was a descriptive-analytical cross-sectional study, and the research population included female high school students from Farsan, Iran, who were studying in 2019-2020. In this regard, 535 high school girls (age: 15.95 ± 1.42, weight: 53.07 ± 10.01, BMI: 20.14 ± 3.48) were selected based on cluster-random sampling to participate in the study. Multidimensional Body Self-relation Questionnaire (MBSRQ), Baecke’s Physical Activity Questionnaire, and the Eating Disorder Diagnostic Scale (EDDS) were used to collect data, and Pearson correlation coefficients were administered to establish statistical relationships.
Results: The results indicated significant positive correlations between body image and PA levels (r = 0.304, P = 0.001). However, no significant correlations were observed between body image and anorexia nervosa (AN) (r = -0.035, P = 0.424), bulimia nervosa (BN) (r = -0.033, P = 0.446), and binge ED (r = -0.041, P = 0.339). Likewise, no relationships were observed between PA and AN (r = 0.084, P = 0.052), BN (r = 0.073, P = 0.092), as well as binge ED (r = 0.071, P = 0.099).
Conclusion: During the COVID-19 pandemic, PA was positively associated with body image but not with EDs. Based on the obtained results, it can be concluded that PA improved body image in adolescent girls during the COVID-19 pandemic.


1. Mardaniyan Ghahfarrokhi M, Banitalebi E, Faramarzi M, Ghorbanpoor Dashtaki M, Earnest CP. 2019 novel coronavirus: emphasis on maintaining optimal levels of physical activity under self-quarantine conditions. Int J Epidemiol Res. 2020;7(2):49-51. doi: 10.34172/ijer.2020.09. 
2. Hall G, Laddu DR, Phillips SA, Lavie CJ, Arena R. A tale of two pandemics: how will COVID-19 and global trends in physical inactivity and sedentary behavior affect one another? Prog Cardiovasc Dis. 2021;64:108-10. doi: 10.1016/j. pcad.2020.04.005. 
3. Chulvi-Medrano I, Villa-González E, Rebullido TR, Faigenbaum AD. The impact of COVID-19 quarantine on youth: from physical inactivity to pediatric depreobesity. Journal of Movement & Health. 2021;18(1):1-4. doi: 10.5027/ jmh-Vol18-Issue1(2021)art100. 
4. Aubert S, Barnes JD, Abdeta C, Abi Nader P, Adeniyi AF, Aguilar-Farias N, et al. Global Matrix 3.0 physical activity report card grades for children and youth: results and analysis from 49 countries. J Phys Act Health. 2018;15(S2):S251-S73. doi: 10.1123/jpah.2018-0472. 
5. Oikawa SY, Holloway TM, Phillips SM. The impact of step reduction on muscle health in aging: protein and exercise as countermeasures. Front Nutr. 2019;6:75. doi: 10.3389/ fnut.2019.00075. 
6. Claussen MC, Fröhlich S, Spörri J, Seifritz E, Markser VZ, Scherr J. Psyche und sport in Zeiten von COVID-19. Sport & Exercise Medicine Switzerland (SEMS). 2020;71(5):e1-e2. doi: 10.5960/dzsm.2020.435. 
7. Wackerhage H, Everett R, Krüger K, Murgia M, Simon P, Gehlert S, et al. Sport, exercise and COVID-19, the disease caused by the SARS-CoV-2 coronavirus. Dtsch Z Sportmed. 2020;71(5):e1-e12. doi: 10.5960/dzsm.2020.441. 
8. Mutz M, Gerke M. Sport and exercise in times of self-quarantine: how Germans changed their behaviour at the beginning of the COVID-19 pandemic. Int Rev Sociol Sport. 2021;56(3):305-16. doi: 10.1177/1012690220934335. 
9. Azizi GG, Orsini M, Júnior SD, Vieira PC, de Carvalho RS, da Rocha Pires CS, et al. COVID-19 and physical activity: what is the relation between exercise immunology and the current pandemic situation? Rev Bras Fisiol Exerc. 2020;19(2 Suppl):S20-S9. doi: 10.33233/rbfe.v19i2.4115. 
10. Bagherian S, Mardaniyan Ghahfarrokhi M, Banitalebi E. Effect of the COVID-19 pandemic on interest in home-based exercise: an application of digital epidemiology. Int J Epidemiol Res. 2021;8(1):47-53. doi: 10.34172/ijer.2021.08. 
11. Gaddad P, Pemde HK, Basu S, Dhankar M, Rajendran S. Relationship of physical activity with body image, self esteem sedentary lifestyle, body mass index and eating attitude in adolescents: a cross-sectional observational study. J Family Med Prim Care. 2018;7(4):775-9. doi: 10.4103/jfmpc. jfmpc_114_18. 
12. Brudzynski LR, Ebben W. Body image as a motivator and barrier to exercise participation. Int J Exerc Sci. 2010;3(1):3. 
13. Schuck K, Munsch S, Schneider S. Body image perceptions and symptoms of disturbed eating behavior among children and adolescents in Germany. Child Adolesc Psychiatry Ment Health. 2018;12:10. doi: 10.1186/s13034-018-0216-5. 
14. Lippi G, Henry BM, Bovo C, Sanchis-Gomar F. Health risks and potential remedies during prolonged lockdowns for coronavirus disease 2019 (COVID-19). Diagnosis (Berl). 2020;7(2):85-90. doi: 10.1515/dx-2020-0041. 
15. Weinberger NA, Kersting A, Riedel-Heller SG, Luck- Sikorski C. Body dissatisfaction in individuals with obesity compared to normal-weight individuals: a systematic review and meta-analysis. Obes Facts. 2016;9(6):424-41. doi: 10.1159/000454837. 
16. Baceviciene M, Jankauskiene R, Balciuniene V. The role of body image, disordered eating and lifestyle on the quality of life in Lithuanian university students. Int J Environ Res Public Health. 2020;17(5):1593. doi: 10.3390/ijerph17051593. 
17. Rundle AG, Park Y, Herbstman JB, Kinsey EW, Wang YC. COVID-19-related school closings and risk of weight gain among children. Obesity (Silver Spring). 2020;28(6):1008-9. doi: 10.1002/oby.22813. 
18. Zachary Z, Brianna F, Brianna L, Garrett P, Jade W, Alyssa D, et al. Self-quarantine and weight gain related risk factors during the COVID-19 pandemic. Obes Res Clin Pract. 2020;14(3):210-6. doi: 10.1016/j.orcp.2020.05.004. 
19. Shahyad S, Mohammadi MT. Psychological impacts of COVID-19 outbreak on mental health status of society individuals: a narrative review. J Mil Med. 2020;22(2):184-92. doi: 10.30491/jmm.22.2.184. [Persian]. 
20. Hayes JF, Fitzsimmons-Craft EE, Karam AM, Jakubiak J, Brown ML, Wilfley DE. Disordered eating attitudes and behaviors in youth with overweight and obesity: implications for treatment. Curr Obes Rep. 2018;7(3):235-46. doi: 10.1007/s13679-018- 0316-9. 
21. Tal A. Shrinkage of De Morgan formulae by spectral techniques. In: 2014 IEEE 55th Annual Symposium on Foundations of Computer Science. Philadelphia, PA: IEEE; 2014. doi: 10.1109/ focs.2014.65. 
22. Thorsteinsdottir G, Ulfarsdottir L. Eating disorders in college students in Iceland. Eur J Psychiatry. 2008;22(2):107-15. 
23. Krabbenborg MA, Danner UN, Larsen JK, van der Veer N, van Elburg AA, de Ridder DT, et al. The Eating Disorder Diagnostic Scale: psychometric features within a clinical population and a cut-off point to differentiate clinical patients from healthy controls. Eur Eat Disord Rev. 2012;20(4):315-20. doi: 10.1002/ erv.1144. 
24. Thompson J. Body Image, Eating Disorders, and Obesity: An Integrative Guide for Assessment and Treatment. American Psychological Association; 2001. 
25. Cash TF. The Body Image Workbook: An 8-Step Program for Learning to Like Your Looks. New Harbinger Publications, Inc; 1997. 
26. Zarshenas S, Karbalayee-Noori A, Hoseini SA, Rahgozar M, Bidokhti NM. The effect of aroabic excersices on females’ attitude toward body image. Rehabilitation. 2010;11:15-20. 
27. Ono R, Hirata S, Yamada M, Nishiyama T, Kurosaka M, Tamura Y. Reliability and validity of the Baecke physical activity questionnaire in adult women with hip disorders. BMC Musculoskelet Disord. 2007;8:61. doi: 10.1186/1471-2474- 8-61. 
28. Treiber FA, Baranowski T, Braden DS, Strong WB, Levy M, Knox W. Social support for exercise: relationship to physical activity in young adults. Prev Med. 1991;20(6):737-50. doi: 10.1016/0091-7435(91)90068-f. 
29. Narici M, Vito G, Franchi M, Paoli A, Moro T, Marcolin G, et al. Impact of sedentarism due to the COVID-19 home confinement on neuromuscular, cardiovascular and metabolic health: physiological and pathophysiological implications and recommendations for physical and nutritional countermeasures. Eur J Sport Sci. 2021;21(4):614-35. doi: 10.1080/17461391.2020.1761076. 
30. Pranata R, Lim MA, Yonas E, Vania R, Lukito AA, Siswanto BB, et al. Body mass index and outcome in patients with COVID-19: a dose-response meta-analysis. Diabetes Metab. 2021;47(2):101178. doi: 10.1016/j.diabet.2020.07.005. 
31. Huang JS, Norman GJ, Zabinski MF, Calfas K, Patrick K. Body image and self-esteem among adolescents undergoing an intervention targeting dietary and physical activity behaviors. J Adolesc Health. 2007;40(3):245-51. doi: 10.1016/j. jadohealth.2006.09.026. 
32. Malete L, Motlhoiwa K, Shaibu S, Wrotniak BH, Maruapula SD, Jackson J, et al. Body image dissatisfaction is increased in male and overweight/obese adolescents in Botswana. J Obes. 2013;2013:763624. doi: 10.1155/2013/763624. 
33. Bolboli L, Habibi Y, Rajabi A. The effect of exercise on body image, body mass and social anxiety in students. J Sch Psychol. 2013;2(2):29-43. [Persian]. 
34. Seguin RA, Eldridge G, Lynch W, Paul LC. Strength training improves body image and physical activity behaviors among midlife and older rural women. J Ext. 2013;51(4):4FEA2. 
35. Laudańska-Krzemińska I, Krzysztoszek J, Naczk M, Gajewska E. Physical activity, physical fitness and the sense of coherence-their role in body acceptance among Polish adolescents. Int J Environ Res Public Health. 2020;17(16):5791. doi: 10.3390/ ijerph17165791. 
36. de Castro Coelho EM, Fonseca SC, Pinto GS, Mourão-Carvalhal MI. Factors associated with body image dissatisfaction in Portuguese adolescents: obesity, sports activity and TV watching. Motricidade. 2016;12(2):18-26. doi: 10.6063/ motricidade.6277. 
37. Laus MF, Braga Costa TM, Almeida SS. Body image dissatisfaction and its relationship with physical activity and body mass index in Brazilian adolescents. J Bras Psiquiatr. 2011;60(4):315-20. doi: 10.1590/s0047-20852011000400013. 
38. Salci LE, Martin Ginis KA. Acute effects of exercise on women with pre-existing body image concerns: a test of potential mediators. Psychol Sport Exerc. 2017;31:113-22. doi: 10.1016/j.psychsport.2017.04.001. 
39. Hubbard EA. The Effects of Exercise Modality on State Body Image. University of South Florida; 2013. 
40. King AJ, Burke LM, Halson SL, Hawley JA. The challenge of maintaining metabolic health during a global pandemic. Sports Med. 2020;50(7):1233-41. doi: 10.1007/s40279-020- 01295-8. 
41. Flaudias V, Iceta S, Zerhouni O, Rodgers RF, Billieux J, Llorca PM, et al. COVID-19 pandemic lockdown and problematic eating behaviors in a student population. J Behav Addict. 2020;9(3):826-35. doi: 10.1556/2006.2020.00053. 
42. Robertson M, Duffy F, Newman E, Prieto Bravo C, Ates HH, Sharpe H. Exploring changes in body image, eating and exercise during the COVID-19 lockdown: a UK survey. Appetite. 2021;159:105062. doi: 10.1016/j.appet.2020.105062. 
43. Schlegl S, Meule A, Favreau M, Voderholzer U. Bulimia nervosa in times of the COVID-19 pandemic-results from an online survey of former inpatients. Eur Eat Disord Rev. 2020;28(6):847-54. doi: 10.1002/erv.2773. 
44. Amatori S, Donati Zeppa S, Preti A, Gervasi M, Gobbi E, Ferrini F, et al. Dietary habits and psychological states during COVID-19 home isolation in Italian college students: the role of physical exercise. Nutrients. 2020;12(12):3660. doi: 10.3390/nu12123660. 
45. Zeiler M, Wittek T, Kahlenberg L, Gröbner EM, Nitsch M, Wagner G, et al. Impact of COVID-19 confinement on adolescent patients with anorexia nervosa: a qualitative interview study involving adolescents and parents. Int J Environ Res Public Health. 2021;18(8):4251. doi: 10.3390/ ijerph18084251. 
46. Mediouni M, Madiouni R, Kaczor-Urbanowicz KE. COVID-19: how the quarantine could lead to the depreobesity. Obes Med. 2020;19:100255. doi: 10.1016/j.obmed.2020.100255.