Body size preferences and perceived current average body size of Samoans has increased dramatically in the last 20 years, a study has found.

The research, "Changing body norms in the context of increasing body size: Samoa in 1995 and 2018", showed that while the average size of Samoans have increased overtime, their preference for bodies smaller than their perceived current size has not changed.

But most importantly, the limits of what both men and women considered “normal” has shifted remarkably at both ends of the scale.

This suggests that people do not view very skinny or very fat bodies as normal like they used to before.

Lead researcher and Masters student at Yale School of Public Health, Sophie Bao-chieu To says this is ‘super-interesting’ as it seems there is a "sweet spot" right in the middle that people aspire to be.

“And that may have implications for how people behave in order to try to attain that body, or how people feel if they are outside of that range, both "too skinny" and "too fat",” she said.

“Back then, it seemed like people thought it was normal for people to be on the very skinny or very fat side -- but now, it seems like people don't view very skinny or very fat bodies as normal as much.”

The study data was collected from adults aged 31 to 59 who participated in two separate cross-sectional studies of obesity and cardiometabolic risk conducted in Samoa in 1995 and 2017 to 2019.

Participants nominated line drawings representing their current size, ideal size, the most attractive and healthiest size, and the lower/upper limits of “normal” size.

“Among both sexes, body size preferences and perceived current size had, on average, increased (ie, in favor of larger bodies), yet preference for bodies smaller than the size people believed they currently were persisted—and appear to have become more pronounced among women,” the report reads.

“This may have significant implications, given that anxieties around failure to meet social expectations of slimness appear to generate stressful forms of stigma that negatively impact both mental and physical health (Brewis, SturtzSreetharan, & Wutich, 2018; Tomiyama et al., 2018).”

Instead of the public health sector standing from afar and saying the do’s and dont’s, Ms. To thinks the public sector may need to factor in the perceptions of the people for their intervention and meet them where they are, for the message to fit easier.

Based on recent national-level surveys, 53.1 per cent of men and 76.7 per cent of women in Samoa had obesity – among the highest prevalence in the world – despite countless efforts to tackle the issue.

Ms. To said this is because these programmes were much more focused on telling people what to do with their bodies and what not to eat and such, which have not been very effective as cases of obesity are still on the rise.

There is a real problem with this approach, she added, hence the decision to look at the issue from a different angle, namely body image.

“Because ultimately people know their bodies’ best and telling people you need to eat this way and some way and I don’t think that’s going to be effective. And interventions in the past have done that and yet obesity is still going up,” she said.

“I think we need a different approach where we talk to who we say we want to serve and try to improve their health, and so I just wanted to focus on the body image angle.

“Because I think that perceptions of people’s bodies need to be taken into account when we try to develop these health interventions and that’s kind of the goal of these studies, so that we are gearing up for these interventions to improve health.”

Ms. To hopes that the study may be the first of many follow ups and eventually working it into interventions in the future.

“Trying to understand where people are with their bodies and meeting them where they are with those perceptions I think is really important,” she said.

“I hope my study will lead to be a part of a bigger study and to just use this in an intervention in a culturally sensitive way and a culturally appropriate way and also build on it.

“This study just is kind of describing what people feel about their bodies but I also feel that there should be studies that ask people in the community, why do you feel this way and how do you think that we should incorporate this in an intervention.”

Recent figures from the World Health Organisation (W.H.O.), showed that as many as one in five children and teenagers in 10 Pacific countries were obese.