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Dianne Neumark-Sztainer, PhD, MPH, RD; Mary Story, PhD, RD; Simone A. French, PhD

Arch Pediatr Adolesc Med. 1996;150(3):304-308.

Abstract
Objectives
To determine if unhealthy weight loss methods are associated with other health-compromising behaviors among adolescents and to examine covariation patterns across gender and age groups.

Study Design and Participants
The study sample was drawn from a larger population of 123 132 adolescents in the 6th, 9th, and 12th grades in Minnesota who completed a statewide school-based survey. The index group included all adolescents who used unhealthy weight loss methods (n=4514), and the comparison group comprised a random sample of 4514 adolescents who did not use these methods and who were matched for gender, ethnicity, and grade.

Main Outcome Measures
Unhealthy weight loss methods included vomiting and use of laxatives, diuretics, and diet pills. Other health-compromising behaviors that were assessed included suicide attempts; delinquency; tobacco, alcohol, and marijuana use; unprotected sexual intercourse; and multiple sexual partners.

Results
Adolescents who used unhealthy weight loss methods were more likely to engage in other healthcompromising behaviors. Odds ratios ranged from 1.9 to 14.8, and odds ratios were all highly significant among boys and girls in early, middle, and late adolescence. Among the girls, a monotonic decrease in the strength of all associations was found with increased age.

Conclusions
Adolescents who engage in unhealthy weight loss methods are more likely to engage in a range of other health-compromising behaviors. Different perceptions of unhealthy weight loss behaviors (eg, normative vs problematic) may in part explain the differences in the strengths of associations between different grade and gender groups. Our results suggest that screening and counseling of adolescents who engage in unhealthy weight loss methods should be comprehensive and intervention programs aimed at the secondary prevention of disordered eating need to address other problematic behaviors.

(Arch Pediatr Adolesc Med. 1996;150:304-308)

Author Affiliations
From the Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis.

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