Covariations of unhealthy weight loss behaviors and other high-risk behaviors among adolescents
D. Neumark-Sztainer, M. Story and S. A. French
Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis, USA.
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 health-compromising 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.
