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S. Bryn Austin, ScD; Alison E. Field, ScD; Jean Wiecha, PhD; Karen E. Peterson, ScD; Steven L. Gortmaker, PhD

Arch Pediatr Adolesc Med. 2005;159:225-230.

Objective  To assess the impact of an obesity prevention intervention on use of self-induced vomiting/laxatives (purging) and diet pills to control weight in girls in early adolescence.

Design  We matched and randomly assigned 10 middle schools to an intervention or a control condition in a randomized controlled trial. Longitudinal multivariable analyses using generalized estimating equations were conducted with data from 480 girls to examine the effects of the intervention on the risk of reporting a new case of purging or diet pill use to control weight at follow-up 21 months later, while controlling for ethnicity and school matched pairs. Girls who reported purging or using diet pills at baseline were excluded from analyses.

Setting  Middle schools.

Participants  Four hundred eighty girls in early adolescence aged 10 to 14 years (mean age, 11.5 years).

Intervention  The Planet Health obesity prevention program was implemented during 2 school years and was designed to promote healthful nutrition and physical activity and to reduce television viewing.

Outcome  Reduced risk of using self-induced vomiting/laxatives or diet pills to control weight in the past 30 days.

Results  After the intervention, we found 14 (6.2%) of 226 girls in control schools and 7 (2.8%) of 254 girls in intervention schools reported purging or using diet pills to control their weight (P = .003). In a multivariable generalized estimating equation model, girls in intervention schools were less than half as likely to report purging or using diet pills at follow-up compared with girls in control schools (odds ratio, 0.41; 95% confidence interval, 0.22-0.75).

Conclusion  These findings provide promising evidence that school-based interventions may effectively integrate prevention of both obesity and disordered weight-control behaviors.

Author Affiliations: Division of Adolescent and Young Adult Medicine, Children’s Hospital (Drs Austin and Field), Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School (Drs Austin and Field), Harvard Prevention Research Center, Department of Society, Human Development, and Health (Drs Wiecha, Peterson, and Gortmaker), and Department of Nutrition (Dr Peterson), Harvard School of Public Health, Boston, Mass.

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