Adolescent Concern For Body Weight And Engagement In Unhealthy Weight Control Behaviors

Engagement in unhealthy weight control behaviors (UCWB) is associated with poor psychosocial health and can lead to further weight gain over time. However, it has yet to be explored whether adolescents` concern for their own body weight, body shape, or size predicts engagement in UCWBs in a nationally representative sample. PURPOSE: To explore the associations between adolescent’s concern for their body weight/shape/size and engagement in UWCBs. METHODS: Analyses included 23,357 (51.8% male) adolescents, ages 10-17 years (mean 13.8 ± 2.3 years), from the 2022 National Survey of Children’s Health. Adolescents were categorized by reported concern of their body weight, shape, or size in the past 12 months (i.e., not at all, somewhat, and very much). UWCB outcomes included: skipping meals or fasting, having low interest in food, extremely picky eating, binge eating, purging or vomiting after eating, using diet pills laxatives, or diuretics, and over-exercising. Logistic regression models, adjusted for age, sex, household income, education, depression, anxiety, and BMI, assessed the odds of each UWCB outcome by reported concern for body weight/ shape/ size. RESULTS: Overall, engagement in UCWB was low with 21.1% reporting picking eating, 13.5% fasting, 11.7% low interest in food, 5.3% binge eating, and <2% purging, over-exercising, or using diet pills, laxatives, or diuretics. Compared to adolescents who were not at all concerned about their body weight/shape/size adolescents who were somewhat or very much concerned about their body weight/shape/size had significantly higher odds (p’s<0.05) of engaging in all UCWB outcomes except for using diet pills or laxatives, which was only significant for adolescents who reported being very much concerned (OR=12.74; CI: [19.16, 36.94]). Further, after stratification by gender and age, there was a significant p-for trend (p’s<0.05), in engagement in UWCBs by concern about body weight/shape/size except for using diet pills or laxatives in 10-11- and 12-14-year-olds. CONCLUSIONS: Expressing concern for body weight/image/size is associated with an increased likelihood of engaging in UCWB in adolescents, regardless of gender or stage of adolescence.