Desire to Weigh Less and Unhealthy Weight Control Behaviors Among U.S. Adults: Evidence From NHANES 2017–2018

ABSTRACT Background With obesity rates remaining high in the United States, many individuals attempt weight loss using self‐directed approaches that may not align with clinical recommendations. Objective This secondary data analysis examines the association between a desire to weigh less and unhealthy weight control behaviors among American adults. Methods Data from the 2017–2018 National Health and Nutrition Examination Survey (NHANES) were assessed through variables representing a desire to weigh less and self‐regulated weight control behaviors that are not clinically recommended: skipping meals, using non‐RX weight loss supplements, and using laxatives or self‐induced vomiting. Chi‐square tests and a linear probability model were employed to evaluate their relationship. Results Of adult survey respondents, 62.6% indicated a desire to weigh less. It was more likely to be reported by female, non‐Hispanic white, and college‐educated participants. Respondents who wanted to weigh less were more likely to engage in unhealthy weight loss strategies than those who wanted to gain weight or maintain their weight. There was a statistically significant relationship between a desire to weigh less and each unhealthy weight loss behavior (all p < 0.001). The linear probability model demonstrated that wanting to weigh less had the strongest effect on skipping meals. Conclusion Findings indicate a strong relationship between a desire to lose weight and engaging in potentially harmful weight control behaviors, broadening our understanding of self‐regulated approaches that adults may resort to. More attention should be directed to patient weight satisfaction and monitoring of unhealthy weight control practices in patient‐provider collaborations through nutrition support and healthcare settings for improved weight management care.