COVARIATIONS OF UNHEALTHY WEIGHT-LOSS BEHAVIORS AND OTHER HIGH-RISK BEHAVIORS AMONG ADOLESCENTS

Objectives: To determine if unhealthy weight loss methods are associat ed with other health-compromising behaviors among adolescents and to e xamine 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 include d all adolescents who used unhealthy weight loss methods (n=4514), and the comparison group comprised a random sample of 4514 adolescents wh o did not use these methods and who were matched for gender, ethnicity , and grade. Main Outcome Measures: Unhealthy weight loss methods incl uded vomiting and use of laxatives, diuretics, and diet pills. Other h ealth-compromising behaviors that were assessed included suicide attem pts; delinquency; tobacco, alcohol, and marijuana use; unprotected sex ual intercourse; and multiple sexual partners. Results: Adolescents wh o used unhealthy weight loss methods were more likely to engage in oth er health-compromising behaviors. Odds ratios ranged from 1.9 to 14.8, and odds ratios were all highly significant among boys and girls in e arly, middle, and late adolescence. Among the girls, a monotonic decre ase in the strength of all associations was found with increased age. Conclusions: Adolescents who engage in unhealthy weight loss methods a re more likely to engage in a range of other health-compromising behav iors. Different perceptions of unhealthy weight loss behaviors leg, no rmative vs problematic) may in part explain the differences in the str engths of associations between different grade and gender groups. Our results suggest that screening and counseling of adolescents who engag e in unhealthy weight loss methods should be comprehensive and interve ntion programs aimed at the secondary prevention of disordered eating need to address other problematic behaviors.