Relation of peer and media influences to the development of purging behaviors among preadolescent and adolescent girls

Objective: To assess prospectively the relation of peer and media influence s on the risk of development of purging behaviors. Design: Prospective cohort study. Setting: One year follow-up of 6982 girls aged 9 to 14 years in 1996 who co mpleted questionnaires in 1996 and 1997 and reported in 1996 that they did not use vomiting or laxatives to control weight. Main Outcome Measure: Self-report of using vomiting or laxatives at least m onthly to control weight. Results: During 1 year of follow-up, 74 girls began using vomiting or laxat ives at least monthly to control weight. Tanner stage of pubic hair develop ment was predictive of beginning to purge (odds ratio [OR] = 1.8; 95% confi dence interval [CI], 1.3-2.4). Independent of age and Tanner stage of pubic hair development, importance of thinness to peers (OR = 2.3; 95% CT, 1.8-3 .0) and trying to look like females on television, in movies, or in magazin es (OR = 1.9; 95% CI, 1.6-2.3) were predictive of beginning to purge at lea st monthly. Regardless of the covariates included in the logistic regressio n model, the risk of beginning to purge increased approximately 30% to 40% per 1-category increase in frequency of trying to look like females on tele vision, in movies, or in magazines. Conclusions: Both peers and popular culture, independent of each other, exe rt influence on girls' weight control beliefs and behaviors. Therefore, to make eating disorder prevention programs more effective, efforts should be made to persuade the television, movie, and magazine industries to employ m ore models and actresses whose weight could be described as healthy, not un derweight.