Abstract
BackgroundWeight control behaviors are common among young people and are associated with poor health outcomes. Yet clinicians rarely ask young people about their weight control; this may be due to uncertainty about which questions to ask, specifically around whether certain weight loss strategies are healthier or unhealthy or about what weight loss behaviors are more likely to lead to adverse outcomes. Thus, the aims of the current study are: to confirm, using item response theory analysis, that the underlying latent constructs of healthy and unhealthy weight control exist; to determine the ‘red flag’ weight loss behaviors that may discriminate unhealthy from healthy weight loss; to determine the relationships between healthy and unhealthy weight loss and mental health; and to examine how weight control may vary among demographic groups.MethodsData were collected as part of a national health and wellbeing survey of secondary school students in New Zealand (n = 9,107) in 2007. Item response theory analyses were conducted to determine the underlying constructs of weight control behaviors and the behaviors that discriminate unhealthy from healthy weight control.ResultsThe current study confirms that there are two underlying constructs of weight loss behaviors which can be described as healthy and unhealthy weight control. Unhealthy weight control was positively correlated with depressive mood. Fasting and skipping meals for weight loss had the lowest item thresholds on the unhealthy weight control continuum, indicating that they act as ‘red flags’ and warrant further discussion in routine clinical assessments.ConclusionsRoutine assessments of weight control strategies by clinicians are warranted, particularly for screening for meal skipping and fasting for weight loss as these behaviors appear to ‘flag’ behaviors that are associated with poor mental wellbeing.
Highlights
Weight control behaviors are common among young people and are associated with poor health outcomes
Unhealthy weight control behaviors are common, especially among overweight young people, and there is abundant evidence that unhealthy weight loss behaviors lead to poor outcomes for adolescents
The specific objectives of the current study are: 1. to determine which weight loss behaviors are on the unhealthy and healthy continuums of weight control, 2. to identify weight loss behaviors that are ‘severe’ and may require urgent attention and behaviors that are less difficult, but are the ‘red flags’ signifying unhealthy weight loss strategies, 3. to explore the association of unhealthy and healthy weight control with symptoms of depression and wellbeing among students, and 4. to examine how weight control may vary among demographic groups and which demographic groups are engaging with healthy and unhealthy weight control behaviors
Summary
Weight control behaviors are common among young people and are associated with poor health outcomes. In a nationally representative sample of adolescents in New Zealand, approximately two-thirds of females and one-third of males had attempted weight loss in the previous year with concerning proportions of unhealthy weight control behaviors are common, especially among overweight young people, and there is abundant evidence that unhealthy weight loss behaviors lead to poor outcomes for adolescents. Adolescents who used diet pills, vomited, took laxatives, took diuretics, fasted, used food substitutes, skipped meals or smoked cigarettes for weight loss had high levels of depression and were more likely to develop suicidal behaviors into young adulthood [3]. Adolescents who diet (change how they eat in order to lose weight) are more likely to develop binge eating behaviors and gain more weight [7] over time, compared to those who do not
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