Relationships Between Maternal Factors and Weight Loss Attempts Among Urban Male and Female Adolescents Living in Soweto, Johannesburg, South Africa.

Abstract

South Africa is undergoing rapid urban transition favoring ideals of thinness, which increases eating disorders risk for female adolescents, whereas older women continue to uphold corpulence as a female cultural value. This study aimed to assess the potential conflicting relationship between urban male and female adolescents' weight loss attempts (WLA) and maternal body image norms within households. The study included a longitudinal sample of mother-daughter and mother-son pairs from the Birth to Twenty Plus Cohort (N= 1,613), using data collected at 13, 17, and 22years. Sociodemographic characteristics, eating attitudes, WLA, and body mass index were assessed in mothers and their offspring. Relationships between maternal factors and offspring's WLA were assessed using both logistic regression and structural equation modeling. More females had WLA compared with their male counterparts at 13, 17, and 22years. Multivariable models showed an independent positive association between maternal household socioeconomic status and boys' WLA at 13years, whereas independent negative associations were found between mothers' body mass index and boys' WLA at 17 and 22years. Mothers' age and sons' WLA at 22years showed an independent positive association. No association was found between maternal factors and daughters' WLA. Strong gender-differentiated intergenerational patterns were observed between maternal factors and offspring's WLA from early adolescence to early adulthood. The lack of relationship between maternal factors and daughters' behavior in contrast to that of sons suggests that Western acculturation may pose a greater risk for females to modern body image disturbances and eating disorders.