Abstract
BackgroundThe aims of the study were to: a) Examine the distribution of gender-stratified body mass index (BMI), eating attitudes and use of addictive substances, under the hypothesis of a confluent prevalence of weight abnormalities, eating disorders and substance abuse. b) Demonstrate the extent to which family, peer-related and psychosocial factors are common elements in categories of compulsive behaviour.Methodology/Principal FindingsIn the present cross-sectional study, data were collected through self reported questionnaires administered to a large sample of 33,185 15–19 years old adolescents (ESPAD®Italia), divided into weight categories based on the BMI percentile distribution. Multinomial analyses were adopted to address the influence of social, family, leisure time factors, Eating Attitude Test (EAT26) on the association between weight categories and drug use.Recent drugs use was more frequent in overweight and underweight adolescents (p<0.05), especially in females. An EAT26 score ≥20 was more common in overweight adolescents. Multinomial analysis abolished the relationship between overweight and the use of most drugs, implicating self-esteem, parents' educational level, and friendships as mediators of the association. Within the overweight category, adolescents reporting recent drug use, showed greater frequency of having drug-abusing friends (∼80%), and severe problems with parents and school (∼30%) compared to overweight adolescents without recent drug use.ConclusionThe frequent association of overweight and substance use and the presence of common underlying social factors, highlights the need for an interdisciplinary approach involving individual-focused treatment models as well as public health, social and environmental changes to reduce food- and substances-related problems.
Highlights
Obesity is a major public health problem, and its prevalence is growing at an alarming rate, especially in children and adolescents
Overeating in obese individuals shares similarities with loss of control and compulsive drug-taking behaviour observed in drugaddicted subjects, and people suffering from an eating disorder may exhibit other addictive behaviours, including alcoholism and drug use
Though studies using functional or metabolic brain imaging may suggest innate alterations in neural circuits controlling reward seeking in subjects with drug addiction, eating disorders and obesity [3], it is important to keep in mind that eating attitudes and self-image perception are greatly dependent on cultural background and social pressure
Summary
Obesity is a major public health problem, and its prevalence is growing at an alarming rate, especially in children and adolescents. Though studies using functional or metabolic brain imaging may suggest innate alterations in neural circuits controlling reward seeking in subjects with drug addiction, eating disorders and obesity [3], it is important to keep in mind that eating attitudes and self-image perception are greatly dependent on cultural background and social pressure. Both eating disorders and drug addiction may indicate low self-esteem, at least partialy modulated by the subject’s interaction with peers and parents. The aims of the study were to: a) Examine the distribution of gender-stratified body mass index (BMI), eating attitudes and use of addictive substances, under the hypothesis of a confluent prevalence of weight abnormalities, eating disorders and substance abuse. b) Demonstrate the extent to which family, peer-related and psychosocial factors are common elements in categories of compulsive behaviour
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