Unhealthy life habits associated with self-induced vomiting and laxative misuse in Brazilian adolescents

Ana Luiza Gomes De Souza,Matias Noll,Priscilla Rayanne E Silva Noll,Alexandre Aparecido De Almeida

doi:10.1038/s41598-021-81942-w

Abstract

Adolescence is a stage in life characterized by important social, cognitive, and physical changes. Adolescents are vulnerable to various psychosocial disorders, including eating disorders. We aimed to investigate the association between unhealthy habits, sociodemographic characteristics, and the practice of self-induced vomiting or laxative misuse in a representative sample of Brazilian adolescent girls and boys. Data from 102,072 students who participated in the National Adolescent School-based Health Survey were analyzed using the dependent variable: presence or absence of self-induced vomiting and/or laxative misuse; independent variables: consumption of unhealthy and high-calorie food items, age during first sexual intercourse, and the use of tobacco, alcohol, and/or illicit drugs. Associations between exposure and outcome were estimated using Poisson’s regression models stratified by sex, and including region, school, age group, and mother's educational history as adjustment variables. Eating ultra-processed foods and age during first sexual intercourse were associated with self-induced vomiting and laxative misuse only for girls; all other variables (consuming unhealthy foods and using legal or illicit substances) were associated with these behaviors for both sexes after applying adjustment variables. Early interventions focusing on changing unhealthy behaviors may prevent development of eating disorders in adolescents. Our findings demonstrate a strong association of many unhealthy habits with laxative misuse and self-induced vomiting practices in Brazilian adolescents.

Highlights

Adolescence is a stage in life characterized by important social, cognitive, and physical changes
As unhealthy life habits evolving from the promotion and sustained abuse of inappropriate compensatory methods for weight loss in adolescents are not completely understood, the present study aimed to investigate the association between sociodemographic characteristics and unhealthy life habits with the practices of self-induced vomiting or laxative misuse in a representative sample of Brazilian adolescents
Consumption of ultra-processed salty food in the last seven days and age during first sexual intercourse were associated with selfinduced vomiting and laxative misuse only for girls (Table 2)

Summary

Introduction

Adolescence is a stage in life characterized by important social, cognitive, and physical changes. Adolescents undergo considerable corporal changes such as increasing body mass and stature, body hair growth, voice thickening, and the emerging of secondary sexual c haracteristics[2,3] In addition to these physical changes, they are developing psychologically, making them vulnerable to various psychosocial disorders, including eating disorders (EDs). North American adolescents report high prevalence of body shape dissatisfaction; it is postulated that about 58.8% of girls and 37.4% of boys make use of unhealthy methods to control weight, including fasting, diet pills, self-induced vomiting, dietary restraint, food substitutes (special drinks or powder), skipping meals, smoking more cigarettes, and other purging practices such as laxatives and d iuretics[21]. As these methods have important negative implications for h ealth[30,31], identifying factors that lead individuals to use them and providing conditions for people to avoid these practices are important aspects of preventive medicine strategies

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