Diet Pill Use Research Articles

Predicting bulimic symptoms: An interactive model of self-efficacy, perfectionism, and perceived weight status

An interactive model of perfectionism, perceived weight status, and self-efficacy was tested on 406 women to predict the bulimic symptoms of binge eating and inappropriate compensatory behaviors separately. This longitudinal study assessed hypothesized vulnerabilities of high perfectionism and low self-efficacy and the stressor of feeling overweight at Time 1 and then gathered weekly assessments of binge eating, vomiting, laxative use, fasting, and diet pill use for 11 weeks. As predicted, results showed that perfectionism, weight perception, and self-efficacy interacted to prospectively predict binge eating. In particular, women high in perfectionism who felt they were overweight and who had low self-efficacy reported the most number of weeks of binge eating. This interactive model did not predict inappropriate compensatory behaviors. Future directions and clinical implications are discussed.

The Impact of a School-Based Obesity Prevention Trial on Disordered Weight-Control Behaviors in Early Adolescent Girls

To assess the impact of an obesity prevention intervention on use of self-induced vomiting/laxatives (purging) and diet pills to control weight in girls in early adolescence. We matched and randomly assigned 10 middle schools to an intervention or a control condition in a randomized controlled trial. Longitudinal multivariable analyses using generalized estimating equations were conducted with data from 480 girls to examine the effects of the intervention on the risk of reporting a new case of purging or diet pill use to control weight at follow-up 21 months later, while controlling for ethnicity and school matched pairs. Girls who reported purging or using diet pills at baseline were excluded from analyses. Middle schools. Four hundred eighty girls in early adolescence aged 10 to 14 years (mean age, 11.5 years). The Planet Health obesity prevention program was implemented during 2 school years and was designed to promote healthful nutrition and physical activity and to reduce television viewing. Reduced risk of using self-induced vomiting/laxatives or diet pills to control weight in the past 30 days. After the intervention, we found 14 (6.2%) of 226 girls in control schools and 7 (2.8%) of 254 girls in intervention schools reported purging or using diet pills to control their weight (P = .003). In a multivariable generalized estimating equation model, girls in intervention schools were less than half as likely to report purging or using diet pills at follow-up compared with girls in control schools (odds ratio, 0.41; 95% confidence interval, 0.22-0.75). These findings provide promising evidence that school-based interventions may effectively integrate prevention of both obesity and disordered weight-control behaviors.

Weight and dieting behavior of college students in Cyprus

The purpose of this study was to provide the first report of weight and dieting behaviour of college students in Cyprus. A cross‐sectional survey was administered to a convenience sample of 451 students studying at the largest private college in Cyprus. The survey was used to determine the prevalence of inappropriate dieting practices that included use of diet pills, fasting, induced vomiting and laxative use to get rid of food eaten. Body mass index and accuracy of self‐perceived weight were also determined. A high rate of underweight among females and a low rate of obesity for all students were found. Students reported unhealthy dieting behaviours including use of diet pills, fasting, induced vomiting and laxative use. The results show that there are serious weight issues for students in Cyprus and indicate that disordered dieting behaviours exist in the Mediterranean.

Preventing Substance Use and Disordered Eating

To implement and to assess the efficacy of a school-based, sport team-centered program to prevent young female high school athletes' disordered eating and body-shaping drug use. Prospective controlled trial in 18 high schools, with balanced random assignment by school to the intervention and usual-care control conditions. We enrolled 928 students from 40 participating sport teams. Mean age was 15.4 years, 92.2% were white, and follow-up retention was 72%. The ATHENA (Athletes Targeting Healthy Exercise and Nutrition Alternative) curriculum's 8 weekly 45-minute sessions were incorporated into a team's usual practice activities. Content was gender-specific, peer-led, and explicitly scripted. Topics included healthy sport nutrition, effective exercise training, drug use and other unhealthy behaviors' effects on sport performance, media images of females, and depression prevention. We assessed participants by confidential questionnaire prior to and following their sport season. We determined program effects using an analysis of covariance-based approach within the Generalized Estimating Equation framework. Experimental athletes reported significantly less ongoing and new use of diet pills and less new use of athletic-enhancing substances (amphetamines, anabolic steroids, and sport supplements) (P<.05 for each). Other health-harming actions also were reduced (less riding with an alcohol-consuming driver [P = .05], more seat belt use [P<.05], and less new sexual activity [P<.05]). The ATHENA athletes had coincident positive changes in strength-training self-efficacy (P<.005) and healthy eating behaviors (P<.001). Reductions occurred in intentions toward future use of diet pills (P<.05), vomiting to lose weight (P<.05), and use of tobacco (P<.05) and muscle-building supplements (P<.005). The program's curriculum components were altered appropriately (controlling mood [P<.005], refusal skills [P = .05], belief in the media [P<.005], and perceptions of closest friends' body-shaping drug use [P<.001]). Sport teams are effective natural vehicles for gender-specific, peer-led curricula to promote healthy lifestyles and to deter disordered eating, athletic-enhancing substance use, and other health-harming behaviors.

Headliners: Chemical Exposures and Childhood Leukemia: Parental Chemical Exposures and ras Mutations in Children

A variety of carcinogens have been shown to induce ras mutations in animal and human tumor models, and ras proto-oncogene mutations have been implicated in the development of many malignancies including pancreatic and breast cancers. However, few data exist associating parental exposures and ras mutations in their children. Now a team including NIEHS grantee Leslie L. Robison of the University of Minnesota report that parents’ chemical exposures may be associated with distinct ras mutations in their children with acute lymphoblastic leukemia (ALL). This study used data from a large case–control study of childhood ALL conducted by the Children’s Oncology Group in Southern California. DNA samples from the study children were examined for ras mutations. A total of 127 out of 837 ALL cases exhibited ras mutations in the K- or N-ras genes. Earlier studies have reported a 5–20% frequency of ras mutations among patients with ALL. A number of parental chemical exposures were associated with significantly increased risks for ras mutation in the children. Use of drugs such as marijuana, LSD, and cocaine was associated with increased risk of N-ras mutation (three-fold higher risk for maternal use and two-fold higher risk for paternal use). Paternal use of amphetamines or diet pills was associated with a four-fold increase in N-ras mutation. Maternal exposure to solvents and plastics during pregnancy raised the risk of K-ras mutation about three-fold and seven-fold, respectively, and maternal exposure to plastics after pregnancy was associated with an eight-fold higher risk. Maternal and paternal exposure to oil and coal products and other hydrocarbons before and during pregnancy was associated with about a two-fold greater risk of N-ras mutation. In previous studies, parental occupational exposure to hydrocarbons (such as chlorinated solvents, benzene, and paints) has been linked to elevated childhood leukemia risk. The present study has extended these findings to include drugs of abuse and additional chemical exposures, and to link them to ras mutations. The authors conclude that parental exposures to hydrocarbons and mind-altering drugs, chemicals that have been previously suggested to increase the risk of childhood leukemia, are related to specific ras mutations in childhood ALL.

Parental Exposure to Medications and Hydrocarbons and ras Mutations in Children with Acute Lymphoblastic Leukemia: A Report from the Children's Oncology Group

Abstract Ras proto-oncogene mutations have been implicated in the pathogenesis of many malignancies, including leukemia. While both human and animal studies have linked several chemical carcinogens to specific ras mutations, little data exist regarding the association of ras mutations with parental exposures and risk of childhood leukemia. Using data from a large case-control study of childhood acute lymphoblastic leukemia (ALL; age &amp;lt;15 years) conducted by the Children's Cancer Group, we used a case-case comparison approach to examine whether reported parental exposure to hydrocarbons at work or use of specific medications are related to ras gene mutations in the leukemia cells of children with ALL. DNA was extracted from archived bone marrow slides or cryopreserved marrow samples for 837 ALL cases. We examined mutations in K-ras and N-ras genes at codons 12, 13, and 61 by PCR and allele-specific oligonucleotide hybridization and confirmed them by DNA sequencing. We interviewed mothers and, if available, fathers by telephone to collect exposure information. Odds ratios (ORs) and 95% confidence intervals (CIs) were derived from logistic regression to examine the association of parental exposures with ras mutations. A total of 127 (15.2%) cases had ras mutations (K-ras 4.7% and N-ras 10.68%). Both maternal (OR 3.2, 95% CI 1.7-6.1) and paternal (OR 2.0, 95% CI 1.1-3.7) reported use of mind-altering drugs were associated with N-ras mutations. Paternal use of amphetamines or diet pills was associated with N-ras mutations (OR 4.1, 95% CI 1.1-15.0); no association was observed with maternal use. Maternal exposure to solvents (OR 3.1, 95% CI 1.0-9.7) and plastic materials (OR 6.9, 95% CI 1.2-39.7) during pregnancy and plastic materials after pregnancy (OR 8.3, 95% CI 1.4-48.8) were related to K-ras mutation. Maternal ever exposure to oil and coal products before case diagnosis (OR 2.3, 95% CI 1.1-4.8) and during the postnatal period (OR 2.2, 95% CI 1.0-5.5) and paternal exposure to plastic materials before index pregnancy (OR 2.4, 95% CI 1.1-5.1) and other hydrocarbons during the postnatal period (OR 1.8, 95% CI 1.0-1.3) were associated with N-ras mutations. This study suggests that parental exposure to specific chemicals may be associated with distinct ras mutations in children who develop ALL.

Prevalence of abnormal eating behaviours and inappropriate methods of weight control in young women from Brazil: a population-based study.

The aim of this epidemiological investigation was to study the prevalence of abnormal eating behaviours in a community sample of young women from Porto Alegre, RS, Brazil. The research team visited 1524 randomly selected households in Porto Alegre and invited all of the women aged 12-29 years to participate in the study: 513 women subsequently completed a socio-economic and demographic questionnaire, the Bulimic Investigatory Test (BITE) and the Eating Attitudes Test (EAT-26). Clinically significant disturbed eating behaviour was revealed in the 16.5% of women who had EAT scores above the cut-off point of 21; 2.9% also had BITE symptom scores of > or = 20. The participants were categorised into three groups on the basis of a new variable combining both instruments: those with abnormal eating behaviours (10.9%), those with unusual eating patterns (23.8%), and those with normal eating behaviours (60.2%). Abnormal eating behaviours were significantly more prevalent in the 16-19 year age range (p = 0.007) and were also more prevalent among overweight/obese women (p = 0.009). Laxative use was reported by 8.5% of the women, followed by fasting (3.1%), use of diuretics (2.8%) and vomiting (1.4%). Abnormal eating behaviours are fairly common among young women in Brazil. In comparison with other population studies, this survey showed a similar use of laxatives, less self-induced vomiting and a greater use of diet pills (probably because they are less strictly controlled in Brazil). Educational programmes aimed at preventing abnormal eating behaviours and developing healthy weight control practices among children and young adolescents should become public health priorities.

Parental medication use and risk of childhood acute lymphoblastic leukemia.

Few studies have examined the risk of childhood acute lymphoblastic leukemia (ALL) associated with parental medication use. As part of a large case-control study conducted by the Children's Cancer Group, we evaluated the association between maternal and paternal medication use and the risk of ALL in offspring. Information on selected medication use in the year before and during the index pregnancy was obtained by telephone interview. Participants included 1842 children of 14 years or younger with newly diagnosed and immunophenotypically defined ALL and 1986 individually matched controls. Data were analyzed using logistic regression models and stratified by immunophenotypes of ALL and age at diagnosis of cases. After adjusting for potential confounders and other medication use, we found that maternal use of vitamins (odds ratio [OR] = 0.7, 99% confidence interval [CI]: 0.5-1.0) and iron supplements (OR = 0.8, 99% CI: 0.7-1.0) only during the index pregnancy was associated with a decreased risk of ALL. Parental use of amphetamines or diet pills and mind-altering drugs before and during the index pregnancy was related to an increased risk of childhood ALL, particularly among children where both parents reported using these drugs (OR = 2.8, 99% CI: 0.5-15.6 for amphetamines or diet pills, OR = 1.8, 99% CI: 1.1-3.0 for mind-altering drugs). Stratified analyses showed that maternal use of antihistamines or allergic remedies and parental use of mind-altering drugs were strongly associated with infant ALL, whereas patterns of association between childhood ALL and parental medication use did not influence markedly the immunophenotypic subgroup of ALL. The findings of this study suggest that certain parental medication use immediately before and during the index pregnancy may influence risk of ALL in offspring.

Cigarette Smoking in the Adolescent Dance Population

Cigarette smoking continues to be a major international health problem that affects adolescents. Most adult smokers report their first contact with smoking occurring before the age of 18 years. Research has established figures of initiation rates to be as low as 5% and as high as 31%, with the male samples consistently smoking at a slightly higher rate than the female samples. This was a prospective study using a questionnaire to sample 397 preprofessional dance students. Participants averaged 16 years of age, and 90% were female. Nearly one third of the dancers who responded identified that they were occasional or regular smokers. Dancers who smoked even occasionally had a higher injury rate and lower overall health. They displayed a higher rate of comorbid behaviors associated with eating disorders, such as laxative use, diet pill use, and vomiting. Their rates of alcohol and illegal drug use were statistically higher than those of their non-smoking cohorts. Finally, nearly two thirds of the smokers reported that they trained with a teacher who was also a smoker. This study suggests that smoking has adverse effects on dancers, including increased injury rate, increased comorbid behaviors, and other health issues. In the world of dance, the teacher, choreographer, or director acts as a role model to students and, as such, has a particularly sensitive position in the choices the adolescent dancer makes. Effective prevention must go beyond informing dancers of health risks and must include the experience of a healthy role model.

Use of nonprescription weight loss products: results from a multistate survey.

Lifestyle changes to lose weight can be difficult; hence, both prescription and nonprescription diet products are appealing. Usage patterns of the nonprescription products phenylpropanolamine (PPA) and ephedra are of particular interest because of recent safety concerns. To estimate the prevalence of overall and specific nonprescription weight loss product use by demographic characteristics, prescription diet pill use, diabetic status, and lifestyle choices. The Behavioral Risk Factor Surveillance System, a random-digit telephone survey conducted in 1998 in 5 states: Florida, Iowa, Michigan, West Virginia, and Wisconsin. Population-based sample of 14 679 noninstitutionalized adults 18 years or older. Prevalence of nonprescription weight loss product use in 1996-1998. Seven percent reported overall nonprescription weight loss product use, 2% reported PPA use, and 1% reported ephedra product use. Overall use was especially common among young obese women (28.4%). Moreover, 7.9% of normal-weight women reported use. There was no difference in nonprescription weight loss product use by daily consumption of fruits and vegetables; however, more users than nonusers reported being physically active (for those who exercised >/=30 minutes 5 times per week, odds ratio, 1.5; 95% confidence interval, 1.2-2.0). Among prescription weight loss product users, 33.8% also took nonprescription product. With increasing rates of obesity, nonprescription product use is likely to increase. Clinicians should know about their patients' use of both prescription and nonprescription weight loss products.

"Diet pills" and major depression in the Canadian population.

To evaluate epidemiological associations between self-reported diet pill consumption and major depressive episodes (MDEs), using data from a large-scale, cross-sectional survey of the Canadian population. Data from the National Population Health Survey (NPHS) were used in this analysis. The NPHS interview included a brief version of the Composite International Diagnostic Interview (CIDI) depression section, known as the CIDI Short Form for Major Depression (CIDI-SFMD), as well as provision for self-reported medication use. Approximately 0.5% of the population reported the use of diet pills. Diet pill use was more common among women than among men. At the time of data collection (1996-1997), the most commonly used medication was fenfluramine (since withdrawn from the market because of cardiovascular toxicity). The use of these medications was strongly associated with MDE: the annual prevalence among persons reporting use was 17.1% (95% CI, 8.6 to 25.6), approximately 4 times the underlying population rate. Because the NPHS was a general health survey, and because self-reported exposure to these medications was relatively uncommon, the data did not permit a detailed multivariate analysis. These findings, however, indicate that depressive psychopathology is strongly associated with the use of appetite-suppressant medications.

Prevalence and Contributing Factors of Eating Disorder Behaviors in Active Duty Service Women in the Army, Navy, Air Force, and Marines

Eating disorders continue to be studied among civilian women. Gross disturbances in eating behaviors characterize the condition of anorexia nervosa (AN), currently seen among 1 to 2% of non-active duty women. Bulimia nervosa (BN) is prevalent among 2% of the female population, and both disorders have a female-to-male ratios of 10:1. Another category of eating disorders known as not otherwise specified (NOS) occurs in 3 to 35% of individuals in the reported literature. This study examined the prevalence of AN, BN, and NOS among a large sample of active duty women currently serving in the Army, Navy, Air Force, and Marines. Multiple military, professional, and behavioral variables were analyzed to provide an increased understanding and awareness of these disorders among all active duty service women. This descriptive, correlational study of 3,613 service women targeted females from the total population of three major medical centers (Army, Navy, and Air Force) and the total population of Marine women serving in Okinawa, Japan, at the time of the study. Anonymous survey return was obtained at 34% (N = 1,278). The study revealed an overall prevalence of 1.1% for AN, 8.1% for BN, and 62.8% for NOS among all service women. However, AN, BN, and NOS were found at significantly higher rates (p = 0.000) among women in the Marines, who reported AN at 4.9%, BN at 15.9%, and NOS at 76.7%. Use of laxatives, diuretics, diet pills, vomiting, and fasting for standards increased during the body measurement and fitness periods for all services, but year-round use of many of these behaviors occurred at significantly higher rates among Marines (p = 0.000). Multiple logistic regression analysis predicted several factors associated with the manifestation of eating disorders in this population of active duty women.

Smoking and weight control in adolescent females

This paper examines the association between smoking and various weight control techniques among adolescent girls in two school-based samples. Previous studies have relied heavily on clinical trials of adults and have focused mainly on dietary restraint rather than purging behavior. This study seeks to determine whether purging is associated with smoking and if purging and dietary restraint effects upon smoking are additive or synergistic. Data from adolescent girls were gathered from two school-based surveys conducted in the upper Midwest. Assessments were conducted for smoking, dietary restraint, diet pill use, and purging. Logistic regression was used to test for main and interaction effects. Analysis revealed significant associations between smoking and weight control. Purging was more highly associated with smoking than dietary restraint or diet pill use. The form of these associations was interactive rather than additive in both data sets. Nonpurging girls were significantly more likely to smoke if they were dieting or using diet pills than if they were not practicing dieting behavior. Thus, the effect of dieting and diet pill use on smoking is dependent on purging behavior. Weight control is associated with smoking behavior in adolescent girls but the form of these associations may be more complex than originally thought. Future research is needed to determine if there are two subtypes of smoking–weight control girls.

Clueless: parental knowledge of risk behaviors of middle school students.

To determine parental knowledge of risk behaviors of their middle-school-aged children and to compare that knowledge with behaviors reported by the students. Confidential surveys were administered to 194 poor and middle-class middle school students and their parents. None. Compare parental awareness and student admission of risk behaviors. Students and parents agree on the prevalence of some risk behaviors, including use of a seat belt, use of a bicycle helmet, arrest by police, use of diet pills, and attempts to lose weight through dieting and exercise. Small differences in perception, which were not statistically significant but which could be defined as trends, were found relating to the prevalence of dieting, exercising, or vomiting to lose weight. Statistically significant differences were found in the perceptions of the prevalence of the following risk behaviors: carrying a weapon to school (P<.001), LSD (lysergic acid diethylamide) or cocaine use (P=.02), suicide attempt (P<.001), sexual intercourse (P<.001), alcohol use (P<.001), tobacco use (P<.001), and marijuana use (P<.001). In many cases, parents dramatically underestimated the prevalence of these behaviors in students. Parents are largely ignorant of the extent to which their adolescents are involved in major risk behaviors. Educating parents in this area encourages them to support comprehensive health education curricula and other preventive programs in schools and communities.

The Use of a Clinical Practice Guideline to Manage and Verify the Weight Loss Outcomes of Patients Treated With Fen‐Phen in Primary Care Settings

Fenfluramine and phenteramine (“fen‐phen”) enjoyed immense popularity as a weight loss drug combination until September 151, 1997, when fenfluramine was withdrawn from the market because of evidence that it might cause valvular heart disease. In response to the emergence in 1996 of physician disagreement about the appropriate use of diet pills in weight loss treatment plans, MeritCare Health System developed a practice guideline to assist clinicians in the appropriate use of anoretic drugs. The purpose of this report was to answer two questions about MeritCare's experience with fen‐phen. First, how was MeritCare able to use a practice guideline to mediate conflict among physicians and to rapidly implement practice changes as imformation about the deleterious effects of fen‐phen because available? Second, how effective was fenphen as a weight loss agent when prescribed by doctors who practiced in primary care settings? A retrospective review of the charts of 401 patients treated with fen‐phen by primary care physicians practicing in four of MeritCare's Fargo clinics was conducted and MeritCare's experience with fenphen was reviewed. The data show that patients treated with fen‐phen experienced, on average, a rapid decline in body mass index (BMI) over the first 4 months of treatment, after which the rate of decline slowed and then reached a plateau. There appeared to be little, if any, further mean weight loss after 6 months. Patients did not, as a rule, achieve target BMIs (defined as 26 to 27) even when treatment was continued for up to 19 months. In fact, after 6 months of treatment with fen‐phen, expected decreases in BMI began to be supplanted by increases in BMI, even thought patients remained on fen‐phen. The data also reveal wide variations in the weight loss responses of patients treated with fen‐phen. Practice guidelines are useful tools in mediating physician disagreement about “best practice” and in rapidly deploying practice changes as new information about “best practice” becomes available. Beneficial weight loss responses to fen‐phen prescribed by primary care physicians in standard primary care settings were highly variable and fell short of target weights.

Problem dieting behaviors among young adolescents.

To examine dieting, eating and exercise behaviors, use of diet pills, and vomiting or use of laxatives to lose weight among younger adolescents. Analysis of data from a modified version of the Youth Risk Behavior Survey administered to middle school students in North Carolina in 1995. Fifty-three randomly selected middle schools in North Carolina. Two thousand three hundred thirty-one students in the sixth, seventh, and eighth grades. None. Responses to questions regarding weight control practices, including vomiting or laxative use, dieting, exercise, or diet pill use. Of the students surveyed, 110 (9.7%) of the girls and 46 (4.0%) of the boys reported vomiting or using laxatives to lose weight. Among the girls, vomiting or laxative use was associated with feeling overweight, other weight loss practices, older age, being a poor student, smoking, eating more salads or vegetables, and eating more candy or other sweets (P< or =.01). A logistic regression model consisting of diet pill use, dieting to lose weight, lower academic achievement, and currently trying to lose weight correctly classified 92% of female students who had or had not vomited or used laxatives. Among boys, vomiting or laxative use was associated with feeling overweight, other weight loss practices, minority racial status, smoking, frequency of eating hamburgers or other high-fat meats, and frequency of eating french fries or potato chips (P< or =.01). A model consisting of diet pill use, minority race, dieting to lose weight, smoking, feeling overweight, and number of servings of hamburgers, hot dogs, or barbecue correctly classified 97% of the boys who had or had not vomited or used laxatives. Younger adolescents trying to lose weight engage in a variety of problem dieting and weight loss behaviors that can compromise health and may be associated with eating disorders.

A Survey of Eating and Weight-Related Behaviors in a Medical University Student Population

The purpose of this study was to assess using a survey questionnaire the lifetime prevalence of several eating- and weight-related behaviors in medical, dental, and nursing students. The sample included 109 students: 59% were female, 67% were single, 84% were Caucasian, and average age was 26.5 years. The results indicated that the prevalence rates of food restriction, exercise, self-induced vomiting, laxative use, and diuretics use was similar to rates reported on more traditional university campuses. The chi-square statistic revealed significant gender differences, with more females than males having engaged in food restriction (75% vs. 40%), vomiting (22% vs. 2%), laxative use (17% vs. 2%), laxative use (17% vs. 2%), and diet pill use (36% vs. 0%). These results indicate that students in health fields (and particularly female students) are not immune to disordered eating- and weight-related behaviors.

Hypertension, obesity and their medications in relation to renal cell carcinoma.

A population-based, case-control study was conducted in Los Angeles County, California, to investigate the inter-relationships of obesity, hypertension and medications in relation to renal cell carcinoma (RCC) risk. A total of 1204 RCC patients and an equal number of neighbourhood controls were included. Obesity was a strong risk factor for RCC. A fourfold increase in risk was observed for those with usual body mass index (kg m(-2)) of > or = 30 vs < 22. A history of hypertension was another strong, independent risk factor for RCC [odds ratio (OR) = 2.2; 95% confidence interval (CI) = 1.8, 2.6]. There was little evidence that use of diuretics was directly related to RCC development. Use of diuretics for reasons other than hypertension (primarily for weight control) was unrelated to risk among self-reported normotensive subjects (OR = 1.2; 95% CI = 0.7, 2.2). Among hypertensive subjects, heavy users of diuretics experienced similar risk as light users (OR = 0.9 among subjects with lifetime dose of > or = 137 g compared with those with lifetime dose of < 43 g). Similarly, normotensive subjects who took non-diuretic antihypertensives regularly showed no increased risk for RCC (OR = 1.1; 95% CI = 0.6-1.8), and intake among hypertensive subjects did not further increase their risk. Regular use of amphetamine-containing diet pills was associated with a twofold increase in RCC risk (95% CI = 1.4-2.8) and the risk increased with increasing dose of amphetamines. However, the fraction of cases possibly related to this exposure is small (population-attributable risk = 5%).

Expectancies, Self-Esteem, Knowledge, and Adolescent Weight Reduction Behavior

The aims of the current study were to assess the factor structure of weight loss expectancy and to explain weight reduction behavior among teenagers. An anonymous questionnaire was administered to a sample of 599 adolescents. Principal components analysis identified four weight loss expectancy factors, which were labeled social confidence, adult approval, self-worth, and negative consequences. Results from regression analyses indicated that dieting frequency, diet pill use, and purging were best explained by different subsets of predictors. Overall, self-esteem, gender, and specific expectancy and knowledge variables accounted for most of the variance in measures of dieting frequency, diet pill use, and purging. The findings suggest that weight management education for teenagers should emphasize self-esteem enhancement. However, curriculum planning must also address the anticipated psychosocial rewards of weight loss and attend to gender-specific concerns.

Problem dieting behaviors among young adolescents

Objective To examine dieting, eating and exercise behaviors, use of diet pills, and vomiting or use of laxatives to lose weight among younger adolescents. Design Analysis of data from a modified version of the Youth Risk Behavior Survey administered to middle school students in North Carolina in 1995. Setting Fifty-three randomly selected middle schools in North Carolina. Subjects Two thousand three hundred thirty-one students in the sixth, seventh, and eighth grades. Interventions None. Main Outcome Measures Responses to questions regarding weight control practices, including vomiting or laxative use, dieting, exercise, or diet pill use. Results Of the students surveyed, 110 (9.7%) of the girls and 46 (4.0%) of the boys reported vomiting or using laxatives to lose weight. Among the girls, vomiting or laxative use was associated with feeling overweight, other weight loss practices, older age, being a poor student, smoking, eating more salads or vegetables, and eating more candy or other sweets ( P ≤.01). A logistic regression model consisting of diet pill use, dieting to lose weight, lower academic achievement, and currently trying to lose weight correctly classified 92% of female students who had or had not vomited or used laxatives. Among boys, vomiting or laxative use was associated with feeling overweight, other weight loss practices, minority racial status, smoking, frequency of eating hamburgers or other high-fat meats, and frequency of eating french fries or potato chips ( P ≤.01). A model consisting of diet pill use, minority race, dieting to lose weight, smoking, feeling overweight, and number of servings of hamburgers, hot dogs, or barbecue correctly classified 97% of the boys who had or had not vomited or used laxatives. Conclusion Younger adolescents trying to lose weight engage in a variety of problem dieting and weight loss behaviors that can compromise health and may be associated with eating disorders.