American Journal of Preventive Medicine
Volume 33, Issue 5 , Pages 359-369.e3, November 2007

Shared Risk and Protective Factors for Overweight and Disordered Eating in Adolescents

  • Dianne R. Neumark-Sztainer, PhD, MPH, RD

      Affiliations

    • Division of Epidemiology and Community Health, School of Public Health, Minneapolis, Minnesota
    • Corresponding Author InformationAddress correspondence and reprint requests to: Dianne Neumark-Sztainer, PhD, MPH, RD, Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 South Second Street, Suite 300, Minneapolis MN 55454.
  • ,
  • Melanie M. Wall, PhD

      Affiliations

    • Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota
  • ,
  • Jess I. Haines, PhD, MHSc, RD

      Affiliations

    • Division of Epidemiology and Community Health, School of Public Health, Minneapolis, Minnesota
    • Department of Ambulatory Care and Prevention, Harvard Medical School, Boston, Massachusetts
  • ,
  • Mary T. Story, PhD, RD

      Affiliations

    • Division of Epidemiology and Community Health, School of Public Health, Minneapolis, Minnesota
  • ,
  • Nancy E. Sherwood, PhD

      Affiliations

    • Division of Epidemiology and Community Health, School of Public Health, Minneapolis, Minnesota
    • HealthPartners Research Foundation, Minneapolis, Minnesota
  • ,
  • Patricia A. van den Berg, PhD

      Affiliations

    • Division of Epidemiology and Community Health, School of Public Health, Minneapolis, Minnesota

Background

Weight-related problems, including obesity, eating disorders, and disordered eating, are major public health problems in adolescents. The identification of shared risk and protective factors for these problems can guide the development of relevant interventions to a broad spectrum of weight-related problems. This paper examines the prevalence and co-occurrence of overweight, binge eating, and extreme weight-control behaviors (vomiting, diet pills, laxatives, and diuretics) in adolescents and identifies shared risk and protective factors from within the socioenvironmental, personal, and behavioral domains for these three adverse weight-related outcomes.

Methods

Data were collected at Time 1 (1998–1999) and Time 2 (2003–2004) on 2516 adolescents participating in Project EAT (Eating Among Teens). Data were analyzed in 2006–2007.

Results

Weight-related problems were identified in 44% of the female subjects and 29% of the male subjects. About 40% of overweight girls and 20% of overweight boys engaged in at least one of the disordered eating behaviors (binge eating and/or extreme weight control). Weight-teasing by family, personal weight concerns, and dieting/unhealthy weight-control behaviors strongly and consistently predicted overweight status, binge eating, and extreme weight-control behaviors after 5 years. Family meals, regular meal patterns, and media exposure to messages about weight loss were also associated with weight-related outcomes, although the strength and consistency of associations differed across outcomes and gender.

Conclusions

Weight-specific socioenvironmental, personal, and behavioral variables are strong and consistent predictors of overweight status, binge eating, and extreme weight-control behaviors later in adolescence. These findings support the need for research to determine if decreasing weight-related social pressures, personal weight concerns, and unhealthy weight-control behaviors can contribute to reductions in obesity in children and adolescents.

 

 The full text of this article is available via AJPM Online at www.ajpm-online.net; 1 unit of Category-1 CME credit is also available, with details on the website.

PII: S0749-3797(07)00498-9

doi:10.1016/j.amepre.2007.07.031

American Journal of Preventive Medicine
Volume 33, Issue 5 , Pages 359-369.e3, November 2007