Weight Loss Practice by Weight Status Among Adolescents

Aim: To determine the association of weight status and Unhealthy Weight Loss Practice (UWLP) among 12-to-18-year-old adolescents Methods: A cross-sectional study of 12-to-18 year olds (N=6,212) from the 2011 Youth Risk Behavior Survey in Florida was conducted. UWLP was categorized based on self-report of at least one of three methods to lose weight: 1) ? 24 hours of fasting, 2) diet pill use and 3) laxative use/purging. The reference group included those with no reported UWLP. Logistic regression, adjusted for demographic, substance use, and exercise variables, assessed relationships between weight status (defined by age-sex-specific body mass index percentiles) and UWLP. Results: Analysis was restricted to 5,323 adolescents who had complete weight status information. About 13.3% of adolescents reported at least one UWLP. A quarter of the sample (25.1%) was either overweight or obese. The prevalence of UWLP was highest in obese (23.1%) and overweight (17.6%) adolescents compared to 11.1% of healthy weight adolescents. Obese and overweight adolescents were significantly more likely than healthy weight adolescents to exhibit at least one UWLP (adjusted odds ratios [AOR]=2.85, 95% confidence interval [CI]=2.17-3.74; AOR=1.66, 95% CI=1.27-2.16, respectively). Adolescents who reported tobacco (AOR=1.78, 95% CI=1.31- 2.40), alcohol (AOR=1.58, 95% CI=1.27-1.96), marijuana (AOR=1.0, 95% CI=0.72-1.39) or cocaine use (AOR=3.69, 95% CI=2.37-5.75) had higher odds of UWLP compared to non-user counterparts. Conclusions: Overweight and obese adolescents present with higher odds of engaging in UWLP compared to healthy weight peers. These findings have important implications as the prevalence of obesity in adolescence remains a concern in Florida and in the United States.