Association of body weight perception and unhealthy weight control behaviors in adolescence

The purpose of this article was to determine how body weight perception is related to weight control behaviors among a nationally representative sample of adolescents. Data came from the CDC's nationally representative Youth Risk Behavior Surveillance System, 2013 (n = 13,857). Mean age was 16.2 years old. Multinomial logistic regressions were used to analyze the relationship between body weight perception (very underweight, slightly underweight, about the right weight, slightly overweight, and very overweight) and both unhealthy weight control behaviors individually (fasting, taking diet pills, and vomiting or taking laxatives) and any unhealthy weight control behavior, controlling for age, race/ethnicity, and BMI percentile and stratifying by gender. 13.35% of the sample reported fasting, 5.13% reported taking diet pills, and 4.20% reported vomiting or taking laxatives. Among girls, there was a significant positive association between feeling very underweight compared to about the right weight and all unhealthy weight control behaviors. In addition, feeling slightly overweight and very overweight increased the odds of fasting behavior or any unhealthy weight control behavior. Among boys, feeling very underweight, slightly overweight, and very overweight was associated with fasting, taking diet pills, vomiting or using laxatives, and any unhealthy weight control behavior. Both boys and girls engage in unhealthy weight control behaviors at a high rate, and the association with feeling under- and overweight overall increases the odds of these unhealthy behaviors. Health promotion efforts should focus on encouraging a healthy, normal body weight perception among adolescents in an effort to reduce unhealthy weight control behaviors. •Both boys and girls engage in unhealthy weight control behaviors at a high rate•Unhealthy weight control behaviors include fasting, using diet pills, and vomiting•Feeling under- and overweight is associated with unhealthy weight control behaviors