Relation Between Dieting and Weight Change Among Preadolescents and Adolescents

Abstract

ABSTRACT. Objective. To assess whether dieting to control weight was associated with weight change among children and adolescents.Methods. A prospective study was conducted of 8203 girls and 6769 boys who were 9 to 14 years of age in 1996, were in an ongoing cohort study, and completed at least 2 annual questionnaires between 1996 and 1999. Dieting to control weight, binge eating, and dietary intake were assessed annually from 1996 through 1998 with instruments designed specifically for children and adolescents. The outcome measure was age-and sex-specific z score of body mass index (BMI).Results. In 1996, 25.0% of the girls and 13.8% of the boys were infrequent dieters and 4.5% of the girls and 2.2% of the boys were frequent dieters. Among the girls, the percentage of dieters increased over the following 2 years. Binge eating was more common among the girls, but in both sexes, it was associated with dieting to control weight (girls: infrequent dieters, odds ratio [OR]: 5.10; frequent dieters, OR: 12.4; boys: infrequent dieters, OR: 3.49; frequent dieters, OR: 7.30). During 3 years of follow-up, dieters gained more weight than nondieters. Among the girls, frequency of dieting was positively associated with increases in age-and sex-specific z scores of BMI (␤ ‫؍‬ 0.05 and ␤ ‫؍‬ 0.04 for frequent and infrequent dieters vs nondieters). Among the boys, both frequent and infrequent dieters gained 0.07 z scores of BMI more than nondieters. In addition, boys who engaged in binge eating gained significantly more weight than nondieters.Conclusions. Although medically supervised weight control may be beneficial for overweight youths, our data suggest that for many adolescents, dieting to control weight is not only ineffective, it may actually promote weight gain.

Weight status and psychosocial factors predict the emergence of dieting in preadolescent girls

“…This model accounted for nearly 50% of the variance in the emergence of dieting, and more than one half of the total variance was accounted for by girls' previous weight status and interactions involving weight status. Although other recent longitudinal findings have underscored the importance of weight status as a predictor of the emergence of dieting among adolescents (Field et al, 2003;Stice, et al, 1999), the current findings indicate that higher weight status confers an elevated risk for the emergence of dieting even earlier in development, during middle childhood. In the current study, girls' weight status at 5 predicted the emergence of dieting at age 9.…”

“…Therefore, higher weight status in both the current study and in the article by Burrows and Cooper interacted with variables associated with the risk for disordered eating, suggesting that the relationships among these predictor variables and the risk for disordered eating are better understood when weight status is also considered. Although it could be argued that overweight children should diet to lose weight, there is growing evidence that dieting attempts in young children and adolescents actually contribute to greater weight gain and overeating over time (Field et al, 2003), indicating that dieting is not an appropriate approach to weight loss or weight management in childhood. Therefore, as dieting is related to an increased risk for both later restrictive eating and overeating problems, as well as binging and purging behaviors, the finding that elevated weight status at age 5 predicted higher dieting factor scores at age 9 underscores the critical role that childhood overweight and obesity has in a cascade of behaviors that may result in trajectories that lead to later eating pathology and subsequent overweight.…”

“…Dieting also increases the likelihood of overeating and greater weight gain over time, creating a cycle of weight gain and further dieting that may emerge before adolescence (Field et al, 2003). In addition, girls as young as 5 years report an awareness of dieting practices (Abramovitz & Birch, 2000) and girls in middle childhood report engaging in dieting behaviors or wanting to lose weight.…”

“…Together, these findings suggest that there should be increased concern about the development of unhealthy eating patterns in girls before they enter adolescence. Although the negative effects of early self-initiated dieting have been described (Field et al, 2003), little is documented about the predictors of the early emergence of dieting.…”

“…Recent work has shown that overweight girls at ages 5 and 7 years indicate lower self-concept across multiple domains (Davison & Birch, 2002) and report greater body dissatisfaction over time (Davison, Markey, & Birch, 2003). Burrows and Cooper (2002) also report that girls ages 11−12 years who were overweight were more likely to engage in restrained eating and that higher weight status has been linked to the initiation of dieting in adolescence (Field et al, 2003;Stice, Cameron, Killen, Hayward, & Taylor, 1999). In a crosssectional study of adolescents, Ackard, Neumark-Sztainer, Story, and Perry (2003) found that those who engaged in overeating were more likely to be overweight or obese, to have a history of past and current dieting, and to indicate that feelings related to weight and body shape are important to their self-concept.…”