Risk Factors for Adopting Extreme Weight-Control Behaviors among Public School Adolescents in Salvador, Brazil: A Case-Control Study

Abstract

Objective: This study identifies the risk factors for extreme weight-control behaviors among adolescents in public school in Salvador, northeastern Brazil.

Methods: A case-control study nested to a cross-sectional study, including 252 adolescents of both sexes, age between 11 to 17 years, with 84 cases and 168 age-matched controls was conducted. The variable outcome is represented by extreme weight-control behaviors, integrated by following the variables: self-induced vomiting and the use of laxatives, diuretics, or diet pills. Covariables included body image dissatisfaction, dieting, prolonged fasting, and self-perception of body weight. The study also investigated the demographic and anthropometric variables and economic conditions of the students’ families. Conditional logistic regression was used to identify risk factors for the adoption of extreme weight-control behaviors among adolescents.

Results: Among the adolescents investigated, the conditional logistic regression explained 22% the occurrence of extreme weight-control behaviors and showed that these behaviors were positively associated to overweight (odds ratio [OR] = 3.61; 95% confidence interval [CI], 1.42–9.17), body image dissatisfaction (OR = 3.87; 95% CI, 1.75–8.54), and the adoption of a restrictive diet (OR = 2.83; 95% CI, 1.16–6.91).

Conclusions: The results of this study suggest that among adolescents, overweight, body image dissatisfaction, and restrictive diet are important risk factors to adoption of extreme weight-control behaviors.

Key words:

• risk factors
• adolescents
• obesity
• body image
• extreme weight control
• case-control study

ACKNOWLEDGMENTS

We thank the Department of Education and Culture of the State of Bahia and the principals, teachers, students, families of students, and staff of the state schools who participated in this study.

FUNDING

The authors wish to thank the Foundation for Research Support in Bahia–FAPESB (Case No. 1431040053551), which provided financial support for the development of this project and the Coordination of Improvement of Higher Education Personnel from the Ministry of Education of Brazil–CAPES/PDEE for providing the funding to study abroad (Case No. 675310-8).