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December 1995, Vol 149, No. 12 >
Article | December 1995

Body Dissatisfaction and Unhealthy Weight-Control Practices Among Adolescents With and Without Chronic Illness: A Population-Based Study FREE

Dianne Neumark-Sztainer, PhD, MPH, RD; Mary Story, PhD, RD; Michael D. Resnick, PhD; Ann Garwick, PhD; Robert Wm. Blum, MD, MPH, PhD
Arch Pediatr Adolesc Med. 1995;149(12):1330-1335. doi:10.1001/archpedi.1995.02170250036005.
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Objective:  To compare body dissatisfaction and unhealthy weight-loss practices among adolescents with and without chronic illness.

Design:  Survey.

Participants:  The sample consisted of 2149 adolescent boys and girls with diabetes, asthma, attention deficit disorder, physical disabilities, or seizure disorders; and a comparison group of 1381 adolescents without chronic illness.

Main Outcome Measures:  Body concerns, binge eating, frequent dieting, vomiting, and laxative or diuretic use among adolescents.

Results:  Adolescents with chronic illness reported higher body dissatisfaction and engaged in more high-risk weight-loss practices than adolescents without chronic illness. This trend was consistent across the different conditions and was not limited to those with a nutrition-related condition such as diabetes. The trend remained after conducting logistic regression and controlling for age, race, socioeconomic status, and body mass index.

Conclusions:  Adolescents with chronic illness are at high risk for engaging in unhealthy weight-loss practices and should be screened and targeted for prevention and treatment.(Arch Pediatr Adolesc Med. 1995;149:1330-1335)

REFERENCES

1 +
Story MS, Rosenwinkel K, Resnick M, Harris LJ, Blum RW.  Demographic and risk factors associated with chronic dieting in adolescents . AJDC . 1991;;15: 15-18.
2 +
Marchi M, Cohen P.  Early childhood eating behaviors and adolescent eating disorders . J Am Acad Child Adolesc Psychiatry . 1990;;19:112-117.
3 +
Neumark-Sztainer D, Palti H, Butler R.  Weight concerns and dieting behaviors among high school girls in Israel . J Adolesc Health . 1995;;16:53-59.
4 +
Stein DM.  The prevalence of bulimia: a review of the empirical research . J Nutr Educ . 1991;;23:205-213.
5 +
Gortmaker SL, Sappenfield W.  Chronic childhood disorders: prevalence and impact . Pediatr Clin North Am . 1984;;31:3-18.
6 +
Gortmaker SL, Walker DK, Weitzman M, Sobol AM.  Chronic conditions, socioeconomic risks, and behavioral problems in children and adolescents . Pediatrics . 1990;;85:267-276.
7 +
Chronic physical illnesses: prevention and services. Adolescent Health–Background and the Effectiveness of Selected Prevention and Treatment Services . Washington, DC: US Office of Technology Assessment. 1991;;2:149-189. Publication OTA-H-466.
8 +
Powers PS, Malone Jl, Duncan JA.  Anorexia nervosa and diabetes mellitus . J Clin Psychiatry . 1983;;44:133-135.
9 +
Hardoff D, Shenker IR, Nussbaum M.  Anorexia nervosa in a patient with juvenile diabetes . NY State J Med . 1984;;82:61.
10 +
Rodin GM, Daneman D.  Eating disorders and IDDM: a problematic association . Diabetes Care . 1992;;15:1402-1412.
11 +
Wing RR, Nowalk MP, Marcus MD, Koeske R, Finegold D.  Subclinical eating disorders and glycemic control in adolescents with type 1 diabetes . Diabetes Care . 1986;;9:162-167.
12 +
Rodin GM, Johnson LE, Garfinkel PE, Daneman D, Kenshole AB.  Eating disorders in female adolescents with insulin dependent diabetes mellitus . Int J Psychiatry Med . 1986-1987;;16:49-57.
13 +
Steel JM, Young RJ, Lloyd GG, Macintyre CCA.  Abnormal eating attitudes in young insulin-dependent diabetics . Br J Psychiatry . 1989;;155:515-521.
14 +
Striegel-Moore RH, Nicholson TJ, Tamborlane WV.  Prevalence of eating disorder symptoms in preadolescent and adolescent girls with IDDM . Diabetes Care . 1992;;15:1361-1368.
15 +
Fairburn CG, Peveler RC, Davies B, Mann JI, Mayou RA.  Eating disorders in young adults with insulin dependent diabetes mellitus: a controlled study . BMJ . 1991;;303:17-20.
16 +
Peveler RC, Fairburn CG, Boller I, Dunger D.  Eating disorders in adolescents with IDDM: a controlled study . Diabetes Care . 1992;;15:1356-1360.
17 +
Meadows G, Treasure J.  Bulimia nervosa and Crohn's disease . Acta Psychiatr Scand . 1989;;79:413-414.
18 +
Mcfarlane AC.  Blindness and anorexia nervosa . Can J Psychiatry . 1989;:34: 431-433.
19 +
Pumariega AJ, Pursell J, Spock A, Jones JD.  Eating disorders in adolescents with cystic fibrosis . J Am Acad Child Adolesc Psychiatry . 1986;;25:269-275.
20 +
Mallett P, Murch S.  Anorexia nervosa complicating inflammatory bowel disease . Arch Dis Child . 1990;:65:298-300.
21 +
Harris LJ, Resnick MD, Blum RW, Rosenwinkel K. Technical report on the adolescent health survey. Minneapolis, Minn: University of Minnesota Adolescent Health Program; 1989.
22 +
Blum RW, Harmon B, Harris L, Resnick MD.  Amercan Indian-Alaskan Native Youth Health . JAMA . 1992;;267:1637-1644.
23 +
Halmi KA, Falk JR, Schwartz E.  Binge-eating and vomiting: a survey of a college population . Psychol Med . 1981;;11:697-706.
24 +
Johnson CL, Lewis C, Love S, Stuckey M, Lewis L.  A descriptive survey of dieting and bulimic behavior in a female high school population . In: Understanding Anorexia Nervosa and Bulimia: Report of the Fourth Ross Conference on Medical Research . Columbus, Ohio: Ross Laboratories; 1981;:14-20.
25 +
Story M, Hauck FR, Broussard BA, White LL, Resnick MD, Blum RW.  Weight perceptions and weight control practices in American Indian and Alaska Native Adolescents . Arch Pediatr Adolesc Med . 1994;;148:567-571.
26 +
Ostrov MR, Ostrov E.  The self-image of asthmatic adolescents . J Asthma . 1986;; 23:187-193.
27 +
Offer D, Ostrov E, Howard K.  Body image, self-perception, and chronic illness in adolescence . In: Blum, R. Chronic Illness and Disabilities in Childhood and Adolescence . New York, NY: Grune & Stratton; 1984;:59-73.
28 +
Wolman C, Blum RW, Resnick MD, Harris LJ.  Emotional well-being of adolescents with chronic conditions . J Adolesc Health . 1994;;15:199-204.
29 +
McAnarney ER.  Social maturation: a challenge for handicapped and chronically ill adolescents . J Adolesc Health . 1985;;6:90-101.
30 +
Blum RW.  Chronic illness and disability in adolescence . J Adolesc Health . 1992;; 13:364-368.
31 +
Motet-Grigoras CN, Schuckit MA.  Depression and substance abuse in handicapped young men . J Clin Psychiatry . 1986;;47:234-236.
32 +
Moore D, Polsgrove L.  Disabilities, developmental handicaps, and substance misuse: a review . Int J Addict . 1991;;26:65-90.
33 +
Moore D. Resarch in substance abuse and disabilities: the implications for prevention and treatment. Plenary session paper presented at The Third National Prevention and Training Conference: People with Disabilities. April 4-9,1990.
34 +
Dean JC, Fox A, Jensen W.  Drug and alcohol use by disabled and nondisabled persons: a comparative study . Int J Addict . 1985;;20:629-641.
35 +
Neumark-Sztainer D. The Prevention of Eating Disturbances Among Adolescent Females. Jerusalem, Israel: Hebrew University. 1993:153.
36 +
Rosen JC, Poplawski D.  The validity of self-reported weight loss and weight gain efforts in adolescents . Int J Eat Disord . 1987;;6:515-523.
37 +
Rodin J, Silberstein L, Striegel-Moore R.  Women and weight: a normative discontent . Nebr Symp Motiv . 1984;:267-307.
38 +
Nylander I.  The feeling of being fat and dieting in a school population: an epidemiological investigation . Acta Sociomed Scand . 1971;;1:17-26.
39 +
Patton GC, Johnson-Sabine E, Wood K, Mann AH, Wakeling A.  Abnormal eating attitudes in London schoolgirls: a prospective epidemiological study: outcome at twelve month follow-up . Psychol Med . 1990;;20:383-394.
40 +
Neumark-Sztainer D.  Dieting for weight loss: normative but not harmless . Nutr Today . 1995;;30:68-74.
41 +
Neumark-Sztainer D, Butler R, Palti H.  Eating disturbances among adolescent girls: evaluation of a school-based primary prevention program . J Nutr Educ . 1995;;27:24-31.
42 +
Levine MP. How schools can help combat student eating disorders: anorexia nervosa and bulimia. National Education Association of the United States. 1987.
43 +
Garner DM, Rockert W, Olmstead MP, Johnson C, Coscina DV.  Psychoeducational principles in the treatment of bulimia and anorexia nervosa . In: Garner DM, Garfinkle PE. Handbook of Psychotherapy for Anorexia Nervosa and Bulimia . New York, NY: Guilford Press; 1986;.
44 +
Pless IB, Perrin JM,  Issues common to a variety of illnesses . In: Hobbs N. Perrin JM, eds. Issues in the Care of Children With Chronic Illness . San Francisco, Calif: Jossey-Bass Inc Publishers; 1985;.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

References

1 +
Story MS, Rosenwinkel K, Resnick M, Harris LJ, Blum RW.  Demographic and risk factors associated with chronic dieting in adolescents . AJDC . 1991;;15: 15-18.
2 +
Marchi M, Cohen P.  Early childhood eating behaviors and adolescent eating disorders . J Am Acad Child Adolesc Psychiatry . 1990;;19:112-117.
3 +
Neumark-Sztainer D, Palti H, Butler R.  Weight concerns and dieting behaviors among high school girls in Israel . J Adolesc Health . 1995;;16:53-59.
4 +
Stein DM.  The prevalence of bulimia: a review of the empirical research . J Nutr Educ . 1991;;23:205-213.
5 +
Gortmaker SL, Sappenfield W.  Chronic childhood disorders: prevalence and impact . Pediatr Clin North Am . 1984;;31:3-18.
6 +
Gortmaker SL, Walker DK, Weitzman M, Sobol AM.  Chronic conditions, socioeconomic risks, and behavioral problems in children and adolescents . Pediatrics . 1990;;85:267-276.
7 +
Chronic physical illnesses: prevention and services. Adolescent Health–Background and the Effectiveness of Selected Prevention and Treatment Services . Washington, DC: US Office of Technology Assessment. 1991;;2:149-189. Publication OTA-H-466.
8 +
Powers PS, Malone Jl, Duncan JA.  Anorexia nervosa and diabetes mellitus . J Clin Psychiatry . 1983;;44:133-135.
9 +
Hardoff D, Shenker IR, Nussbaum M.  Anorexia nervosa in a patient with juvenile diabetes . NY State J Med . 1984;;82:61.
10 +
Rodin GM, Daneman D.  Eating disorders and IDDM: a problematic association . Diabetes Care . 1992;;15:1402-1412.
11 +
Wing RR, Nowalk MP, Marcus MD, Koeske R, Finegold D.  Subclinical eating disorders and glycemic control in adolescents with type 1 diabetes . Diabetes Care . 1986;;9:162-167.
12 +
Rodin GM, Johnson LE, Garfinkel PE, Daneman D, Kenshole AB.  Eating disorders in female adolescents with insulin dependent diabetes mellitus . Int J Psychiatry Med . 1986-1987;;16:49-57.
13 +
Steel JM, Young RJ, Lloyd GG, Macintyre CCA.  Abnormal eating attitudes in young insulin-dependent diabetics . Br J Psychiatry . 1989;;155:515-521.
14 +
Striegel-Moore RH, Nicholson TJ, Tamborlane WV.  Prevalence of eating disorder symptoms in preadolescent and adolescent girls with IDDM . Diabetes Care . 1992;;15:1361-1368.
15 +
Fairburn CG, Peveler RC, Davies B, Mann JI, Mayou RA.  Eating disorders in young adults with insulin dependent diabetes mellitus: a controlled study . BMJ . 1991;;303:17-20.
16 +
Peveler RC, Fairburn CG, Boller I, Dunger D.  Eating disorders in adolescents with IDDM: a controlled study . Diabetes Care . 1992;;15:1356-1360.
17 +
Meadows G, Treasure J.  Bulimia nervosa and Crohn's disease . Acta Psychiatr Scand . 1989;;79:413-414.
18 +
Mcfarlane AC.  Blindness and anorexia nervosa . Can J Psychiatry . 1989;:34: 431-433.
19 +
Pumariega AJ, Pursell J, Spock A, Jones JD.  Eating disorders in adolescents with cystic fibrosis . J Am Acad Child Adolesc Psychiatry . 1986;;25:269-275.
20 +
Mallett P, Murch S.  Anorexia nervosa complicating inflammatory bowel disease . Arch Dis Child . 1990;:65:298-300.
21 +
Harris LJ, Resnick MD, Blum RW, Rosenwinkel K. Technical report on the adolescent health survey. Minneapolis, Minn: University of Minnesota Adolescent Health Program; 1989.
22 +
Blum RW, Harmon B, Harris L, Resnick MD.  Amercan Indian-Alaskan Native Youth Health . JAMA . 1992;;267:1637-1644.
23 +
Halmi KA, Falk JR, Schwartz E.  Binge-eating and vomiting: a survey of a college population . Psychol Med . 1981;;11:697-706.
24 +
Johnson CL, Lewis C, Love S, Stuckey M, Lewis L.  A descriptive survey of dieting and bulimic behavior in a female high school population . In: Understanding Anorexia Nervosa and Bulimia: Report of the Fourth Ross Conference on Medical Research . Columbus, Ohio: Ross Laboratories; 1981;:14-20.
25 +
Story M, Hauck FR, Broussard BA, White LL, Resnick MD, Blum RW.  Weight perceptions and weight control practices in American Indian and Alaska Native Adolescents . Arch Pediatr Adolesc Med . 1994;;148:567-571.
26 +
Ostrov MR, Ostrov E.  The self-image of asthmatic adolescents . J Asthma . 1986;; 23:187-193.
27 +
Offer D, Ostrov E, Howard K.  Body image, self-perception, and chronic illness in adolescence . In: Blum, R. Chronic Illness and Disabilities in Childhood and Adolescence . New York, NY: Grune & Stratton; 1984;:59-73.
28 +
Wolman C, Blum RW, Resnick MD, Harris LJ.  Emotional well-being of adolescents with chronic conditions . J Adolesc Health . 1994;;15:199-204.
29 +
McAnarney ER.  Social maturation: a challenge for handicapped and chronically ill adolescents . J Adolesc Health . 1985;;6:90-101.
30 +
Blum RW.  Chronic illness and disability in adolescence . J Adolesc Health . 1992;; 13:364-368.
31 +
Motet-Grigoras CN, Schuckit MA.  Depression and substance abuse in handicapped young men . J Clin Psychiatry . 1986;;47:234-236.
32 +
Moore D, Polsgrove L.  Disabilities, developmental handicaps, and substance misuse: a review . Int J Addict . 1991;;26:65-90.
33 +
Moore D. Resarch in substance abuse and disabilities: the implications for prevention and treatment. Plenary session paper presented at The Third National Prevention and Training Conference: People with Disabilities. April 4-9,1990.
34 +
Dean JC, Fox A, Jensen W.  Drug and alcohol use by disabled and nondisabled persons: a comparative study . Int J Addict . 1985;;20:629-641.
35 +
Neumark-Sztainer D. The Prevention of Eating Disturbances Among Adolescent Females. Jerusalem, Israel: Hebrew University. 1993:153.
36 +
Rosen JC, Poplawski D.  The validity of self-reported weight loss and weight gain efforts in adolescents . Int J Eat Disord . 1987;;6:515-523.
37 +
Rodin J, Silberstein L, Striegel-Moore R.  Women and weight: a normative discontent . Nebr Symp Motiv . 1984;:267-307.
38 +
Nylander I.  The feeling of being fat and dieting in a school population: an epidemiological investigation . Acta Sociomed Scand . 1971;;1:17-26.
39 +
Patton GC, Johnson-Sabine E, Wood K, Mann AH, Wakeling A.  Abnormal eating attitudes in London schoolgirls: a prospective epidemiological study: outcome at twelve month follow-up . Psychol Med . 1990;;20:383-394.
40 +
Neumark-Sztainer D.  Dieting for weight loss: normative but not harmless . Nutr Today . 1995;;30:68-74.
41 +
Neumark-Sztainer D, Butler R, Palti H.  Eating disturbances among adolescent girls: evaluation of a school-based primary prevention program . J Nutr Educ . 1995;;27:24-31.
42 +
Levine MP. How schools can help combat student eating disorders: anorexia nervosa and bulimia. National Education Association of the United States. 1987.
43 +
Garner DM, Rockert W, Olmstead MP, Johnson C, Coscina DV.  Psychoeducational principles in the treatment of bulimia and anorexia nervosa . In: Garner DM, Garfinkle PE. Handbook of Psychotherapy for Anorexia Nervosa and Bulimia . New York, NY: Guilford Press; 1986;.
44 +
Pless IB, Perrin JM,  Issues common to a variety of illnesses . In: Hobbs N. Perrin JM, eds. Issues in the Care of Children With Chronic Illness . San Francisco, Calif: Jossey-Bass Inc Publishers; 1985;.

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