Obesity, disordered eating, and eating disorders in a longitudinal study of adolescents: how do dieters fare 5 years later?

J Am Diet Assoc. 2006 Apr;106(4):559-68. doi: 10.1016/j.jada.2006.01.003.


Objective: To determine if adolescents who report dieting and different weight-control behaviors are at increased or decreased risk for gains in body mass index, overweight status, binge eating, extreme weight-control behaviors, and eating disorders 5 years later.

Design: Population-based 5-year longitudinal study.

Participants: Adolescents (N=2,516) from diverse ethnic and socioeconomic backgrounds who completed Project EAT (Eating Among Teens) surveys in 1999 (Time 1) and 2004 (Time 2).

Main outcome measures: Weight status, binge eating, extreme weight control, and self-reported eating disorder.

Statistical analysis: Multiple linear and logistic regressions.

Results: Adolescents using unhealthful weight-control behaviors at Time 1 increased their body mass index by about 1 unit more than adolescents not using any weight-control behaviors and were at approximately three times greater risk for being overweight at Time 2 (odds ratio [OR]=2.7 for girls; OR=3.2 for boys). Adolescents using unhealthful weight-control behaviors were also at increased risk for binge eating with loss of control (OR=6.4 for girls; OR=5.9 for boys) and for extreme weight-control behaviors such as self-induced vomiting and use of diet pills, laxatives, and diuretics (OR=2.5 for girls; OR=4.8 for boys) 5 years later, compared with adolescents not using any weight-control behaviors.

Conclusions: Dieting and unhealthful weight-control behaviors predict outcomes related to obesity and eating disorders 5 years later. A shift away from dieting and drastic weight-control measures toward the long-term implementation of healthful eating and physical activity behaviors is needed to prevent obesity and eating disorders in adolescents.

Publication types

  • Comparative Study
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adolescent Behavior*
  • Adolescent Nutritional Physiological Phenomena*
  • Body Mass Index
  • Body Weight / physiology*
  • Confidence Intervals
  • Diet, Reducing / adverse effects*
  • Feeding and Eating Disorders / epidemiology*
  • Feeding and Eating Disorders / etiology
  • Feeding and Eating Disorders / psychology
  • Female
  • Follow-Up Studies
  • Humans
  • Linear Models
  • Logistic Models
  • Longitudinal Studies
  • Male
  • Obesity / epidemiology*
  • Obesity / etiology
  • Obesity / psychology
  • Odds Ratio
  • Prevalence
  • Risk Factors