Adolescents' Perceptions of Relative Weight and Self-Reported Weight Loss Activities

Article excerpt

In 1985, the National Institutes of Health convened a consensus conference on the health implications of excess body weight (obesity).The conference concluded excess weight, defined as 120% of desirable weight,constitutes a significant risk factor for several chronic diseases including coronary heart disease, hypertension, and cancer. These effects increase both morbidity and mortality among overweight individuals. [1] Twenty-seven percent of U.S. women and 24% of U.S. men are overweight. [2] Once individuals become overweight remediation is difficult, and efforts to lose weight may be as or more harmful than the condition itself.[3] Prevention, rather than remediation,is the most desirable and, perhaps the only practical, safe way to significantly decrease the number of overweight persons.

While chronic disease outcomes related to obesity usually are not manifest until adulthood, behaviors that predispose individuals to obesity often are established during adolescence. As many as 70% of overweight adolescents become overweight adults. [4] Researchers estimate 15% to 30% of U.S. adolescents may be overweight. [5] Gortmaker et al[6] analyzed trends in adolescent obesity from 1963 to 1980 using data from four surveys of the U.S. population. During that period obesity increased 39% for the population; 35% for Whites and 53% for Blacks. Gortmaker et al[6] estimated the prevalence of obesity for 12-17 year olds at 18% for males and 26% for females.

Increases in the prevalence of obesity among adolescents pose negative implications, not only for long-term health risks, but for immediate physiological and psychological well being. Obesity, the leading cause of sustained hypertension in adolescents, has been linked to orthopedic disorders and diabetics.[6] The increase in adolescent obesity occurred despite a cultural standard that encourages thinness. Thus, adolescents, particularly females, often hold a concept of attractiveness that does not conform to reality.[7] In a study on teen-age nutrition and physique, Huenemann et al[8] reported as many as 70% of adolescent girls were dissatisifed with their bodies and wanted to lose weight. Moore[9] found 67% of adolescent girls were dissatisfied with their weight. Of the 63% who believed they were overweight, only 40% actually were overweight. Storz and Green[10] also found a high prevalence of dissatisfaction with body size among adolescent girls; 62% of girls who desired weight loss actuary were within the normal weight range.

When reviewing weight loss methods used by adolescents ages 14-18, Storz and Green[10] found exercise the most popular method, followed by low-energy crash diets. Of adolescents attempting to lose weight, 41% used undesirable methods such as fasting or diet pills. Dieting by young women of normal weight could pose a threat to nutritional status and predispose them to later eating disorders.[11] One study of adolescent girls in grades 9-12 reported vomiting rates of 11.2% and laxative use rates of 4.7%. Bulimics often report their bulimia began in adolescence and was associated with attempts to lose weight[12]

The positive relationship between adolescent and adult obesity, combined with the immediate negative impact of obesity on physical and psychological health status, prompted the U.S. Public Health Service to target adolescent obesity in Healthy Youth 2000: National health promotion and disease prevention Objectives for adolescents specifically the goal seeks to reduce the prevalence of obesity to no more than 15% among individuals ages 12-19.[2] To accomplish this goal the complex etiology of adolescent obesity must be better understood. Genetic factors influence body weight as do organic factors.[13] Black women, for example, are more likely than White women to be overweight. An ethnic differential also exists in mortality rates with overweight Black women recording higher death rates from coronary heart disease, stroke, diabetes, and hypertension than overweight White women. …