Marla E. Eisenberg

Body Dissatisfaction Prospectively Predicts Depressive Mood and Low Self-Esteem in Adolescent Girls and Boys

This research examined whether body dissatisfaction prospectively predicted depressive mood and low self-esteem in adolescent girls and boys 5 years later. Participants were early-adolescent girls (n = 440, Time 1 M age = 12.7 years) and boys (n = 366, Time 1 M age = 12.8 years) and midadolescent girls (n = 946, Time 1 M age = 15.8 years) and boys (n = 764, Time 1 M age = 15.9 years). After controlling for Time 1 of the relevant dependent variable, ethnicity, socioeconomic status, and body mass index, Time 1 body dissatisfaction was a unique predictor of Time 2 depressive mood and low self-esteem in early-adolescent girls (depressive mood: F = 4.80, p < .05; self-esteem: F = 9.64, p < .01) and midadolescent boys (depressive mood: F = 12.27, p < .001; self-esteem: F = 9.38, p < .01) but not in early-adolescent boys or midadolescent girls. These findings are consistent with the hypothesis that body dissatisfaction is a risk factor for depressive mood and low self-esteem in both girls and boys but in different phases of adolescence.

Dieting and Disordered Eating Behaviors from Adolescence to Young Adulthood: Findings from a 10-Year Longitudinal Study

BACKGROUND Disordered eating behaviors are prevalent in adolescence and can have harmful consequences. An important question is whether use of these behaviors in adolescence sets the pattern for continued use into young adulthood. OBJECTIVE To examine the prevalence and tracking of dieting, unhealthy and extreme weight control behaviors, and binge eating from adolescence to young adulthood. DESIGN Population-based, 10-year longitudinal study (Project EAT-III: Eating Among Teens and Young Adults, 1999-2010). PARTICIPANTS/SETTING The study population included 2,287 young adults (55% girls, 52% nonwhite). The sample included a younger group (mean age 12.8±0.7 years at baseline and 23.2±1.0 years at follow-up) and an older group (mean age 15.9±0.8 at baseline and 26.2±0.9 years at follow-up). STATISTICAL ANALYSES PERFORMED Longitudinal trends in prevalence of behaviors were tested using generalized estimating equations. Tracking of behaviors were estimated using the relative risk of behaviors at follow-up given presence at baseline. RESULTS In general, the prevalence of dieting and disordered eating was high and remained constant, or increased, from adolescence to young adulthood. Furthermore, behaviors tended to track within individuals and, in general, participants who engaged in dieting and disordered eating behaviors during adolescence were at increased risk for these behaviors 10 years later. Tracking was particularly consistent for the older girls and boys transitioning from middle adolescence to middle young adulthood. CONCLUSIONS Study findings indicate that disordered eating behaviors are not just an adolescent problem, but continue to be prevalent among young adults. The tracking of dieting and disordered eating within individuals suggests that early use is likely to set the stage for ongoing use. Findings suggest a need for both early prevention efforts before the onset of harmful behavioral patterns as well as ongoing prevention and treatment interventions to address the high prevalence of disordered eating throughout adolescence and young adulthood.

Prospective predictors of body dissatisfaction in adolescent girls and boys : a five-year longitudinal study.

This study investigated prospective risk factors for increases in body dissatisfaction in adolescent girls and boys in the Eating Among Teens Project. At the time of first assessment (Time 1), participants were a cohort of early adolescent girls (N=440) and boys (N=366) and a cohort of middle adolescent girls (N=946) and boys (N=764). Participants were followed up 5 years later (Time 2). Potential prospective risk factors examined included body mass index, socioeconomic status, ethnicity, parent dieting environment, peer environment, and psychological factors. Predictors of Time 2 body dissatisfaction were Time 1 body dissatisfaction, body mass index, socioeconomic status, being African American, friend dieting and teasing, self-esteem, and depression. However, the profile of predictors differed across the samples.

Weight Teasing and Disordered Eating Behaviors in Adolescents: Longitudinal Findings From Project EAT (Eating Among Teens)

OBJECTIVE. To assess whether weight-related teasing predicts the development of binge eating, unhealthy weight control behaviors, and frequent dieting among male and female adolescents. METHODS. A prospective study was conducted with an ethnically and socioeconomically diverse sample of 2516 adolescents who completed surveys at both time 1 (1998–1999) and time 2 (2003–2004) of the Project EAT (Eating Among Teens) study. RESULTS. In 1998–1999, approximately one fourth of participants reported being teased about their weight at least a few times a year. After adjustment for age, race/ethnicity, socioeconomic status (SES), and BMI, boys who were teased about their weight were more likely than their peers to initiate binge eating with loss of control and unhealthy weight control behaviors 5 years later. The predicted prevalence for incident binge eating behaviors with loss of control among boys who were teased was 4.1% as compared with 1.4% for those who were not teased, after adjustment for age, race/ethnicity, SES, and BMI. For unhealthy weight control behaviors at time 2, the predicted prevalence was 27.5% among boys who were teased and 19.3% for boys who were not teased, after adjustment for age, race/ethnicity, SES, and BMI. Girls who were teased were more likely than their peers to become frequent dieters. The predicted prevalence for incident frequent dieting among girls who were teased was 18.2% as compared with 11.0% for those who were not teased, after adjustment for age, race/ethnicity, SES, and BMI. CONCLUSIONS. Weight teasing in adolescence predicts disordered eating behaviors at 5-year follow-up. The patterns of these associations differ by gender. Reducing teasing through educational interventions and policies may reduce the level of disordered eating behaviors among youths.

Family Meals and Disordered Eating in Adolescents Longitudinal Findings From Project EAT

OBJECTIVE To examine 5-year longitudinal associations between family meal frequency and disordered eating behaviors in adolescents. DESIGN Longitudinal study. SETTING Participants from 31 Minnesota schools completed in-class assessments in 1999 (time 1) and mailed surveys in 2004 (time 2). PARTICIPANTS Adolescents (N=2516) who completed Project EAT (Eating Among Teens)-I (time 1) and -II (time 2) assessments. MAIN OUTCOME MEASURES Time 1 family meal frequency and time 2 disordered eating behaviors, including extreme weight control behaviors (self-induced vomiting and use of laxatives, diet pills, or diuretics), less extreme unhealthy weight control behaviors (eating very little, fasting, using food substitutes, skipping meals, or smoking), binge eating, and chronic dieting. RESULTS Among adolescent girls, time 1 regular family meals (> or = 5 meals/wk) were associated with lower prevalences of time 2 extreme weight control behaviors (odds ratio, 0.71; 95% confidence interval, 0.52-0.97), even after adjusting for sociodemographic characteristics, body mass index, family connectedness, parental encouragement to diet, and extreme weight control behaviors at time 1. Associations with other disordered eating behaviors were also suggestive of a protective effect of family meals in unadjusted analyses but were not statistically significant in adjusted analyses. Among adolescent boys, regular family meals did not predict lower levels of disordered eating behaviors. CONCLUSIONS The high prevalence of disordered eating behaviors among adolescent girls and the protective role of family meals suggest a need for interventions aimed at promoting family meals. Further exploration of predictors of disordered eating behaviors in adolescent boys and the role of family meals is warranted.

The Link Between Body Dissatisfaction and Self-Esteem in Adolescents: Similarities Across Gender, Age, Weight Status, Race/Ethnicity, and Socioeconomic Status

PURPOSE The present study examined whether the cross-sectional association between body dissatisfaction and low self-esteem varies across gender, age, body weight status, race/ethnicity, and socioeconomic status (SES). We also examined the association longitudinally. METHODS A school-based survey of eating, weight, and related attitudes was conducted with a diverse sample of adolescents aged 11-18 years (N = 4,746). Height and weight were measured in the schools at Time 1. Participants were resurveyed through mails 5 years later (Time, 2; N = 2,516). RESULTS The relationship between body dissatisfaction and self-esteem was strong and significant in both boys and girls (all p values < .0001), and did not differ significantly between genders (p = .16), or between the middle school and high school cohorts in either boys (p = .79) or girls (p = .80). Among girls, the relationship between body dissatisfaction and self-esteem was strong, but did vary across weight status, race/ethnicity, and SES (all p values = .0001-.03). The relationship was nonsignificant in underweight girls (p = .36), and weaker but still significant among black, Asian, and low SES group girls (all p values < .0001) in comparison to white and high SES group girls. Among boys, the association did not differ significantly across demographic groups (all p values = .18-.79). In longitudinal analyses, the strength of the association did not change significantly as adolescents grew older. CONCLUSIONS Findings indicate that body dissatisfaction and self-esteem are strongly related among nearly all groups of adolescents. This suggests the importance of addressing body image concerns with adolescents of all backgrounds and ages.

Fast Food Intake: Longitudinal Trends during the Transition to Young Adulthood and Correlates of Intake

PURPOSE Frequent fast food intake is associated with poorer diet quality and greater weight gain. The aims of this study were to describe changes in fast food intake during the transition from middle adolescence to young adulthood, and to identify baseline correlates of this eating behavior in early young adulthood. METHODS Data were drawn from Project EAT, a population-based, longitudinal study in Minnesota. Surveys were completed by 935 females and 751 males in high school classrooms at baseline (1998-1999; mean age = 15.9 years) and by mail at follow-up (2003-2004; mean age = 20.5 years). RESULTS Frequent intake of fast food (> or =3 times/week) was reported by 24% of males and 21% of females during adolescence. At follow-up, in early young adulthood the eating behavior increased among males (33%, p < .001), and there was no further increase among females (23%; p = .16). Baseline snack frequency was positively associated with frequency of fast food intake at follow-up among both genders. Baseline peer support for healthy eating among males and both concern about health and self-efficacy for healthy eating among females were inversely related to follow-up fast food intake. Among females, baseline perceptions of time and taste barriers to healthy eating, lunch frequency, television viewing, and unhealthy food availability at home were also positively associated with follow-up fast food intake. CONCLUSIONS Interventions are needed to address the high prevalence of frequent fast food intake among adolescents and young adults. Health professionals should help young people identify convenient and healthful food choices for meals and snacks consumed away from home.

Substance use behaviors among college students with same-sex and opposite-sex experience: results from a national study

OBJECTIVES This study seeks to describe the population of college students with same-sex sexual experience and determine if these students report more substance use than their peers with only opposite-sex experience. METHODS Questionnaires were completed by a national random sample of college students on 119 campuses in 1999. A total of 10,301 sexually active students were categorized as having only opposite-sex, only same-sex, or both-sex partners, and their smoking, binge drinking, and marijuana use behaviors were compared. RESULTS Students who report same-sex sexual experiences comprise 6.1% of respondent. Women with both-sex partners were approximately twice as likely to smoke, binge drink, and use marijuana as women with only opposite-sex partners (OR=1.41-2.78), but women with only same-sex partners were not at increased risk for these behaviors. Men with both-sex partners were less likely to binge drink (OR=0.54) than men with only opposite-sex partners. CONCLUSIONS Students with same-sex experience are present at every type of college. College women with both-sex partners appear to be an appropriate target for health interventions; outreach to these students and further study of related behaviors are warranted.

Fruit and Vegetable Intake Correlates During the Transition to Young Adulthood

BACKGROUND During the transition from adolescence to young adulthood, the intake of fruit and vegetables tends to decline, and national survey data indicate that few young adults consume the recommended amounts. This study aimed to identify longitudinal correlates of follow-up fruit and vegetable intake in early young adulthood. METHODS Surveys and food frequency questionnaires were completed by 1495 adolescent participants in high school classrooms at baseline (in 1998-1999; mean age=15.9 years, SD=0.8) and by mail at follow-up (in 2003-2004; mean age=20.4 years, SD=0.8). In 2007, linear regression methods were used to identify baseline factors associated with follow-up fruit and vegetable intake. RESULTS Baseline taste preferences, perceived benefits of healthy eating, fast-food intake, time spent watching television, family-meal frequency, and home food availability were correlates of both fruit and vegetable intake during young adulthood across gender. After adjusting for baseline intake, the only correlate of both fruit and vegetable intake during young adulthood across gender was taste preferences. CONCLUSIONS The findings suggest that nutrition interventions for adolescents should provide opportunities for them to taste more fruit and vegetables, and should address supports for healthy eating both within and outside the home environment.

Family Meals and Substance Use: Is There a Long-Term Protective Association?

PURPOSE To examine 5-year longitudinal associations between family meal patterns and subsequent substance use in adolescents. METHODS A total of 806 Minnesota adolescents were surveyed in public schools in 1998-1999 (mean age, 12.8 years) and again by mail in 2003-2004 (mean age, 17.2 years) as part of a longitudinal population-based study. Logistic regression was used to estimate the odds of tobacco, alcohol, and marijuana use at follow-up for adolescents reporting regular family meals at baseline compared with those without regular family meals, adjusting for family connectedness and prior substance use. RESULTS Family meal frequency at baseline was associated with significantly lower odds of cigarette smoking, alcohol use, and marijuana use at follow-up among female adolescents, even after adjusting for baseline substance use and additional covariates. Family meals were not associated with use of any substance at follow-up for male adolescents after adjusting for baseline use. CONCLUSIONS Results from this study suggest that regular family meals in adolescence may have a long-term protective association with the development of substance use over 5 years among females. Parents should be encouraged to establish a pattern of regular family meals, as this activity may have long lasting benefits.