Marla E. Eisenberg

Body dissatisfaction from adolescence to young adulthood: Findings from a 10-year longitudinal study

Given mixed findings regarding the unique trajectories of female and male adolescents body dissatisfaction over time, comprehensive longitudinal examinations are needed. This 10-year longitudinal, population-based study, with 1902 participants from diverse ethnic/racial and socioeconomic backgrounds in the Minneapolis/St. Paul metropolitan area, examined changes in body dissatisfaction from adolescence to young adulthood. Results revealed that: (a) female and male participants body dissatisfaction increased between middle and high school, (b) body dissatisfaction increased further during the transition to young adulthood, and (c) this increase was associated with an increase in BMI over time, such that the upward trend in body dissatisfaction became nonsignificant when BMI was controlled. These results highlight a trend in which diverse female and male youth are increasingly dissatisfied with their bodies as their BMI increases from middle school to young adulthood, and emphasize the need for targeted prevention efforts to intervene in this trajectory and mitigate potential harm.

Multiple Types of Harassment: Associations With Emotional Well-Being and Unhealthy Behaviors in Adolescents

PURPOSEnTo explore relationships between harassment (i.e., race-, weight-, socioeconomic-status (SES)-based, and sexual) and health-related outcomes, including self-esteem, depressive symptoms, body satisfaction, substance use, and self-harm behavior, among diverse adolescents.nnnMETHODnCross-sectional analysis using data from a population-based study of adolescents participating in Eating and Activity in Teens 2010 (EAT 2010) (n = 2,793; mean age = 14.4 years). Sample was socioeconomically and racially/ethnically diverse (81% racial/ethnic minority; 54% low or low-middle income).nnnRESULTSnHaving experienced any type of harassment was significantly associated with poor self-esteem, depressive symptoms, low body satisfaction, substance use, and self-harm behaviors. After mutually adjusting for other types of harassment, weight-based harassment was consistently associated with lower self-esteem and lower body satisfaction in both genders (standardized βs ranged in magnitude from .39 to .48); sexual harassment was significantly associated with self-harm and substance use in both genders (ORs: 1.64 to 2.92); and both weight-based and sexual harassment were significantly associated with depressive symptoms among girls (standardized βs = .34 and .37). Increases in the number of different harassment types reported by adolescents were associated with elevated risk for alcohol, cigarette, and marijuana use, and self-harm (ORs: 1.22 to 1.42) as well as emotional well-being (standardized βs: .13 to .26).nnnCONCLUSIONSnHaving had any harassment experience was significantly associated with a variety of negative health and well-being outcomes among adolescents, and risk for these outcomes increases with the number of harassment types an adolescent experiences. Early detection and intervention to decrease harassment experiences may be particularly important in mitigating psychological and behavioral harm among adolescents.

What's for dinner? Types of food served at family dinner differ across parent and family characteristics.

OBJECTIVEnTo examine the types of food served at family dinner in the homes of adolescents and correlations with parent and family sociodemographic characteristics, psychosocial factors and meal-specific variables.nnnDESIGNnA cross-sectional population-based survey completed by mail or telephone by parents participating in Project F-EAT (Families and Eating and Activity in Teens) in 2009-2010.nnnSETTINGnHomes of families with adolescents in Minneapolis/St. Paul urban area, MN, USA.nnnSUBJECTSnParticipants included 1923 parents/guardians (90·8% female; 68·5% from ethnic/racial minorities) of adolescents who participated in EAT 2010.nnnRESULTSnLess than a third (28%) of parents reported serving a green salad at family dinner on a regular basis, but 70% reported regularly serving vegetables (other than potatoes). About one-fifth (21%) of families had fast food at family dinners two or more times per week. Variables from within the sociodemographic domain (low educational attainment) psychosocial domain (high work-life stress, depressive symptoms, low family functioning) and meal-specific domain (low value of family meals, low enjoyment of cooking, low meal planning, high food purchasing barriers and fewer hours in food preparation) were associated with lower healthfulness of foods served at family dinners, in analyses adjusted for sociodemographic characteristics.nnnCONCLUSIONSnThere is a need for interventions to improve the healthfulness of food served at family meals. Interventions need to be suitable for parents with low levels of education; take parent and family psychosocial factors into account; promote more positive attitudes toward family meals; and provide skills to make it easier to plan and prepare healthful family meals.

Parent conversations about healthful eating and weight associations with adolescent disordered eating behaviors

IMPORTANCEnThe prevalence of weight-related problems in adolescents is high. Parents of adolescents may wonder whether talking about eating habits and weight is useful or detrimental.nnnOBJECTIVEnTo examine the associations between parent conversations about healthful eating and weight and adolescent disordered eating behaviors.nnnDESIGNnCross-sectional analysis using data from 2 linked multilevel population-based studies.nnnSETTINGnAnthropometric assessments and surveys completed at school by adolescents and surveys completed at home by parents in 2009-2010.nnnPARTICIPANTSnSocioeconomically and racially/ethnically diverse sample (81% ethnic minority; 60% low income) of adolescents from Eating and Activity in Teens 2010 (EAT 2010) (nu2009=u20092793; mean age, 14.4 years) and parents from Project Families and Eating and Activity in Teens (Project F-EAT) (nu2009=u20093709; mean age, 42.3 years). EXPOSURE Parent conversations about healthful eating and weight/size.nnnMAIN OUTCOMES AND MEASURESnAdolescent dieting, unhealthy weight-control behaviors, and binge eating.nnnRESULTSnMothers and fathers who engaged in weight-related conversations had adolescents who were more likely to diet, use unhealthy weight-control behaviors, and engage in binge eating. Overweight or obese adolescents whose mothers engaged in conversations that were focused only on healthful eating behaviors were less likely to diet and use unhealthy weight-control behaviors. Additionally, subanalyses with adolescents with data from 2 parents showed that when both parents engaged in healthful eating conversations, their overweight or obese adolescent children were less likely to diet and use unhealthy weight-control behaviors.nnnCONCLUSIONS AND RELEVANCEnParent conversations focused on weight/size are associated with increased risk for adolescent disordered eating behaviors, whereas conversations focused on healthful eating are protective against disordered eating behaviors.

Intuitive eating in young adults. Who is doing it, and how is it related to disordered eating behaviors?

Intuitive eating (i.e., reliance on physiologic hunger and satiety cues to guide eating) has been proposed as a healthier, more effective, and more innate alternative to current strategies of weight management. The current study explored intuitive eating among young adults according to socio-demographic characteristics and body mass index (BMI), and examined associations between intuitive and disordered eating behaviors. Data were drawn from Project EAT-III, a population-based study of 2287 young adults (mean age: 25.3 years). More males reported trusting their bodies to tell them how much to eat than did females. Intuitive eating was inversely associated with BMI in both genders. Males and females who reported trusting their body to tell them how much to eat had lower odds of utilizing disordered eating behaviors compared to those that did not have this trust. Females who reported that they stop eating when they are full had lower odds of chronic dieting and binge eating than those who do not stop eating when full. Overall, this study found that intuitive eating practices are inversely associated with a number of harmful outcomes. Clinicians should discuss the concept of intuitive eating with their young adult patients to promote healthier weight-related outcomes.

Weightism, Racism, Classism, and Sexism: Shared Forms of Harassment in Adolescents

PURPOSEnTo document the prevalence of harassment on the basis of weight, race/ethnicity, and socioeconomic status, as well as sexual harassment, among a diverse population of adolescents. Specifically, this study examined rates of each type of harassment reported across groups within the corresponding sociodemographic category (e.g., racial/ethnic category differences in prevalence of racial harassment), and also explored patterns of cross-harassment (i.e., differences in prevalence of each harassment type across all other sociodemographic characteristics).nnnMETHODSnWe used data from Project Eating and Activity in Teens 2010 for the study. The sample was composed of 2,793 adolescents (53% female; 81% nonwhite). We conducted regression analyses to yield prevalence estimates of each type of harassment in each demographic and body mass index category.nnnRESULTSnWeight- and race-based harassment (35.3% and 35.2%, respectively) was most prevalent, followed by sexual harassment (25.0%) and socioeconomic status-based harassment (16.1%). Overweight and obese adolescents reported disproportionately higher rates of all forms of harassment than did normal-weight and underweight adolescents. In addition, Asian and mixed-/other race adolescents were more vulnerable to harassment overall compared with those from other racial/ethnic groups.nnnCONCLUSIONSnHarassment experiences are prevalent among adolescent boys and girls. Differential rates of each type of harassment are reported across groups within the corresponding sociodemographic category, but a pattern of cross-harassment also is evident, such that differences in prevalence of each type of harassment emerge across a variety of sociodemographic characteristics. Adolescents from various intersecting sociodemographic and weight-status groups are particularly vulnerable to certain types of harassment.

Weight-related teasing in the school environment: associations with psychosocial health and weight control practices among adolescent boys and girls.

Weight-related teasing has been found to be associated with low self-esteem, depressive symptoms, body dissatisfaction, and weight control behaviors in adolescents. While research has typically examined weight-related teasing directed towards the individual, little is known about weight-related teasing at the school level. This study aimed to determine the association between the school-level prevalence of weight-related teasing and psychosocial factors, body dissatisfaction and weight control behaviors in adolescents. Adolescents (Nxa0=xa02,793; 53.2xa0% female) attending 20 US public middle and high schools were surveyed as part of the Eating and Activity in Teens (EAT) 2010 study. Generalized estimating equations were used to estimate the association between school-level weight-related teasing and health variables, controlling for individual-level weight-related teasing, clustering of individuals within schools, and relevant covariates. A greater school-level prevalence of weight-related teasing was associated with lower self-esteem and greater body fat dissatisfaction in girls, and greater depressive symptoms in boys, over and above individual-level weight-related teasing. Dieting was associated with the school-level prevalence of weight-related teasing in analysis adjusted for covariates in girls, but not following adjustment for individual-level weight-related teasing. Unhealthy weight control behaviors, extreme weight control behaviors, and muscle-enhancing behaviors were not associated with the school-level prevalence of weight-related teasing in girls or boys. Findings from the current study, in conjunction with previous findings showing associations between weight-related teasing, psychological concerns, and weight control behaviors, highlight the importance of implementing strategies to decrease weight-related teasing in schools.

The unique and additive associations of family functioning and parenting practices with disordered eating behaviors in diverse adolescents

To examine the unique and additive associations of family functioning and parenting practices with adolescent disordered eating behaviors (i.e., dieting, unhealthy weight control behaviors, binge eating). Data from EAT (Eating and Activity in Teens) 2010, a population-based study assessing eating and activity among racially/ethnically and socio-economically diverse adolescents (nxa0=xa02,793; mean agexa0=xa014.4, SDxa0=xa02.0; age rangexa0=xa011–19) was used. Logistic regression models were used to examine associations between adolescent dieting and disordered eating behaviors and family functioning and parenting variables, including interactions. All analyses controlled for demographics and body mass index. Higher family functioning, parent connection, and parental knowledge about child’s whereabouts (e.g. who child is with, what they are doing, where they are at) were significantly associated with lower odds of engaging in dieting and disordered eating behaviors in adolescents, while parent psychological control was associated with greater odds of engaging in dieting and disordered eating behaviors. Although the majority of interactions were non-significant, parental psychological control moderated the protective relationship between family functioning and disordered eating behaviors in adolescent girls. Clinicians and health care providers may want to discuss the importance of balancing specific parenting behaviors, such as increasing parent knowledge about child whereabouts while decreasing psychological control in order to enhance the protective relationship between family functioning and disordered eating behaviors in adolescents.

Disparities in Weight and Weight Behaviors by Sexual Orientation in College Students.

Objectives. We assessed disparities in weight and weight-related behaviors among college students by sexual orientation and gender. Methods. We performed cross-sectional analyses of pooled annual data (2007-2011; nu2009=u200933u2009907) from students participating in a Minnesota state-based survey of 40 two- and four-year colleges and universities. Sexual orientation included heterosexual, gay or lesbian, bisexual, unsure, and discordant heterosexual (heterosexuals engaging in same-sex sexual experiences). Dependent variables included weight status (derived from self-reported weight and height), diet (fruits, vegetables, soda, fast food, restaurant meals, breakfast), physical activity, screen time, unhealthy weight control, and body satisfaction. Results. Bisexual and lesbian women were more likely to be obese than heterosexual and discordant heterosexual women. Bisexual women were at high risk for unhealthy weight, diet, physical activity, and weight control behaviors. Gay and bisexual men exhibited poor activity patterns, though gay men consumed significantly less regular soda (and significantly more diet soda) than heterosexual men. Conclusions. We observed disparities in weight-, diet-, and physical activity-related factors across sexual orientation among college youths. Additional research is needed to better understand these disparities and the most appropriate intervention strategies to address them.

Social Norms in the Development of Adolescent Substance Use: A Longitudinal Analysis of the International Youth Development Study

Identifying specific aspects of peer social norms that influence adolescent substance use may assist international prevention efforts. This study examines two aggregated measures of social norms in the school setting and their predictive association with substance (alcohol, tobacco and marijuana) use 2xa0years later in a large cross-national population-based cohort of adolescents. The primary hypothesis is that in Grade 7 both “injunctive” school norms (where students associate substance use with “coolness”) and “descriptive” norms (where student substance use is common) will predict Grade 9 substance use. Data come from the International Youth Development Study, including 2,248 students (51.2xa0% female) in the US and Australia attending 121 schools in Grade 7. Independent variables included injunctive norms (aggregating measures of school-wide coolness ratings of each substance use) and descriptive norms (aggregating the prevalence of school substance use) in Grade 7. Dependent variables included binge drinking and current use of alcohol, tobacco and marijuana in Grade 9. Associations between each type of school-wide social norm and substance use behaviors in Grade 9 were tested using multilevel logistic regression, adjusting for covariates. In unadjusted models, both injunctive and descriptive norms each significantly predicted subsequent substance use. In fully adjusted models, injunctive norms were no longer significantly associated with Grade 9 use, but descriptive norms remained significantly associated with tobacco and marijuana use in the expected direction. The findings identify descriptive social norms in the school context as a particularly important area to address in adolescent substance use prevention efforts.