The relationship between body mass index and unhealthy weight control behaviors among adolescents: The role of family and peer social support

Adolescents classified as overweight or obese are more likely to use unhealthy weight control behaviors such as skipping meals or fasting than their healthy weight peers. Adolescents with low perceived social support may be at particular risk. Therefore, the purpose of the present study was to investigate the association between adolescent overweight and obesity, indices of perceived peer and family social support, and their interaction in the use of unhealthy weight control behaviors among adolescents. The present study used data from the 2001–2002 Health Behavior in School-Aged Children collaborative survey. Participants included 4598 adolescent girls and boys in the ninth and tenth grades. Results of binary logistic regression analyses showed that obese boys and girls were more likely to use unhealthy weight control behaviors than their healthy weight peers. Boys and girls who endorsed difficult communication with their parents, low levels of parent school support, or frequent bullying were more likely to engage in unhealthy weight control behaviors than relevant comparison groups. Among girls, poor classmate relationships were associated with increased use of unhealthy weight control behaviors whereas fewer friendships were associated with decreased use. Results suggest that adolescents are at high risk for use of unhealthy weight control behaviors and would benefit from interventions to increase knowledge and social support for achieving and maintaining a healthy weight.

► Unhealthy weight control behaviors (UWCBs) are common among adolescents.
► UWCBs were associated with BMI classification and indices of low parent support.
► Bullying and poor classmate relations were associated with increased UWCBs.
► The effects of BMI classification were independent and not offset by social support.
► Interventions to promote healthy weight control behaviors are needed.