ERIC EJ833245: Middle School Students' Weight Perceptions, Dieting Behaviors, and Life Satisfaction

2008·0.13 MB·English

by  ERIC

Research Article
Middle School Students’ Weight Perceptions,
Dieting Behaviors, and Life Satisfaction
Laura Esch and Keith J. Zullig
ABSTRACT
Background: Previous research has posited that significant relationships exist between health status and psychologi-
cal measures of health (e.g., self-esteem). Less is known about the relationship between perceived quality of life (e.g.,
life satisfaction), weight perceptions, and dieting behaviors, particularly among middle school adolescents. Purpose:
This study investigated the association between weight perceptions and unhealthful dieting behaviors and overall life
satisfaction among middle school students. Methods: Separate models were created for 245 7th and 8th grade males
and females using the CDC’s 2005 Youth Risk Behavior Survey (YRBS). ANOVA analyses and Tukey Honest Signifi-
cant Difference (HSD) tests compared weight perceptions and dieting behaviors to overall life satisfaction. Results:
Females were significantly more likely to report reduced life satisfaction if reporting being overweight, eating less,
fasting, or taking diet pills to lose weight (effect sizes 0.96-5.80) (p<.01). Males were significantly more likely to report
reduced life satisfaction if reporting being overweight or fasting to lose weight (effect sizes 4.58-4.75) (p<.05). Discus-
sion: Unhealthful weight perceptions and dieting behaviors develop early in adolescence and impact life satisfaction.
Translation to Health Education Practice: Comprehensive educational programs for prevention and intervention of
weight misperceptions and unhealthful dieting are needed and must acknowledge gender differences.
BACKGROUND own appearance and their child’s appear- of psychological maturation, stress and
A struggle to comply with modern social, ance, and enforcement of food choices and anxiety build and adolescents may turn to
environmental, and psychological influences eating behaviors, parents may create an alcohol consumption, sexual intercourse,
on weight perceptions and dieting behaviors environment contributing to body dissatis- and violent behavior to cope with and adapt
has contributed to an increased prevalence faction problems.6-7 As young children age, to changes.11 An early onset of such risky be-
of weight-related health issues.1-4 Societal, peers and the media become more influen- haviors and the experience of significant life
peer, and parental pressures to achieve the tial on appearance as these factors reinforce
thin cultural norm can lead to impaired cultural weight ideals that attribute thinness
feelings of well-being, unhealthful weight with female attractiveness and success.7-9 Laura Esch is the assistant to the director of
control and food consumption behaviors, Young adolescents risk developing health education in the Department of Student
and poor body weight perceptions.5 Students disordered eating behaviors because this Health Services, Miami University, 102 Student
in the 4th and 5th grade have been shown to population is in a transitional period and Health Services, Oxford, OH 45056; E-mail:
be particularly vulnerable to parental influ- are learning to adjust to increased inde- [email protected]. Keith J. Zullig is an as-
ences on appearance and weight, especially pendence while attempting to resolve peer, sociate professor, Department of Community
female students. Through parental modeling relationship, gender identity, body image, Medicine, School of Medicine, West Virginia
of dieting behaviors, comments about their and weight conflicts.5,10,11 During this phase University, Morgantown, WV 26506.
American Journal of Health Education — November/December 2008, Volume 39, No. 6 345
Laura Esch and Keith J. Zullig
events at a young age, like parental illness or including fasting and taking diet pills, ments and enable individuals with diverse
disappointed educational expectations, are these behaviors are unhealthful weight loss values, experiences, and cultural ideas to rate
correlated with premature development of strategies. Such behaviors actually deter- their internal feelings of well-being based
weight dissatisfaction and low self-esteem.12 mine a later onset of disordered eating on personal perceptions of life satisfac-
For example, weight dissatisfaction and low practices, eating disorders, and weight gain tion.22 Desirable circumstances like positive
self-esteem impact females as they age and while negatively impacting physical and feelings of purpose, mastery, or self-regard
contribute to the misperceptions normal mental development.2,8,17 influence an individual’s reported feelings
weight women may have regarding being Weight regulating practices and disor- of life satisfaction.21,22 In adolescents specifi-
overweight.12 Despite attempts to make the dered eating behaviors have been shown to cally, constructive feelings about themselves,
transition to adolescence less complicated, a cause impairing physical and mental health school experiences, friends, family, and
number of young people still experience an consequences.4 Excess body weight in living environment positively influence
onset or continuation of unhealthful weight overweight and obese adolescents can limit life satisfaction reports.23-25Alternatively,
issues during adolescence. physical functioning and, if left unchecked, undesirable circumstances like poor weight
Weight control practices, including lead to disabling cardiovascular conditions, perceptions and unhealthful dieting issues
weight gain and weight loss, are prevalent diabetes, or chronic pain.4,5 Food binges, have been shown to be related to adolescent
in young adolescents. For example, The self-induced vomiting, and laxative abuse life dissatisfaction reports.26
National Health and Nutrition Examina- in those practicing certain weight control Although more objective Body Mass
tion Survey concluded the prevalence of behaviors can damage the digestive and Index (BMI) measurements of weight have
overweight 16-19 year olds increased from cardiac systems resulting in major physi- been associated with reduced life satisfaction
11% in 1988-1994 to 15% in 1999-2000, cal limitations.4,18 Mental health concerns, in both adolescents and adults,5,27,28 Burns
highlighting obesity as a primary health including feelings of depression, diminished et al.5 argue that subjective weight estimates
concern in young adolescents.1 The survey self-esteem, and impaired school and social have a greater impact on well-being than
also identified 31.2% of the 6-11 year olds functioning, were more frequently reported realistic weight assessments because, as
sampled as being at risk for becoming over- in overweight and obese adolescents ages observed by Csikszentmihalyi,29 subjective
weight or obese and specified 15.8% of the 12-14 than in their normal weight coun- experience is not just one of the dimensions
sample as overweight.1 On the other end of terparts.4,18 Underweight adolescents also of life, it is life itself. For example, two recent
the weight spectrum, a recent study of 9-14 reported mental health impairments from studies confirmed a significant relationship
year olds found 25% of girls and 13.8% preoccupations with food and body shape between negative self-perceived weight per-
of boys sampled were infrequent dieters and symptoms of anxiety, personality dis- ceptions, poor dieting behaviors, and self-
and 4.5% of girls and 2.2% of boys were orders, depression, co-morbidity disorders, reported life dissatisfaction in South Carolina
frequent dieters.8 Further, studies have also and low self-esteem.18 high school students and students from a
demonstrated body dissatisfaction in both More notably, reports of poor physical Midwestern university, respectively.26,30 In
girls13 and boys.14 However, it is difficult to and mental health are significantly related light of the elevated risk of negative weight
obtain a complete report on the frequency to adolescent quality of life (QOL). QOL perceptions and dieting behaviors in young
of adolescent dieters exhibiting more serious measurements assess general feelings of adults, the present study aimed to investigate
eating disorder issues. well-being and detail positivity in the physi- if such correlations were established prior to
The DSM-IV diagnostic criteria used to cal, psychological, and social domains of high school by sampling a population of 7th
clinically diagnose eating disorders pertains well-being.4,19 For instance, zullig et al.20 and 8th grade students. Although previous
to those at an advanced cognitive level, found that as adolescents reported more research has suggested a lower number of
making it developmentally challenging for poor physical and mental health days, female dieters in the 6th and 8th grades com-
young adolescents to describe and report their odds of reporting life dissatisfaction pared to the 10th grade, this study’s purpose
disordered eating behaviors.15 In addition, increased linearly. was to explore the effects of weight percep-
adolescents may exhibit disordered eat- QOL measurements are categorized into tions and dieting behaviors on life satisfac-
ing behaviors without receiving a clinical objective and subjective areas for appropri- tion in younger adolescents.10,12,31
diagnosis, thus contributing to an under- ate surveying. Objective QOL measurements
reporting of adolescent eating disorders.7 assess standard, external socioeconomic and PURPOSE
Researchers have suggested that disordered environmental conditions contributing to This study hypothesized that 7th and
eating practices lie on a continuum from well-being, such as income and access to 8th grade students reporting poor weight
normal eating behaviors to clinical eating health care, making objective conditions easy perceptions and dieting behaviors would
disorders.16 Despite the number of adoles- to compare across populations.21 Subjective report significantly reduced satisfaction
cents practicing weight control behaviors, QOL measurements refer to individual judg- with life.
346 American Journal of Health Education — November/December 2008, Volume 39, No. 6
Laura Esch and Keith J. Zullig
METHODS
Table 1. Sample Demographics of Student in Grade 7-8
Sample
in the Sample and National Distribution
During the spring of 2005, a convenience
sample of 245 7th and 8th grade students Characteristic Sample National
were selected from two public school dis- Distribution Distribution
tricts to participate - as one part of a larger (%) (%)
study investigating the test-retest reliability
Gender
of the 2005 Middle School YRBS (MSYRBS)
Male 45.3 51.2
from the CDC.32 Schools were selected to
Female 54.7 48.8
participate in the study based on previ-

ous work in curriculum deliberation and
program evaluation. Each school was given Grade
7 80.9 50.3
$250 to assist with student recruitment.
8 19.1 49.7
Classroom-level sampling was done with

second period classes to maximize student
eligibility. Table 1 presents the sample demo- Race
graphics of the students in this study. The White 93.5 76.7
Non-white 6.5 23.3
sample contained 136 females and 109

males. Most students reported being in 7th
grade and the majority of students were of Age
white race or ethnicity. The demograph- <11 1.7 3.1
ics of this sample were similar to national 12 to 13 90.9 80.9
distributions in gender and age, but not >14 7.4 16.0
for race or ethnicity or grade per the 2000
U.S. Census Bureau. Specifically, 7th grade
students reporting “white” race or ethnicity
their children to participate were required Table 2 contains each independent vari-
were overrepresented.
to sign and return the form, designating able and accompanying frequency counts for
Data Collection Procedures active consent to participate. The survey this study. Data from the nationally imple-
All data collection procedures were was administered in each school’s audito- mented YRBS reveals a very similar frequen-
approved by the referent university’s Hu- rium or cafeteria by trained data collectors cy of youth in grades 9 to 12 engaged in the
man Subjects Review Board. Following who emphasized anonymity, privacy, and same surveyed risk variables as the 7th and
methods from previous test-retest reliabil- confidentiality. During Time 1, data collec- 8th grade students in this study.36 The only
ity studies,33-35 two questionnaire scantrons tors reminded students that they would be significant differences in reports between
were coded with the same unique number returning to the school in two weeks to ask high school students and middle school stu-
ranging from 1 to 250. Each pair of identi- students to complete a similar question- dents were that a substantial number of high
cally numbered scantrons were then placed naire. school males and females reported being
into a single large envelope along with Instrumentation overweight, 25.1% of high school males and
the MSYRBS instrument and distributed The MSYRBS is a self-reported instru- 38.1% of high school females, and more high
to each student participant during Time ment. Four items request demographic in- school females (61%) reported attempting to
1. Each student then removed and used one formation; two items request student’s height lose weight compared to 47.79% of middle
scantron. The envelope containing only the and weight; and the remaining items query school females. 36
second identically numbered scantron was students on health risk behaviors. For this Dependent Variable
then sealed and signed across the seal by study, seven questions composed the inde- The dependent variable in this study was
the student. When survey administrators pendent variables of weight perceptions and measured using one question from the Brief
returned for Time 2 (14 days later), students dieting behavior resulting in moderate to Multidimensional Students’ Life Satisfaction
received their signed and sealed envelope, substantial reliability [Kappas 51.6-77.3]32 Scale (BMSLSS) querying students about
removed the second scantron, and destroyed for middle school students. These seven their overall life satisfaction and contained
the envelope. Parent-notification forms were weight perception and dietary behavior the following response options: (1) Terrible;
distributed at least seven days in advance of questions were exactly the same as the items (2) Unhappy; (3) Mostly dissatisfied; (4)
survey administration. Parents who wanted used on the national high school YRBS.36 Mixed-about equally satisfied and dissatis-
American Journal of Health Education — November/December 2008, Volume 39, No. 6 347
Laura Esch and Keith J. Zullig
fied; (5) Mostly satisfied; (6) Pleased; and (7)
Delighted.24,25 According to Huebner et al., 37 Table 2. Risk Variables and Frequencies
the psychometrically sound BMSLSS was de-
Risk Variable Males n (%) Females n (%)
veloped to measure overall life satisfaction of
adolescents across a wide range of ages (ages Self described weight
8-18) and levels of ability, yet be sufficiently About the right weight 26 (23.8) 39 (28.8)
brief and cost effective in large scale research Underweight 79 (72.5) 90 (66.1)
efforts. The BMSLSS contains one domain Overweight 4 (3.7) 7 (5.1)
from the longer 40-item Multidimensional
Students’ Life Satisfaction Scale (MSLSS).38
Attempts to control weight
The domains are satisfaction with school, Stay the same weight 29 (26.6) 38 (28.0)
friends living environment, family, self, and Lose weight 32 (29.3) 65 (47.8)
the optional overall life satisfaction item used Gain weight 20 (18.4) 4 (2.9)
for this study. Not trying to do anything 28 (25.7) 29 (21.3)
Although the other BMSLSS domains
were not available for the present study,
Exercised to lose weight
previous research validating the scale has Yes 61 (56.0) 97 (71.3)
shown the overall life satisfaction item to No 48 (44.0) 39 (28.7)
correlate highly with the other five pooled
BMSLSS domains where between 49-64%
Ate less to lose weight
of the variance in overall adolescent life
Yes 30 (27.5) 71 (52.2)
satisfaction reports was explained by the
No 79 (72.5) 65 (47.8)
other domains.24,25 In addition, the BMSLSS
scale alpha coefficient has been reported as
Fasted to lose weight
.75 among middle and high school students.
Yes 8 (7.3) 23 (16.9)
24 Inclusion of the overall life satisfaction
No 101 (92.7) 113 (83.1)
item raised the alpha coefficient to .85,39

suggesting the overall item is acceptable
Used diet pills, powders, or liquids to lose weight
for research purposes. Table 3 contains the
Yes 6 (5.5) 10 (7.3)
frequency counts for the overall life satisfac-
No 103 (94.5) 126 (92.7)
tion variable.

Data Analysis
Vomited or used laxatives to lose weight
Time 1 survey administrations from each
Yes 2 (1.8) 13 (9.6)
of the participating schools were combined
No 107 (98.2) 123 (90.4)
for analysis. Of the 402 students selected to
participate in this study, 249 (62%) complet-
ed the questionnaire during the first survey
administration. Of these 249 students, 98% Table 3. Life Satisfaction Self-Report Frequencies
(n = 245) provided complete information
on all items. Males Females
The seven questions on weight percep- Degree of Life Satisfaction n (%) n (%)
tions and dieting behaviors were examined
Terrible 4 (3.7) 1 (0.7)
through a series of one-way ANOVAs and
Unhappy 2 (1.8) 2 (1.5)
Tukey Honest Significant Difference (HSD)
tests using PCSAS. Overall life satisfaction Mostly Dissatisfied 5 (4.6) 3 (2.2)
served as the dependent variable. Effect size
Mixed 16 (14.7) 34 (25.0)
(ES) was also calculated from the post-hoc
Mostly Satisfied 16 (14.7) 29 (21.3)
comparisons to determine the magnitude
of specific comparisons by dividing the Pleased 26 (23.8) 33 (24.3)
mean difference by the pooled standard
Delighted 40 (36.7) 34 (25.0)
deviation. Effect size values indicate the
348 American Journal of Health Education — November/December 2008, Volume 39, No. 6
Laura Esch and Keith J. Zullig
magnitude of observed differences and, in a detected for females who reported eating likely to report dissatisfaction with life. In
practical sense, show the size of differences less food or fewer calories to lose weight (F addition, observed effect sizes confirm that
between means. Effect sizes of .20, .50, and (1,134) = 6.34, p<.01) (M = 5.08, SD = 1.23) the observed differences are all large and
.80 indicate small, medium, and large effects, when compared to females who did not (M = carry practical significance.
respectively. 40 Small effect sizes are generally 5.64, SD = 1.32) (ES = 1.14). No significant This was the first study to both examine
not conceived as being practically important, findings were detected for males. and demonstrate a relationship between
whereas medium and large effects are under- middle school students’ self-reported life
Fasted to Lose Weight
stood as being important. satisfaction and unhealthful weight per-
Significantly reduced life satisfaction was
Separate models were created for males ceptions and dieting behaviors. The study
detected for females who reported fasting for
and females owing to observed differ- supplements prior research supporting a
24 hours or more to lose weight (F (1,134) =
ences between males and females in previous significant relationship between life sat-
10.86, p<.001) (M = 4.55, SD = 1.30) when
weight perception, dieting behavior, and isfaction, weight perceptions, and dieting
compared to females who did not (M = 5.51,
life satisfaction research among both high behaviors in both high school students26 and
SD = 1.24) (ES = 0.96). Significantly reduced
school students26 and college students. 30 college students.30 Examining the common
life satisfaction was also detected for males
variables of these three studies confirms
who reported fasting for 24 hours or more
RESULTS an association between life dissatisfaction
to lose weight (F (1,108) = 4.14, p<.05)
and unhealthful weight perceptions and
Self-Described Weight (M = 4.50, SD = 1.20) when compared to
poor dieting behaviors, which starts at a
Significantly reduced life satisfaction males who did not (M = 5.65, SD = 1.56)
young age and continues at least through
was detected for females who reported (ES = 4.58).
the college years. The relationship appears
their weight as overweight (F (2,133) =
Used Diet Pills, Powders, or Liquids
to become more expansive, encompassing
6.61, p<.001) (M = 3.86, SD = 1.36) when
to Lose Weight
a greater range of weight perceptions and
compared to females who reported being
Significantly reduced life satisfaction was
dieting behaviors over time. For example,
underweight (M = 5.55, SD = 1.19) (ES =
detected for females who reported using
with increasing age female reports of ad-
3.31) and about the right weight (M = 5.15,
diet pills, powders, or liquids to lose weight
ditional behaviors, like attempting to lose
SD = 1.37) (ES = 2.53). Significantly reduced
(F (1,134) = 11.23, p<.001) (M = 4.00, SD
weight, vomiting to lose weight, and describ-
life satisfaction was also detected for males
= 1.22) when compared to females who
ing oneself as underweight, become related
who reported their weight as overweight (F
did not (M = 5.45, SD = 1.25) (ES = 5.80).
to life dissatisfaction26,30 and as males age,
(2,107) = 4.32, p<.05) (M = 3.33, SD = 1.91)
No significant findings were detected for
perceptions of being underweight, vomit-
when compared to males who reported be-
males.
ing/using laxatives, and taking diet pills to
ing underweight only (M = 5.75, SD = 1.55)
Vomited or Used Laxatives lose weight become related to reports of life
(ES = 4.75).
to Lose Weight dissatisfaction.26,30
Attempts to Control Weight
Finally, although a hypothesized trend Related to the above, this study maintains
Although a hypothesized trend in re-
in reduced life satisfaction was detected as that females are more likely to report poor
duced life satisfaction was detected as stu-
students reported ‘yes’ and ‘no’ to vomiting dieting behaviors and further supports the
dents moved from reporting ‘trying to stay
or using laxatives to lose weight, the relation- influence of gender on variation in reported
the same’ to ‘lose weight’ to ‘gain weight’ for
ship did not achieve statistical significance weight perceptions and dieting behaviors26,30
both males and females, the relationship did
for both males and females (F (1,109) = while suggesting that these findings may not
not achieve statistical significance for both
0.27, p=.61 and F (1,134) = 3.50, p=.06, be limited to American youth. For instance,
males and females (F (2,107) = 0.39, p=.69
respectively). in a study of 11-16 year olds in Portugal,
and F (2,133) = 0.91, p=.40, respectively).
Portuguese girls reported more dieting than
Exercised to Lose Weight DISCUSSION Portuguese boys.27 In the present study, self
Again, although a hypothesized trend in This was a cross-sectional study exploring perceptions of being overweight (males and
reduced life satisfaction was detected as stu- the association between self-reported overall females), eating less to lose weight (females),
dents reported ‘yes’ and ‘no’ to this question, life satisfaction and weight perceptions and fasting for 24 hours or more to lose weight
the relationship did not achieve statistical
dieting behaviors among a sample of 7th (males and females), and taking diet pills
significance for both males and females (F
and 8th grade middle school students. Re- (females) were associated with reported
(1,109) = 0.00, p=.99 and F (1,134) = 3.18,
sults indicated a portion of students in this life dissatisfaction. In a study conducted by
p=.07, respectively).
sample reported poor weight perceptions, a Neumark-Sztainer,2 the most overweight
Ate Less to Lose Weight substantial number practiced risky dieting adolescent females were at the highest risk
Significantly reduced life satisfaction was behavior, and that these students were more of practicing extremely unhealthful weight
American Journal of Health Education — November/December 2008, Volume 39, No. 6 349
Laura Esch and Keith J. Zullig
control behaviors and were more likely dieting behaviors, and life satisfaction. In study, in combination with other discussed
to report decreased life satisfaction. The this study, the use of self-reports is sup- literature, is beginning to unfold the nature
most underweight and most overweight ported by previous research authenticating and development of disordered eating and
males reported the highest number of self-reports for objective data collection and its relationship to life satisfaction levels. This
extreme weight control behaviors. In ad- MSYRBS Kappas values showing moderate relationship has now been confirmed in
dition, Swallen et al.5 determined an onset reliability and validity.32,41 However, factors middle school students and is shown to con-
of weight controlling behaviors in 12-14 like recollection of events, social desir- tinue in high school and through college, but
year olds correlated with life dissatisfaction ability, and questionnaire administration available evidence suggests intervention ef-
as overweight and obese adolescents were in a peer group setting have the potential forts may be conducted in the middle school
significantly more likely to be depressed, to influence the validity of self-reported years or earlier for the greatest impact.
have low self-esteem, and function poorly data.42 For example, social desirability may
in school and social environments when sway younger students to overestimate traits TRANSLATION TO HEALTH
compared to 12-14 year olds with a normal that are deemed desirable while underesti- EDUCATION PRACTICE
BMI. These findings further emphasize a mating undesirable health-related traits in In addition to the apparent need for
need to acknowledge gender when aiming to self-reports.43 comprehensive disordered eating prevention
deter the development of unhealthful weight A second limitation of this study is programs acknowledging gender differences
perceptions and poor dieting behaviors in related to the convenience sample used. and parental influences, weight-related mis-
adolescents, which can contribute to more However, the validity of this sample’s self perceptions and health problems are also
serious disordered eating behaviors and life reports is supported by national high school attributed to underlying cultural, social, and
satisfaction issues later in life.17,26,30 data collected by Eaton et al.36 and addi- medical factors. For example, one explana-
The combined findings suggest efforts tional studies consistent with this study’s tion for the increase in such weight and diet-
to curtail poor weight perceptions and independent variable results. Neumark- ing issues may be correlated with adolescent
unhealthful dieting behaviors should con- Sztainer2 determined 56.9% of adolescent weight management education.44 The 2000
centrate on early, concrete life events and females sampled engaged in unhealthful School Health Policies and Program Study
influences. A study of 6th, 8th, 9th, and weight control behaviors, such as fasting (SHPPS) assessed the health education
10th grade females identified 9th grade and skipping meals, while another 12.4% policies applied in kindergarten through
as the fundamental year when influences of females sampled displayed disordered grade 12. A nationally representative sample
on disordered eating shift from concrete eating behaviors, including taking diet pills, provided information on the number of
events like menarche and dating status to using laxatives, and vomiting in attempt to schools that offered at least one required
more psychological and abstract issues.31 control weight. Weight control behaviors course covering topics and skills related to
This may explain why QOL evaluations differed across gender with 32.7% of adoles- nutrition and dietary behaviors.44
actually decline with age as 15-17 year old cent males sampled practicing unhealthful Nationally, 86.9% of all schools covered
overweight and obese adolescents were more weight control behaviors and 4.6% reporting the topic “accepting body size differences”
likely to be depressed or have low self-esteem disordered eating behaviors.2 Neumark- with 88.5% of elementary schools, 82.9%
when compared to younger adolescents.4 Sztainer’s2 frequencies compare to the data of middle/junior high schools, and 87.7%
Menarche and dating status predicted simple from the present study in that 69.12% of of senior high schools discussing body size.
dieting in 6th and 8th graders, but current
adolescent females practiced unhealthful However, the topic of “eating disorders” was
body shape predicted dieting participation
weight control behaviors, including eating only covered by 51.2% of all schools, includ-
in 10th graders.31 Primary caregivers and
less or fasting to lose weight, and 16.92% ing 30.1% of elementary schools, 74.2%
parents may also contribute to or protect a
of females displayed disordered eating of middle/junior high schools, and 90.7%
young adolescent from developing negative
behaviors of using diet pills or vomiting. of senior high schools. The topic of “risks
weight perceptions and dieting behaviors
Of the 7th and 8th grade males sampled of unhealthy weight control” was taught
with the sort of home environment they
in this study, 35.64% reported practicing by 69.2% of all schools, including 57.1%
create.2 Teaching parents how to implement
unhealthful weight control behaviors and of elementary schools, 81.1% of middle/
and practice healthy eating behaviors and
7.33% reported disordered eating behaviors. junior high schools, and 94.2% of senior
abstain from openly dieting, encouraging di-
Still, this sample may not be considered high schools.44 It may be suggested that ad-
eting, or focusing on weight can help prevent
representative of the national geographic ditional attention also be given to advancing
disordered eating in adolescents.17
population, particularly with ethnicity and the 57.4% of all schools currently teaching
Limitations age characteristics. the skill “resisting peer pressure related to
The MSYRBS relies on self-reports to Finally, a cross-sectional study design unhealthy dietary behavior.”
obtain measurements of weight perceptions, does not imply causality. Nevertheless, this Not all schools implement health edu-
350 American Journal of Health Education — November/December 2008, Volume 39, No. 6
Laura Esch and Keith J. Zullig
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