NEW YORK (Reuters Health) - Nearly one in five adolescent girls who are very overweight may resort to extreme weight-control measures such as diet pills, laxatives, diuretics or vomiting, according to a new study.

As obesity rates among US teens and adults continue to climb, experts are worried that many young people are ill-equipped to sensibly control their weight. And with the social pressure to be thin, many may resort to unhealthy means to shed excess pounds.

In the new report, Dr. Dianne Neumark-Sztainer of the University of Minnesota in Minneapolis and colleagues call for prevention strategies that address the different aspects of weight control among teens.

"For example, within interventions for overweight adolescents, there is a need to address body image issues and unhealthy dieting behaviors in addition to focusing on changes in eating and physical activity behaviors," they write in the February issue of the Archives of Pediatrics and Adolescent Medicine.

The researchers base their conclusions on their evaluation of more than 4,700 junior high and high school students in Minnesota. Height and weight measurements were collected and a range of weight-related concerns were addressed in a survey.

Overall, the authors report, healthy weight control practices such as decreasing fat intake were more common than less healthy means such as skipping meals or extreme measures such as self-induced vomiting.

Nevertheless, many overweight and normal-weight students reported unhealthy or extreme weight-control tactics. Roughly 18% of very overweight and 16% of moderately overweight girls said they had ever resorted to measures such as vomiting and taking diet pills or laxatives. The same was true of about 6% of very overweight and 5% of moderately overweight boys.

The investigators also found that, on average, about 57% of overweight girls and 30% of overweight boys skipped meals, and between 10% and 20% of these students reported binge eating.

"The high prevalence of binge eating and unhealthy or extreme weight control behaviors exhibited by overweight youth (especially by overweight girls) demonstrates a need to also address these behaviors within interventions for overweight youth," Neumark-Sztainer and colleagues write.

With regard to healthy weight-control measures, between 80% and 90% of the moderately overweight and very overweight boys and girls reported exercising, and most said that they had reduced fat intake, and were eating more fruits and vegetables and fewer sweets.

However, the researchers note, many teens who say they are taking these prudent approaches "may not be implementing them adequately."

"The high prevalence and co-occurrence of obesity and unhealthy weight control behaviors found in this study suggest that there is a need for interventions that address the broad spectrum of weight-related disorders," the authors conclude.

SOURCE: Archives of Pediatrics and Adolescent Medicine 2002;156:171-178.

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