| 其他摘要 | Unhealthy weight control behaviors are common among adolescents in China and many industrialized countries. Since different studies have different operational definitions of unhealthy weight control behaviors and most of them are cross-sectional studies, the profile and progress of unhealthy weight control behaviors, risk factors and consequences among adolescents in China are still unclear. One aim of the current study was to investigate the developmental trajactory, sex differences, and risk factors of unhealthy weight control behaviors among middle and high school students in Dandong city with the unhealthy weight control behavior scale developed by our group. The other aim of this study was to investigate the prediction ability of sociocultural attitudes toward appearance on later unhealthy weight control behaviors of adolescents, as well as the consequences of unhealthy weight control behaviors in Dandong city through a longitudinal study.In Study 1, 1182 students from Grade 7 to 12 in Dandong city were enrolled. Categories and frequencies of potential unhealthy weight control behavior, perceived weight status, sociocultural attitudes toward appearance and level of intuitive eating were measured. Unhealthy weight control behaviors were common among participants, and the proportion of girls adopted unhealthy weight control behaviors was significantly larger than that of boys (Z=-3.073, p<0.05). From Grade 7 to 12, the total score of unhealthy weight control behaviors and the number of categories of unhealthy weight control behaviors adopted by boys did not change significantly, while both measures increased in girls with the grade raised, except for the two graduation grades (Grades 9 and 12). “Skipping the meal” and “eating less” were two unhealthy weight control behaviors most frequently adopted by both male and female students in both middle and high school students. As compared to middle school students, high school students were more likely to “drink coffee” and “use substitute food” to control weight. Risk factors for unhealthy weight control behavior in boys were slightly different from those in girls. Perceived weight, intuitive eating, negative emotion, objectification and sociocultural attitudes toward appearance contributed to the severity of unhealthy weight control behavior in boys. All of these variables, except for perceived weight were significant in girls. For both boys and girls, severity of unhealthy weight control behaviors was most strongly influenced by sociocultural attitudes toward appearance. When controlling related variables, peer pressure had a significant influence on boys’ severity of unhealthy weight control behaviors, while family pressure and peer pressure (in a trend; p=0.092) showed such influence in girls. In Study 2, 350 students participated in Study 1 were followed up for six months to examine the prediction effects of sociocultural attitudes toward appearance on the unhealthy weight control behaviors. In both male and female students, the level of sociocultural attitudes at the baseline could significantly predict the severity of unhealthy weight control behaviors during retest. Sex difference was observed when considering the influence of the five domains of sociocultural factors, namely muscle internalization, thin internalization, media pressure, family pressure and peer pressure, on later development of unhealthy weight control behaviors. For boys, the media pressure at the baseline could predict the level of unhealthy weight control behaviors during retest; while thin internalization and family pressure could predict the level of unhealthy weight control behaviors during retest in girls. In order to examine the change of sociocultural attitude toward appearance to the unhealthy weight control behaviors, level of sociocultural factors at the baseline was controlled. It turned out that the media pressure during retest could also significantly predict the level of unhealthy weight control behavior in boys; while thin internalization during retest had a significant impact on girls' level of unhealthy weight control behaviors. Furthermore, the difference score of unhealthy weight control behavior between the two test sessions could positively predict the level of negative emotions during the retest in boys and girls. In addition, the change of unhealthy weight control behaviors could also significantly predict the BMI of boys during retest, namely every 1-point increase of unhealthy weight control behavior was associated with an increase of 0.21kg/m2 in BMI.In conclusion, this study revealed that unhealthy weight control behaviors are common among adolescents in Dandong, and the situation is more severe in girls than in boys. Moreover, the level and number of categories of unhealthy weight control behaviors among girls show an increase trend with grades, while no such change was observed in boys. For boys, peer pressure was closely associated with concurrent level of unhealthy weight control behavior, but media pressure and its change could predict the level of unhealthy weight control behaviors six month later. For girls, family and peer pressure could predict concurrent level of unhealthy weight control behaviors, while family pressure and change of thinness internalization during two tests could predict unhealthy weight control behaviors six month later. The findings of this study provide a theoretical basis for the prevention and intervention of unhealthy weight control behaviors among Chinese adolescents. |
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