Division of Adolescent Health and Medicine, Department of Pediatrics, University of Minnesota, 717 Delaware Street SE, Minneapolis, MN 55414, USA.
J Adolesc Health. 2010 Jul;47(1):67-73. doi: 10.1016/j.jadohealth.2009.12.030. Epub 2010 Mar 15.
Use of disordered eating behaviors is common among adolescents, and cross-sectional research has suggested that friends may be an important influence, especially among females. The current study seeks to expand upon this literature using a longitudinal design and a large, diverse sample of male and female youth.
A total of 2,516 adolescents provided survey data at baseline (1998-1999) and follow-up (2003-2004) regarding their friends' involvement in dieting and their own experience of chronic dieting, unhealthy weight control, extreme weight control, and binge eating. General linear modeling was used to generate predicted probabilities of disordered eating at follow-up across four levels of friends' dieting at baseline, adjusting for baseline use of disordered eating, and other covariates. Interaction terms were used to determine whether the association between friends' dieting and disordered eating differed across age cohorts.
One-third of participants reported that their friends were "not at all" involved in dieting at baseline, and 8.8% reported that their friends were very involved in dieting. Friends' dieting at baseline was positively associated with chronic dieting, unhealthy weight control behaviors, extreme weight control behaviors, and binge eating 5 years later among females, and with extreme weight control behaviors five years later among males. For both males and females, these associations were similar across age groups.
Interventions targeting friendship groups rather than focusing solely on individuals may be an important strategy for the prevention of disordered eating. Health care providers may wish to ask adolescents about their friends' eating and dieting practices so as to address these issues in a clinical setting.
饮食失调行为在青少年中很常见,横断面研究表明,朋友可能是一个重要的影响因素,尤其是在女性中。本研究旨在使用纵向设计和大量不同性别和年龄的青少年样本,对这一文献进行扩展。
共有 2516 名青少年在基线(1998-1999 年)和随访(2003-2004 年)时提供了关于朋友参与节食以及自己长期节食、不健康的体重控制、极端体重控制和暴食的调查数据。使用一般线性模型,根据基线时的饮食失调使用情况和其他协变量,生成四个朋友节食水平的随访时饮食失调的预测概率。使用交互项来确定朋友节食和饮食失调之间的关联是否因年龄组而异。
三分之一的参与者报告说他们的朋友在基线时“一点也不”参与节食,8.8%的人报告说他们的朋友非常参与节食。基线时朋友的节食与女性五年后的长期节食、不健康的体重控制行为、极端体重控制行为和暴食,以及男性五年后的极端体重控制行为呈正相关。对于男性和女性来说,这些关联在不同年龄组之间是相似的。
针对友谊群体的干预措施而不是仅仅关注个体,可能是预防饮食失调的重要策略。医疗保健提供者可能希望询问青少年关于他们朋友的饮食和节食习惯,以便在临床环境中解决这些问题。