Journal of Child and Family Studies

, Volume 15, Issue 4, pp 418–432 | Cite as

Characteristics of Dieting and Nondieting Adolescents in a Psychiatric Inpatient Setting

  • Ana M. Abrantes
  • David R. Strong
  • Susan E. Ramsey
  • Peter M. Lewinsohn
  • Richard A. Brown

The clinical and psychosocial characteristics of 239 dieting and nondieting adolescents (61% female; mean age=15.3) recruited from an inpatient psychiatric setting were examined. Dieting adolescents were compared to nondieting adolescents on exercise frequency, weight control behaviors, risky behaviors, psychiatric comorbidity and distress, eating disorder symptomatology, smoking, coping, and family factors. While dieters did not statistically differ from nondieters on scores of body mass index, dieting youth reported greater levels of self-reported distress, poorer coping, greater eating disorder symptomatology, and were more likely to engage in extreme weight control behaviors. In addition, dieting was associated with higher rates of major depression (58% vs 34%) and eating disorders (14% vs 1%). Among adolescent smokers, dieters endorsed smoking as a weight control behavior. Engaging in risky behaviors or familial factors did not differentiate dieters from nondieters. Given the number of negative correlates associated with dieting in adolescents, identifying dieting and weight control behaviors in clinical settings may prove to be an effective strategy in the development of prevention and intervention efforts for youth.


adolescents dieting inpatient psychiatric disorders eating behavior 



This research was supported by Grant CA 77082 from the National Cancer Institute to Richard A. Brown, Ph.D. and a grant from the Brown University Department of Psychiatry and Human Behavior to Susan E. Ramsey, Ph.D.


  1. Aseltine, R. H., Gore, S., & Colten, M. E. (1999). The co-occurrence of depression and substance abuse in late adolescence. Development and Psychopathology, 10, 549570.CrossRefGoogle Scholar
  2. Austin, S. B., & Gortmaker, S. L. (2001). Dieting and smoking initiation in early adolescent girls and boys: a prospective study. American Journal of Public Health, 91, 446–450.PubMedCrossRefGoogle Scholar
  3. Barnes, H., & Olson, D. H. (1982). The Adolescent-Parent Communication Form. St. Paul, MN: Family Social Science, University of Minnesota.Google Scholar
  4. Borresen, R., & Rosenvinge, J. H. (2003). Body dissatisfaction and dieting in 4,952 Norwegian children aged 11–15 years: less evidence for gender and age differences. Eating and Weight Disorders, 8, 238241.PubMedGoogle Scholar
  5. Brener, N. D., Kann, L., McManus, T., Kinchen, S. A., Sundberg, E. C., & Ross, J. G. (2003). Reliability of the 1999 Youth Risk Behaviors Survey Questionnaire. Journal of Adolescent Health, 31, 336342.CrossRefGoogle Scholar
  6. Brown, R. A., Burgess, E. S., Sales, S. D., Whiteley, J. A., Evans, D. M. &, Miller, I. W. (1998). Reliability and validity of a smoking timeline followback interview. Psychology of Addictive Behaviors, 12, 101112.CrossRefGoogle Scholar
  7. Brown, R. A., Ramsey, S. E., Strong, D. R., Myers, M. G., Kahler, C. W., Lejuez, C. W., Niaura, R., Pallonen, U. E., Kazura, A. N., Goldstein, M. G., & Abrams, D. B. (2003). Effects of motivational interviewing on smoking cessation in adolescents with psychiatric disorders. Tobacco Control, 12 Suppl 4, IV3–IV10.PubMedGoogle Scholar
  8. Burns, C. M., Tijhuis, M. A. R., & Seidell, J. C. (2001). The relationship between quality of life and perceived body weight and dieting history in Dutch men and women. International Journal of Obesity, 25, 13861392.PubMedCrossRefGoogle Scholar
  9. Byely, L., Archibald, A. B., Graber, J., & Brooks-Gunn, J. (2000). A prospective study of familial and social influences on girls’ body image and dieting. International Journal of Eating Disorders, 28, 155164.PubMedCrossRefGoogle Scholar
  10. Cachelin, F. M., Weiss, J. W., & Garbanati, J. A. (2003). Dieting and its relationship to smoking, acculturation, and family environment in Asian and Hispanic adolescents. Eating Disorders, 11, 5161.PubMedCrossRefGoogle Scholar
  11. Casper, R. C., & Offer, D. (1990). Weight and dieting concerns in adolescents, fashion or symptom? Pediatrics, 8, 384390.Google Scholar
  12. Costello, A. J., Edelbrock, C., Duncan, M. K., Kalas, R., Klaric, S. (1984). Development and testing of the NIMH Diagnostic Interview Schedule for Children on a clinical population: Final Report (Contract #RFP-DB-81-0027). Rockville MD: Center for Epidemiologic Studies: National Institute for Mental Health.Google Scholar
  13. Derogatis, L. R., & Melisaratos, N. (1983). The brief symptom inventory: An introductory report. Psychological Medicine, 13, 595605.PubMedCrossRefGoogle Scholar
  14. Donovan, J. E., & Jessor, R. (1985). Structure of problem behavior in adolescence and young adulthood. Journal of Consulting and Clinical Psychology, 53, 890904.PubMedCrossRefGoogle Scholar
  15. Fagerstrom, K. O. (1978). Measuring degree of physical dependence to tobacco smoking with reference to individualization of treatment. Addictive Behaviors, 3, 235241.PubMedCrossRefGoogle Scholar
  16. Field, A. E., Austin, S. B., Taylor, C. B., Malspeis, S., Rosner, B., Rockett, H. R., Gillman, M. W., & Colditz, G. A. (2003). Relation between dieting and weight change among preadolescents and adolescents. Pediatrics, 112, 900906.PubMedCrossRefGoogle Scholar
  17. French, S. A., Perry, C. L., Leon, G. R., & Fulkerson, J. A. (1995). Changes in psychological variables and health behaviors by dieting status over a three-year period in a cohort of adolescent females. Journal of Adolescent Health, 16, 438447.PubMedCrossRefGoogle Scholar
  18. Green, M. W., Jones, A. D., Smith, I. D., Cobain, M. R., Williams, M. G., Healy, H., Cowen, P. J., Powell, J., & Durlach, P. J. (2003). Impairments in working memory associated with naturalistic dieting in women: no relationship between task performance and urinary 5-HIAA levels. Appetite, 40, 145153.PubMedCrossRefGoogle Scholar
  19. Green, M. W., Rogers, P. J., Elliman, N. A., & Gatenby, S. J. (1994). Impairments of cognitive performance associated with dieting and high levels of dietary restraint. Physiology and Behavior, 55, 447452.PubMedCrossRefGoogle Scholar
  20. Huon, G., & Lim, J. (2000). The emergence of dieting among female adolescents: age, body mass index, and season effects. International Journal of Eating Disorders, 28, 221225.PubMedCrossRefGoogle Scholar
  21. Huon, G. F., & Strong, K. G. (1998). The initiation and the maintenance of dieting: Structural models for large-scale longitudinal investigations. International Journal of Eating Disorders, 23, 361370.PubMedCrossRefGoogle Scholar
  22. Kolbe, L. J., Kann, L., & Collins, J. L. (1993). Overview of the youth risk behaviors surveillance system. Public Health Report, 108 Suppl 1, 210.Google Scholar
  23. Koskelainen, M., Sourander, A., & Helenius, H. (2001). Dieting and weight concerns among Finnish adolescents. Nordic Journal of Psychiatry, 55, 427431.PubMedCrossRefGoogle Scholar
  24. Lewinsohn, P. M., Striegel-Moore, R. H., & Seeley, J. R. (2000). Epidemiology and natural course of eating disorders in young women from adolescence to young adulthood. Journal of the American Academy of Child and Adolescent Psychiatry, 39, 12841292.PubMedCrossRefGoogle Scholar
  25. Lowry, R., Galuska, D. A., Fulton, J. E., Wechsler, H., & Kann, L. (1999). Weight management goals and practices among U.S. high school students: associations with physical activity, diet, and smoking. Journal of Adolescent Health, 31, 133144.CrossRefGoogle Scholar
  26. McGuire, M. T., Story, M., Neumark-Sztainer, D., Halcon, L., Campbell-Forrester, S., & Blum, R. W. M. (2002). Prevalence and correlated of weight-control behaviors among Caribbean Adolescent Students. Journal of Adolescent Health, 31, 208211.PubMedCrossRefGoogle Scholar
  27. Mellin, A. E., Neumark-Sztainer, D., Story, M., Ireland, M., & Resnick, M. D. (2002). Unhealthy behaviors and psychosocial difficulties among overweight adolescents; the potential impact of familial factors. Journal of Adolescent Health, 31, 145153.PubMedCrossRefGoogle Scholar
  28. Neumark-Sztainer, D., & Story, M. (1998). Dieting and binge eating among adolescents: what do they really mean? Journal of the American Dietetic Association, 98, 446450.PubMedCrossRefGoogle Scholar
  29. Patton, G. C., Selzer, R., Coffey, C., Carlin, J. B., & Wolfe, R. (1999). Onset of adolescent eating disorders: population based cohort study over 3 years. British Medical Journal, 318, 765768.PubMedGoogle Scholar
  30. Radziszewska, B., Richardson, J. L., Dent, C. W., & Flay, B. R. (1996). Parenting style and adolescent depressive symptoms, smoking, and academic achievement: ethnic, gender and SES differences. Journal of Behavioral Medicine, 9, 289305.CrossRefGoogle Scholar
  31. Ramsey, S. E., Strong, D. R., Stuart, G. L., Weinstock, M. C., Williams, L. A., Tarnoff, G., Picotte-Prillmayer, D. M., & Brown, R. A. (2003). Substance use and diagnostic characteristics that differentiate smoking and nonsmoking adolescents in a psychiatric setting. Journal of Nervous and Mental Disease, 191, 759762.PubMedCrossRefGoogle Scholar
  32. Roberts, S. J., Maxwell, S. M., Bagnall, G., & Bilton, R. (2001). The incidence of dieting amongst adolescent girls: a question of interpretation? Journal of Human Nutrition and Dietetics, 14, 103109.PubMedCrossRefGoogle Scholar
  33. Rogers, P. J., & Green, M. W. (1993). Dieting, dietary restraint and cognitive performance. British Journal of Clinical Psychology, 32, 113116.PubMedGoogle Scholar
  34. Rosenbaum, M. A. (1980). schedule for assessing self-control behaviors: preliminary findings. Behavior Therapy, 11, 109121.CrossRefGoogle Scholar
  35. Sobell, L. C., & Sobell, M. B. (1996). Timeline followback: A calendar method for assessing alcohol and drug use. Toronto Canada: Addiction Research Foundation.Google Scholar
  36. Stice, E., & Bearman, S. K. (2001). Body-image and eating disturbances prospectively predict increases in depressive symptoms in adolescent girls: a growth curve analysis. Developmental Psychology, 37, 597607.PubMedCrossRefGoogle Scholar
  37. Stice, E., Cameron, R. P., Hayward, C., Taylor, C. B., & Killen, J. D. (1999). Naturalistic weight-reduction efforts prospectively predict growth in relative weight and onset of obesity among female adolescents. Journal of Consulting and Clinical Psychology, 67, 967674.PubMedCrossRefGoogle Scholar
  38. Thompson, K. M., Wonderlich, S. A., Crosby, R. D., & Mitchell, J. E. (1999). The neglected link between eating disturbances and aggressive behavior in girls. Journal of the American Academy of Child and Adolescent Psychiatry, 38, 12771283.PubMedCrossRefGoogle Scholar
  39. Tomeo, C. A., Field, A. E., Berkey, C. S., Colditz, G. A., & Frazier, A. L. (1999). Weight concerns, weight control behaviors, and smoking initiation. Pediatrics, 104, 918924.PubMedCrossRefGoogle Scholar
  40. Velicer, W. F., DiClemente, C. C., Prochaska, J. O., & Brandenberg, N. (1985). A decisional balance measure for assessing and predicting smoking status. Journal of Personality and Social Psychology, 48, 12791289.PubMedCrossRefGoogle Scholar
  41. Velicer, W. F., DiClemente, C. C., Rossi, J. S., & Prochaska, J. O. (1990). Relapse situations and self-efficacy: An integrative model. Addictive Behaviors, 15, 271283.PubMedCrossRefGoogle Scholar
  42. Waaddegaard, M., & Petersen, T. (2002). Dieting and desire for weight loss among adolescents in Denmark: a questionnaire survey. European Eating Disorders Review, 10, 329346.CrossRefGoogle Scholar
  43. Weinstein, S. R., Noam, G. G., Grimes, K., Stone, K., Schwab-Stone, M. (1990). Convergence of DSM-III diagnoses and self-reported symptoms in child and adolescent inpatients. Journal of the American Academy of Child and Adolescent Psychiatry, 29, 627634.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, Inc. 2006

Authors and Affiliations

  • Ana M. Abrantes
    • 1
    • 5
  • David R. Strong
    • 1
  • Susan E. Ramsey
    • 2
  • Peter M. Lewinsohn
    • 3
  • Richard A. Brown
    • 4
  1. 1.Assistant Professor (Research)Brown Medical School/Butler HospitalProvidenceUSA
  2. 2.Assistant Professor (Research), Brown Medical School/Rhode Island HospitalProvidenceUSA
  3. 3.Senior Research ScientistOregon Research InstituteEugeneUSA
  4. 4.Associate Professor, Brown Medical School/Butler HospitalProvidenceUSA
  5. 5.Butler Hospital, Addiction ResearchProvidenceUSA

Personalised recommendations