Adolescent binge/purge and weight loss behaviors: associations with developmental assets.

PURPOSE: To study associations between binge/purge and weight loss behaviors and "developmental assets" among adolescent girls and boys. METHODS: The Search Institute's Profile of Student Life: Attitudes and Behaviors self-report questionnaire was administered to 48,264 girls and 47,131 boys in grades 6 through 12 at schools in 213 cities or towns across the United States. The 156-item questionnaire measured 40 "developmental assets," or protective factors associated with successful adolescent development. Developmental assets were examined using multiple logistic regression among students who reported binge/purge behaviors, weight loss behavior, both, or neither. RESULTS: Developmental assets related to positive identity were the strongest discriminators of binge/purge and weight loss behaviors in both girls and boys. Girls who reported binge/purge and weight loss behaviors were about half as likely to report feeling a sense of purpose [odds ratio (OR) = 0.45, 95% confidence interval (CI) = 0.40, 0.50] and high self-esteem (OR = 0.55, 95% CI = 0.49, 0.61), compared with girls not reporting either of these behaviors. Among boys the ORs were: sense of purpose OR = 0.53 (95% CI = 0.46, 0.61) and self-esteem OR = 0.76 (95% CI = 0.65, 0.88). Assets related to values about abstinence from alcohol, drugs, or sex ("restraint") were also significant correlates. Girls and boys who reported these values were less likely to report binge/purge and weight loss behaviors, compared with those who did not report these values (girls: OR = 0.56, 95% CI = 0.50, 0.63; boys: OR = 0.83, 95% CI = 0.70, 0.97). CONCLUSIONS: Internal assets such as self-esteem, sense of purpose, and values related to abstinence from alcohol and sex appear to be protective against unhealthy eating behaviors and may reflect a general resilience that buffers against a broad range of health risk behaviors.

Duke Scholars

Author Mary T Story Family Medicine and Community Health