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Purpose: To explore associations between adolescent’s concern for their body weight/shape/size and engagement in unhealthy weight control behaviors (UWCBs). Design: Secondary data analysis. Setting: 2022 National Survey of Children’s Health. Subjects: Analyses included 23 357 (51.8% male) adolescents, ages 10-17 years (mean 13.8 ± 2.3 years). Measures: Reported concern for body weight/shape/size, and UWCBs including skipping meals/ fasting; low interest in food; picky eating; binge eating, purging; diet pills; and over-exercising. Analysis: Logistic regression models assessed the odds of engaging in UWCBs by reported concern for body weight/shape/size. Results: Engagement in UCWBs was low with 21.1% reporting picky eating, 13.5% fasting, 11.7% low interest in food, 5.3% binge eating, and <2% purging, over-exercising, or using diet pills. Compared to adolescents who were not at all concerned about their body weight/shape/size, adolescents who were somewhat or very much concerned had significantly higher odds (P’s < 0.05) of engaging in all UCWB outcomes except for using diet pills or laxatives, which was only significant for adolescents who reported being very concerned (OR = 12.74; CI: [19.16, 36.94]). Further, after stratification by gender and age, there was a significant p-for trend (P’s < 0.05), in engagement in UWCBs by concern for body weight/shape/size except for using diet pills or laxatives in 10-11- and 12-14-year-olds. Conclusion: Expressing concern for body weight/image/size is associated with an increased likelihood of engaging in UCWB in adolescents, regardless of gender or stage of adolescence. © The Author(s) 2025
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Purpose: In young women with obesity, we sought to explore their: (1) psychosocial health; (2) perceptions of their and engagement in current health behaviors; (2) motivation to change their health behaviors; and (3) desired characteristics of a health behavior intervention. Approach: Convergent-parallel mixed methods study. Setting: Focus groups were conducted over zoom. Participants: 34 young women with obesity (M ± SD; age = 23.79 ± 4.22 years; BMI = 35.66 ± 5.56 kg/m2 ; 41.2% non-Hispanic White). Method: Quantitative data were collected via Qualtrics prior to focus groups. We conducted 8 semi-structured focus groups (2-7 participants per group; 32-93 minutes) to address the pre-specified objectives. Results: Participants reported poor psychosocial health, with 100% meeting the cut-point indicative of significant depressive symptoms and 79.4% for clinically meaningful anxiety. Participants expressed the interconnectedness of their physical and mental health and desire to improve consistency in their eating and physical activity behaviors. However, participants did not want to emphasize weight loss as the primary focus of a health behavior intervention. Preferences for the characteristics of a health behavior intervention were in support of a hybrid format, with in-person meetings focusing on active engagement (e.g., cooking classes). Conclusions: Our findings support shifting the focus from a weight-normative to a weight inclusive approach to health behavior interventions to meet the needs and preferences of young women with obesity. © The Author(s) 2025
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