20. In an Ethnically/Racially and Socioeconomically Diverse Sample of Adolescents, do Weight Stigma, Family Functioning, and Parenting Practices Predict Disordered Eating Behaviors Eight Years Later?


      Weight stigma is a prevalent problem with concerning health consequences in young people. For example, studies in adolescents and young adults have consistently found that weight stigma is associated with higher prevalence of depressive symptoms, low self-esteem, body dissatisfaction, and disordered eating behaviors. Because of the crucial role of family members and the home environment for adolescent psychosocial development, it is important to understand the relationship between weight stigma and disordered eating behaviors within the familial context. The present study aimed to examine whether weight stigma, family functioning, and parenting practices during adolescence predict unhealthy weight control behaviors (UWCB) eight years later.


      Ethnically/racially and socioeconomically diverse adolescents in this prospective cohort study were surveyed within local public schools in the Project EAT 2010-2018 study (mean age=14.4 years at baseline, N=1534). Adolescents self-reported on four weight stigma variables (hurtful weight-related comments from family, weight teasing from peers, weight teasing from family, and weight teasing from any source) and four family variables (family functioning, parental connection, parental monitoring, and parental psychological control). The outcome, UWCB (e.g. fasting, vomiting, laxative use), was self-reported by young adults eight years later. Logistic regression models estimated odds ratios (OR) and 95% confidence intervals (CI) of UWCB for four weight stigma predictors and four family predictors. Models were adjusted for sociodemographic characteristics, baseline UWCB, and baseline BMI percentile, and predictors were modeled separately.


      In analyses adjusted for sociodemographic characteristics, all weight stigma and family variables during adolescence longitudinally predicted significantly higher odds of UWCB eight years later. After additionally adjusting for baseline UWCB and baseline BMI percentile, two weight stigma variables (weight teasing from family [OR: 1.42, 95% CI: 1.08, 1.87] and hurtful weight-related comments from family [OR: 1.34, 95% CI: 1.06, 1.70]) and one family variable (poor family functioning [OR: 1.44, 95% CI: 1.14, 1.81]) remained significantly associated with subsequent UWCB.


      Findings indicate that there are long-term consequences, across major development periods, of weight teasing from family, hurtful weight-related comments from family, and low family functioning during adolescence on disordered eating behaviors. These results suggest that healthcare providers should educate adolescents and their family members about weight stigma, its harmful health consequences, and the vital role family members play both in creating a supportive home environment and in communication about weight-related health.

      Sources of Support

      This study was supported by grant numbers R01HL127077 and R35HL139853 from the National Heart, Lung, and Blood Institute (PI: Dianne Neumark-Sztainer). Laura Hooper’s time was supported by the National Institutes of Health’s National Center for Advancing.