Self-reported weight perceptions, dieting behavior, and breakfast eating among high school adolescents

This study explored the relationships among weight perceptions, dieting behavior, and breakfast eating in 4597 public high school adolescents using the Centers for Disease Control and Prevention Youth Risk Behavior Survey. Adjusted multiple logistic regression models were constructed separately for race and gender groups via SUDAAN (Survey Data Analysis). Adjusted odds ratios [ORs] and 95% confidence intervals were calculated to determine the strength of relationships. Approximately 42% of the sample reported not eating breakfast within the past 5 days, while 41% were trying to lose weight, and 37% were dieting to lose weight. Excessive dietary practices (eg, fasting, taking diet pills or laxatives, and vomiting to lose weight) were reported by approximately 25% of the sample. When compared to those eating breakfast within the past 5 days, all race and gender groups that did not report eating breakfast were significantly more likely to report fasting to lose weight (ORs 1.70-2.97). In addition, all race/gender groups, with the exception of black females, were significantly more likely to perceive themselves as overweight (ORs = 1.44-1.61) and trying to lose weight (ORs = 1.40-1.72). Among males, not eating breakfast was significantly associated with taking diet pills to lose weight (ORs = 2.31-2.40), eating fewer calories to lose weight (ORs = 1.38-1.49), and inversely associated with trying to gain weight (ORs = 0.71-0.74). Results suggest that these adolescents may be skipping breakfast as part of a patterned lifestyle of unhealthy weight management and that efforts to encourage youth to eat breakfast will likely not ameliorate all dietary challenges that appear beyond the scope of increased breakfast offerings.