Dieting frequency among college females: Association with disordered eating, body image, and related psychological problems

Abstract

Objective: To examine associations between dieting frequency and eating disorder behaviors, body satisfaction, and related factors. Method: Females (N=345) whose average age and body mass index (BMI) were 20.58 and 21.79, respectively, were grouped into three categories of lifetime dieting frequency (never, 1–5 times, or 6 or more times) and matched on current BMI across categories. Results: Positive associations were found between dieting frequency and eating disorder symptoms and related problems such as body dissatisfaction, current body size perception, depression, exercise preoccupation, and feelings of ineffectiveness and insecurity. Dieting frequency was inversely associated with self-esteem, ideal body size, emotional regulation, and impulse control. Discussion: Independent of current BMI, frequency of dieting behaviors is strongly associated with negative emotions and problematic behaviors. As this study is correlational in nature, future longitudinal studies should ascertain the sequence of onset of these experiences.

Introduction

While the definition of “dieting” includes weight-reduction efforts generally considered to be healthy (e.g., increased fruit and vegetable intake and decreased fat and sugar intake), many individuals also consider “dieting” to include unhealthy weight-control behaviors such as fasting, skipping meals, and eliminating food groups [1]. Regardless of how one defines dieting, the lifetime prevalence of these weight-control behaviors in females is alarming. Results from a nationally representative population-based survey of high schools girls indicate that 58% had dieted [2], and in a study of over 4000 adults, 75% of the women indicated that they had been on a diet [3].

There are issues of concern over the practice of dieting. First, many of the individuals who diet are of normal weight for their height. In 1985, over 34.1 million men and women dieters were found to be of normal weight, as compared to 22.6 million dieters who were overweight [4]. Studies have also indicated that approximately 47% of normal-weight women and 32% of normal-weight girls diet to lose weight [4], [5], [6].

Second, many of the individuals who diet use unhealthy weight-control behaviors such as fasting and use of appetite suppressants, rather than healthier weight-loss practices such as reducing intake of fat and sweets and increasing physical activity. For example, in a community-based weight-gain prevention program, 22% of women and 17% of men reported the use of at least one unhealthy weight reduction behavior over the past year [7]. Adolescents are also using unhealthy weight-control measures. In a state-wide survey of 133,794 male and female adolescent students in Minnesota, 43% of girls and over 13% of boys in the 9th and 12th grades reported fasting or skipping meals to control or lose weight [8]. Diet pills or speed were used by 2% of boys and over 8% of girls in the 9th and 12th grades, and 2% of all youth surveyed reported using laxatives in an attempt to control or lose weight.

Third, there is debate as to the accuracy of restraint theory (the assumption that dietary restraint is etiologically significant for the development of eating disorders). Supporting restraint theory, results from a prospective study of 1010 adolescent girls indicate that among the 34.6% of the overall study population who indicated dieting at baseline, 21% of these girls developed eating disorders by the time of the 12-month follow-up [9]. In contrast, recent research by Lowe [10], [11] raises question as to the etiological relationship between dieting and binge-eating. No significant relationship between dieting and binge-eating was found in either study. Consequently, the authors conclude that factors other than dieting maintain binge-eating in bulimic individuals [11].

While dieting efforts among average weight or underweight individuals are most often considered negative [5], dieting efforts among overweight individuals have been viewed more positively [1]. For example, Wing and Jeffery [12] found that among overweight individuals, modest weight reductions (10–15% of initial body weight) achieved by the combination of calorie reduction and exercise implementation were associated with positive changes in cardiovascular risk factors. Furthermore, results from a study of over 14,000 respondents to a popular magazine survey suggest that the frequency of dieting is less important than the individual's perception of being a weight cycler in its association with psychological problems such as low self-esteem and body satisfaction [13]. However, detrimental consequences of dieting have also been documented, including later onset of obesity among female adolescents [14], as well as socioenvironmental, psychological, and other physical effects [15].

Despite a large body of literature on emotional and behavioral factors associated with dieting, we are unaware of any studies that have looked at these associations independent of body mass index (BMI). It has been well established that BMI is strongly associated with dieting frequency [16] as well as disordered eating and body image dissatisfaction [13], [17], [18], [19]. Consequently, BMI has been statistically controlled in the current study in order to obtain a more accurate understanding of the specific relationship between dieting and disordered eating, body image dissatisfaction, and other psychopathology. The purpose of the present study was to evaluate the relationship between lifetime dieting frequency and disordered eating behaviors and characteristics, body image satisfaction, depression, self-esteem, and other psychological variables, after controlling for current BMI.