Skipping meals, fasting 'red flags' for depression

17:00, Aug 28 2012
Jojo Woodham
HARD LESSON: Seeing a close friend deal with the devastating effects of anorexia was enough to keep Jojo Woodham, 17, from trying any dangerous diets.

Young Maori and Pacific females are most at risk of developing unhealthy weight-loss habits and warrant closer monitoring by clinicians, new research suggests.

A group of Auckland University researchers say female adolescents and those of Maori or Pacific ethnicity are most likely to adopt dangerous habits to help them lose weight.

Skipping meals, fasting, vomiting and taking diet pills were associated with depression and suicidal behaviour, the School of Population and Health researchers said in the report, published in the International Journal of Behavioural Nutrition and Physical Activity last week. But clinicians were often pressed for time to ask detailed questions.

Lead author Jennifer Utter proposed clinicians screen patients for skipping meals and fasting, which were “red flag” alerts, because of their close association with “poor mental wellbeing”.

“Unfortunately unhealthy weight-control behaviours are common, especially among overweight young people, and there is abundant evidence that unhealthy weight-loss behaviours lead to poor outcomes for adolescents.

“For example, adolescents who used diet pills, vomited, took laxatives, took diuretics, fasted, used food substitutes, skipped meals or smoked cigarettes for weight loss had high levels of depression and were more likely to develop suicidal behaviours into young adulthood,” Dr Utter said.


Youths who dieted were also more likely to engage in risk-taking behaviour, have a lower nutrient intake and were more likely to develop binge-eating behaviours and gain more weight over time, compared with those who did not.

The group surveyed 9100 students from 115 New Zealand secondary schools in 2007 and asked them what strategies they had used in the 12 months prior to help them lose weight.

Two-thirds of females and just over one-third of males surveyed said they had tried to lose weight in the past 12 months.

About 90 per cent said they had exercised, 72 per cent said they had eaten less and 52 per cent said they had eaten fewer sweets to help them lose weight. These were healthy strategies, the researchers said.

About 8 per cent had vomited, 3.5 per cent had used diet pills, nearly one in 10 people had smoked cigarettes or fasted and 31 per cent had skipped meals in an attempt to lose weight.

Females were most likely to endorse unhealthy weight controls, while Maori and Pacific students were less likely to endorse healthy strategies - like counting calories - but more likely to endorse vomiting and taking diet pills, the study found.


Seeing a close friend deal with the devastating effects of anorexia was enough to keep Jojo Woodham from trying any dangerous diets.

The 17-year-old Onslow College pupil said most girls experienced some level of self-consciousness during high school, and many would turn to dieting to feel in control.

"We are always going to be self-conscious. Some girls want to do something radical to change that, and it won't always be the healthiest or safest option."

In some ways girls had to work out for themselves how to approach nutrition as they got used to their bodies, she said.

Seeing the impact of anorexia on a schoolmate had pushed Jojo to stick to less risky food behaviours, she said. "If I have a big meal of McDonald's or something then I'll make sure to keep the rest of my day pretty healthy."

While her friend was now recovering, it had taught Jojo's friends some tough lessons, she said.

"It's been rough for her and us, but I don't think any of us will fall into those habits now that we've seen what they can do."

The Dominion Post