ArticleBMC public health2026
Weight-loss practices and dietary quality in Chinese adolescents.
Article in BMC public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionThis cross-sectional study aimed to investigate the associations between various weight-loss practices and unhealthy dietary patterns among Chinese adolescents.
methodsWe analyzed 17,483 students aged 6-19 years from The Zhejiang Childhood Behavior and Health Cohort, a school-based, multistage stratified cluster sample. Six weight-loss behaviors (laxatives, vomiting, non-prescribed diet pills, dieting/low-calorie foods, ≥ 24 h fasting, increased exercise) were assessed with yes/no items. Dietary quality was quantified with the 8-item Unhealthy Dietary Score (UDS-8; range 0-80, and categorized into low, moderate and high unhealthy dietary groups. Multivariable logistic regression estimated adjusted odds ratios (OR, 95% CI) for the association between each weight-loss method and dietary category.
resultsIn the fully adjusted model, fasting ≥ 24 h conferred the highest risk of high unhealthy diet scores overall (OR = 4.65, 95% CI: 2.90-7.44), followed by vomiting (OR = 4.75, 95% CI: 2.25-10.00), diet pills (OR = 4.03, 95% CI: 1.90-8.56), and laxatives (OR = 2.65, 95% CI: 1.60-4.39), while increased exercise remained protective (OR = 0.83, 95% CI: 0.74-0.92). BMI-stratified analyses revealed that underweight adolescents showed the strongest associations for fasting (OR = 8.21) and vomiting (OR = 5.43); among those with overweight or obesity, fasting remained significant (OR = 3.32) and exercise showed the strongest protective effect (OR = 0.54); among normal-weight adolescents, dieting (OR = 1.59) and fasting (OR = 2.47) were significantly associated with high unhealthy diet, whereas exercise showed no significant association (OR = 1.03, 95% CI: 0.78-1.35). Notably, the associations between extreme weight-loss behaviors (e.g., vomiting, fasting ≥ 24 h) and unhealthy diet scores were more pronounced among underweight and obese adolescents, revealing important BMI-stratified heterogeneity.
conclusionExtreme weight-control behaviors are strongly coupled with poor-quality diets among adolescents, with BMI-stratified heterogeneity, whereas increased exercise predicts healthier eating. School-based programs should prioritize the identification of extreme weight-loss behaviors and promote physical activity and balanced diets to prevent disordered eating.
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