The association of weight control attempts with suicidality: The role of objective weight status and weight perception among adolescents of United States

Background: The evidence for the association of weight control attempts with suicidality by objective weight status, subjective weight perception, and distorted weight perception among adolescents was limited.Methods: Data were extracted from a national representative sample of Youth Risk Behavior Surveys in the United States from 2011 to 2019. Binary logistic regression models with complex sampling designs were used to explore the association of weight control attempts, objective weight status, and weight perception with suicidality.Findings: The adolescents attempting to lose weight had higher weighted prevalence of suicidal ideation, suicide plan, suicide attempt, and suicide attempt with medical treatment compared with other attempts of weight control. Totally, attempting to lose weight was significantly associated with increased risk of suicidal ideation (OR: 1.17, 95%CI: 1.05-1.30) and suicide attempt (OR: 1.26, 95%CI: 1.10-1.46) when adjusting objective weight status, weight perception and all other covariates. In the subgroup analyses, attempting to lose weight was significantly associated with increased risk of suicidality in the adolescents of normal weight, underweight, perceived normal weight, perceived underweight, right estimation of objective weight status.Limitations: Uncertain causal relationship existed because of cross-sectional design.Conclusions: The risk of suicidality associated with weight control attempts varied among different subgroups. The findings in this study suggest that not only objective weight status but also weight perception should be with consideration when performing weight control attempts.