Fear of fatness and adolescent girls: implications for obesity prevention.

Female adolescence is the phase of growth and development bridging childhood and womanhood; a physical transition necessitating unique social and psychological adjustment. In physical terms, growth during adolescence includes the development of the sexual organs to full reproductive function, and contributes to the average female adult approximately 15 % of her height, 40 % of her weight (Hoey et al. 1986) and 40 % of her total bone mineral content (Matkovic, 1991). The start of adolescence is characterized by the pubertal growth spurt which in females is usually about 2 years earlier than in males, and represents one of the most rapid periods of growth experienced by women during their lifetime. Although the duration of the growth spurt is usually the same ( 3 4 years) the timing of its inception varies within each sex, usually occurring between the ages of 9 and 13 years in females. Consequently nutritional requirements during female adolescence correlate more closely with biological maturity than with chronological age. To support this growth and development adolescent girls require diets of high nutritional quality and, thus, represent a nutritionally vulnerable group. Any event which carries additional nutritional costs, such as pregnancy, lactation, illness or participation in competitive sports, greatly increases their risks of dietary inadequacy. Similarly any event interfering with their food intake, such as dietary restraint associated with a fear of fatness, can also lead to malnutrition. Crawley & Shergill-Bonner (1995) recently described how dieting 16-17-year-old British girls had significantly lower intakes of all micronutrients compared with girls who were not dieting. Apart from increased risks due to inadequate intakes of specific nutrients, for example of osteoporosis due to low Ca intakes (National Institutes of Health, 1994), it has been documented that such dietary restraint can lead to growth failure and delayed puberty (Pugliese et al. 1983). Although the long-term risks of growth failure during adolescence are largely unknown, it has been suggested that this may be linked with an increased mortality risk in girls (Nieto et al. 1992).