Disordered Weight Control Behaviors in a Longitudinal Sample of Adolescents and Emerging Adults: An Intersectional and Transdiagnostic Examination

Disordered weight control behaviors (DWCB) are a pervasive and serious public health issue associated with a wide variety of psychological and physiological problems. Using the transdiagnostic cognitive behavioral model and an intersectional framework, this study uses latent class analysis to examine DWCB in a national longitudinal sample (N = 2,874) of late adolescents and emerging adults (19-22 years) with focus on gender and race/ethnicity. Three latent classes were identified cross-sectionally across all timepoints: A restriction behaviors group, a combined restriction and compensatory behaviors group, and a group exhibiting low DWCB. Women of all racial/ethnic groups were consistently more likely than were men to classify in the restriction behaviors class, and Black and Hispanic women were more likely to classify in the combined behaviors class in waves 6 and 7. Longitudinally, two classes were identified: A low stable and a higher stable class. Women of all racial/ethnic groups were more likely to classify in the high stable class compared with White men, however, no other racial/ethnic differences emerged. Hispanic men were more likely to classify in the high stable group. This study highlights the utility of transdiagnostic, intersectional, cross-sectional, and longitudinal approaches to studying DWCB in nonclinical populations. More work is needed to examine the influence of restriction and combined DWCB behaviors on adolescent and emerging adult development and functioning. In addition, this work underlines the need for more nuanced measurement of disordered eating pathology in national studies and epidemiological research. Finally, this study demonstrates the need for continual focus on intersectionality frameworks and the addition of cultural and identity-related variables in disordered eating research to promote wellbeing, health, and equity for all individuals.