BY BECKY HAM

Teens who use extreme methods like diet pills or vomiting to control their weight are also more likely to smoke, drink, use marijuana and attempt suicide, a new study of adolescent dieting behavior concludes.

These extreme dieters made up 19.2 percent of the 4,187 teens surveyed in the study. Another 43.2 percent of the teens were moderate dieters, who ate less and exercised more to control their weight. These moderate dieters were less likely to smoke cigarettes and use marijuana than extreme dieters were.

The study surveyed dieting behaviors in white and black boys and girls. While there were some notable differences in dieting methods between genders and races, Anca Codruta Rafiroiu, M.D., Ph.D., and colleagues note that the "high prevalence rates of extreme weight-control methods across all gender-race categories are a concern."

Previous studies suggested that dieting may be "part of a constellation of unhealthy problem behaviors in adolescents," according to the researchers, who wanted to find out whether all dieting methods, or just extreme ones, were associated with risky health behaviors like smoking or drinking.

Rafiroiu and colleagues used data from the 1999 South Carolina Youth Risk Behavior Survey to examine the links between dieting methods, risky behaviors and healthy behaviors like exercising regularly and eating a diet rich in fruits and vegetables.

White girls reported higher rates of use for all weight control methods compared to white boys, but black boys had higher rates of diet pill use and vomiting compared to black girls, the researchers found. Both black and white extreme dieting girls were more likely to engage in vigorous exercise compared to extreme dieting boys.

Although rates of drug and alcohol use, smoking and suicide were higher among extreme dieters, their risky behaviors did not extend to all categories, according to the researchers. Extreme dieters did not have more unprotected sex or eat fewer fruits and vegetables than moderate dieters or non-dieters.

The highest rates of extreme and moderate dieting were found among white girls in the study, but the researchers caution that boys should not be ignored in weight-control studies.

"Men are increasingly becoming dissatisfied with their body image," Rafiroiu says.

Rafiroiu and colleagues note that the links between extreme dieting and other unhealthy behaviors may reflect underlying problems of self-esteem or peer influence.

The study results are published in the January/February issue of the American Journal of Health Behavior.

---Health Behavior News Service