Is having a distorted body image (DBI) associated with binge drinking among high school girls? Results from the 2013 Youth Risk Behavioral Survey (YRBS)

Background: A distorted body image (DBI) refers to an unrealistic view of body perception. Issues around weight and body image are common among adolescent girls and there is an established relationship between weight-related and risk behaviors in this population. We sought to examine the association between DBI and binge drinking among high school girls in the U.S.

Methods: Analyses were conducted using nationally-representative data from high-school students surveyed through the 2013 YRBS. Survey-weighted multivariable logistic regression analyses with multiple imputation were conducted to examine the association between having a DBI (reporting being 1) underweight and trying to lose/stay the same weight, 2) normal weight and trying to lose/gain weight, or 3) overweight and reporting trying to stay the same/gain weight) and binge drinking (>5 drinks in a couple of hours) among female students. Restricting the sample to those aged 14-18 with a lifetime prevalence of drinking alcohol yielded 4,352 participants.    

Results: 28.9% of the sample had reported ever binge drinking and 39.8% screened in for having a DBI. In the final analytic model, which controlled for demographics (grade, race/ethnicity), depression, current cigarette smoking, and exercise, compared to students who did not screen for a DBI, those who did had a 1.23 times greater odds (AOR:1.02-1.48; p=0.028) of ever binge drinking.

Conclusions: Developing effective preventative strategies that address DBI will be important in preventing risky substance-related behaviors, including binge drinking, among adolescent females. Additional studies that explore the relationship between having a distorted sense of weight and body image and alcohol/other drug use are recommended.