Public Health Nutrition

Special groups

Environmental factors associated with disordered weight-control behaviours among youth: a systematic review

Monica L Wanga1a2 c1, Karen E Petersona3, Marie C McCormicka2 and S Bryn Austina2a4

a1 Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, S7-746, Worcester, MA 01605, USA

a2 Department of Society, Human Development and Health, Harvard School of Public Health, Boston, MA, USA

a3 Human Nutrition Program, Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA

a4 Division of Adolescent and Young Adult Medicine, Children's Hospital, Boston, MA, USA


Objective Environmental factors may be very important in the development of disordered weight-control behaviours (DWCB) among youth, yet no study to date has conducted a review that synthesizes these findings. The purpose of the present study was to systematically review existing literature on environmental influences on DWCB among youth and to identify conceptual and methodological gaps in the literature.

Design Systematic review.

Setting Studies were identified through a systematic search using PubMed, PsycINFO, Google Scholar and secondary references. Inclusion criteria included observational studies published in peer-reviewed journals from 1994 to 2012 that examined environmental exposure(s) associated with DWCB among youth.

Subjects Ninety-three studies, the majority of which utilized a cross-sectional design (75 %; n 70), were identified. Longitudinal studies’ follow-up time ranged from 8 months to 10 years.

Results Parental, peer and media influences have been extensively studied as factors associated with DWCB among youth. Fewer studies have examined behavioural settings (i.e. homes, schools, neighbourhoods) or sectors of influence other than the media on DWCB. No studies utilized multilevel methods to parse out environmental influences on DWCB. Most studies (69 %, n 64) did not explicitly utilize a theory or model to guide the research.

Conclusions Findings indicate that exploring a wider range of environmental influences on DWCB, specifically behavioural settings and sectors of influence, using diverse study samples and multilevel methodology is needed to advance the field and to inform the design of comprehensive prevention programmes that target DWCB and other weight-related behaviours.

(Received July 12 2012)

(Revised March 10 2013)

(Accepted April 17 2013)

(Online publication June 19 2013)


  • Environment;
  • Disordered weight control;
  • Youth


c1 Corresponding author: Email