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. Author manuscript; available in PMC: 2015 Sep 1.
Published in final edited form as: Appetite. 2014 May 20;80:190–196. doi: 10.1016/j.appet.2014.05.016

Parental Encouragement of Dieting Promotes Daughters' Early Dieting

Katherine N Balantekin a,b,*, Jennifer S Savage a,b, Michele E Marini a, Leann L Birch a,b,c
PMCID: PMC4138045  NIHMSID: NIHMS599036  PMID: 24858835

Abstract

Dieting to lose weight is common among female adolescents. This research investigated the association between maternal and paternal encouragement to diet and their daughters' self-reported “early dieting” (prior to age 11y) and adolescent dieting (between 11y and 15y), and how parental encouragement to diet is related to changes in daughter BMI percentiles. Participants in this study were 174 non-Hispanic white girls and their parents, assessed when daughters were age 9-, 11-, 13-, and 15y. The Parent Encouragement of Child Weight Loss Scale was used to measure encouragement to diet. Logistic regression was used to examine the relationship between parental encouragement to diet and daughters' reports of dieting by 11y and by 15y, adjusting for daughters' weight status at baseline. Compared to girls whose mothers didn't encourage dieting, girls who were encouraged to diet were twice as likely to diet by 11y; girls who were encouraged by their fathers were also twice as likely to diet by 11y. Girls who were encouraged to diet by both parents were 8 times more likely to report early dieting than girls who were not. Neither maternal nor paternal encouragement predicted the emergence of dieting during adolescence. Girls who dieted and had parental encouragement to do so had increases in BMI percentile from 9y to 15y. Findings reveal that parental encouragement to diet may be counterproductive and that parents need alternative approaches to promote healthy patterns of intake and growth among young girls.

Keywords: Encouragement to diet, dieting, maternal, paternal, children

Introduction

Dieting to maintain or lose weight is common among girls (Abramovitz & Birch, 2000; Davison, Markey, & Birch, 2000; Dixon, Adair, & O'Connor, 1996; Ricciardelli, McCabe, & Banfield, 2000). Girls as young as 5y are aware of dieting practices (Abramovitz & Birch, 2000), and girls report the emergence of dieting or wanting to lose weight by middle childhood, age 9y, (Sinton & Birch, 2005), suggesting that some early attempts at dieting may emerge prior to adolescence. Estimates suggest that roughly 40% of pre-adolescent school-aged children have attempted to diet to lose weight (Maloney, McGuire, Daniels, & Specker, 1989), with that number rising to roughly two-thirds of adolescent girls (Eaton et al., 2012).

Although overweight adolescents report more frequent dieting and use of weight control behaviors than normal weight adolescents, a high percentage of normal weight adolescent girls also report dieting (Neumark-Sztainer, Story, Hannan, Perry, & Irving, 2002), suggesting that even normal weight girls may be dieting to achieve the “thin ideal.” Because dieting is often not successful and may increase risk for the development of disordered eating (Hsu, 1996; Neumark-Sztainer et al., 2006; Patton, Selzer, Coffey, Carlin, & Wolfe, 1999) and greater long-term weight gain (Field et al., 2003; Hill, 2004; Stice, Cameron, Killen, Hayward, & Taylor, 1999), it is important to understand the factors involved in the etiology of dieting. There are multiple factors that have been found to impact the onset of dieting in childhood and adolescence, including peer and media influence (Field, Camargo, Taylor, Berkey, & Colditz, 1999; Field et al., 2001; Levine, Smolak, & Hayden, 1994), and both direct and indirect parental influence (Dixon et al., 1996).

Parents shape both children's health-related behaviors and their food environments (Tinsley, 1992), thus playing a primary role in the development of eating behavior. Costanzo and Woody's (1985) domain-specific obesity proneness model posits that parents who are concerned about their child's obesity proneness may exert more control over eating behavior, potentially through use of restrictive feeding practices and encouragement to diet. This may have an influence on later eating and dieting behavior (Birch & Fisher, 1998). Motivation behind using these controlling behaviors reported by both mothers and fathers is that parents may want to help their child lose weight in order to improve their physical appearance (Striegel-Moore & Kearney-Cooke, 1994), thus, transmitting a thin ideal to their child that may also influence the emergence of dieting (Thelen & Cormier, 1995). Parents may also use these controlling behaviors in response to the child's developing sense of autonomy of control over their food choices (Bassett, Chapman, & Beagan, 2008).

Increases in body fat and the emergence of secondary sexual characteristics are normative changes that occur during the transition from childhood to adolescence, and may prompt the initiation of girls' dieting (Byely, Archibald, Graber, & Brooks-Gunn, 2000). Parents may also respond to these developmental changes with encouragement and information about dieting and weight control. Research also indicates that parents report using higher levels of encouragement to diet with overweight children (Fulkerson et al., 2002). However, normal weight adolescents are also encouraged to diet (Fulkerson et al., 2002), suggesting that the child's weight is not the only factor in eliciting encouragement to diet from the parent. Additionally, parental encouragement to diet often predicts dieting behavior even after controlling for daughters' weight status (Wertheim, 1999).

Parental encouragement to diet has been shown to start in childhood (Thelen & Cormier, 1995) and early adolescence and persist into late adolescence (Bauer, Laska, Fulkerson, & Neumark-Sztainer, 2011). Among adolescent girls, parental encouragement to diet predicts daughter dieting (Dixon et al., 1996; Strong & Huon, 1998). In these prior studies, parental encouragement was used as a general term, maternal and paternal encouragement were not assessed separately, and was assessed using daughters' reports. While Thelen and Cormier (1995) reported that levels of encouragement to diet are similar between mothers and fathers, there has been limited research examining the independent effects of maternal and paternal encouragement. Maternal encouragement to diet predicts adolescent daughters' dieting behavior (Huon, Lim, & Gunewardene, 2000). While evidence is limited, data from Project EAT indicated that paternal encouragement did not predict adolescent daughter dieting behavior after accounting for maternal encouragement (Neumark-Sztainer et al., 2010).

Less is known about how parental encouragement to diet predicts the emergence of dieting during childhood. Limited reports on parental encouragement to diet in children suggest that both maternal and paternal encouragement to diet are related to an increased frequency of dieting (Thelen & Cormier, 1995), but they did not examine the effect of paternal encouragement to diet on the emergence of dieting. Additionally, research is limited on the potential combined influence of having two parents encourage dieting. The cumulative risk hypothesis (Appleyard, Egeland, van Dulmen, & Sroufe, 2005) proposes that exposure to multiple risk factors increases the risk of an outcome, suggesting that combined encouragement to diet from both parents might be a predictor worth examining. A potential methodological limitation is that the majority of studies examining the influence of parental encouragement on dieting have used children's perceived reports of parental encouragement (Dixon et al., 1996; Haines, Neumark-Sztainer, Wall, & Story, 2007; Huon et al., 2000) or have used a single item regarding the extent to which parents “encouraged their adolescent to diet to control his/her weight” (Fulkerson et al., 2002).

The primary aim of this study was to investigate maternal and paternal reports of encouragement to diet as independent predictors of the emergence of daughters' dieting attempts during childhood (“early dieting,” by 11y) and during adolescence (between 11y and 15y), and when controlling for daughters' weight status. A secondary aim of this study was to determine if parental encouragement predicted change in daughters' BMI percentile from 9y to 15y, and if these effects differed for dieting that emerged early, during childhood, or in adolescence.

Research Methods

Participants

Participants at study entry included 197 non-Hispanic, white families living in Central Pennsylvania recruited as part of a longitudinal study of the health and development of young girls, concentrating on parental influence associated with early dieting in girls. Eligibility criteria for girls' participation at recruitment included living with the biological mother and father, the absence of severe food allergies or chronic medical problems affecting food intake, and the absence of dietary restrictions involving animal products. The sample was not recruited based on weight status. Parents and their 5y old daughter (m = 5.4 ± 0.4 y) were recruited for participation into the study using flyers and newspaper advertisements. In addition, families with age-eligible female children within a five-county radius received mailings and follow-up phone calls (Metromail Inc.). Families were assessed at baseline and then assessed every 2y at daughter age 7 (n=192), 9 (n=183), 11 (n=177), 13 (n=168), and 15 (n=167). Attrition was primarily due to family relocation outside of the area. Families with complete data from 9y to 11y (n=174) were included in this in the final sample predicting early dieting, and families with complete data from 9y to 15y were included in the final sample predicting adolescent dieting (n=110). No significant differences were found between the initial weight status of participants lost to follow-up (n=9) and of participants who completed the study at age 15 (n=165).

The Pennsylvania State University Human Subjects Institutional Review Board approved all study procedures, and parents provided consent for their family's participation before the study began.

Procedure

Parent Measures

Demographics

Maternal and paternal years of education and family income were self-reported at study entry. Parents selected their combined family income from the following: less than $20,000; $20,000-$35,000; $35,000-$50,000; and greater than $50,000.

Parent weight status (BMI)

Parent heights and weights were measured at study entry by a trained staff member following procedures described by Lohman et al. (1988). All subjects were weighed and measured in light clothing without shoes. Height was measured in triplicate to the nearest 0.1 cm using a stadiometer. Weight was measured in triplicate to the nearest 0.1 kg on an electronic scale (Seca Corp, Birmingham, United Kingdom). Weight and height were used to calculate body mass index (BMI = weight (kg)/height (m2 )).

Parent encouragement of daughters' dieting

Maternal and paternal encouragement of daughter dieting was assessed when daughters were 9-, 11-, 13-, and 15y using the Parent Encouragement of Child Weight Loss Scale. This measure was created for this study due to the lack of a previously validated measure on the topic, and is partially described by Davison and Deane (2010). The measure contains 16 items assessing the ways in which parents encourage their child to lose weight, and includes items about food intake and physical activity, for example: “Have you talked to your daughter about the things she could do to lose weight?” For each item, responses were measured on a 4-point scale (1=definitely not; 2=not really; 3=a little; 4=a lot/definitely). At each time point, a mean score across all 16 items was created to reflect the level of encouragement to diet at that time point. In order to get a measure of the number of times the parent reported encouraging dieting during the current study (ranging from 0, never, to 4, at ages 9, 11, 13, and 15), a measure of the consistency of encouragement for maternal and paternal encouragement was created. This was done by classifying parents as a dichotomous yes/no (did encourage dieting/did not encourage dieting) at each time of assessment. A mean score across all items greater than or equal to 2 represents parental encouragement to diet at that time of assessment. To examine the cumulative influence of having both parents encourage dieting, a measure of combined parental encouragement was created using the dichotomous measure of encouragement at each time of assessment. Response options include ‘neither,’ ‘either,’ or ‘both,’ and reflect parental encouragement to diet at least once during the study period. The internal consistency coefficient for parental encouragement of dieting, for both mothers and fathers, was α=.72 or higher for all times of assessment.

Daughters' Measures

Weight status (BMI percentile)

Height and weight were measured at daughter age 9, 11, 13, and 15 by a trained staff member following procedures described by Lohman (1988). Girls were dressed in light clothing and measured without shoes. Height was measured in triplicate to the nearest 0.1 cm using a Shorr Productions stadiometer (Irwin Shorr, Olney MD). Weight was measured in triplicate to the nearest 0.1 kg using a Seca Electronic Scale (Seca Corp, Birmingham, United Kingdom). BMI (weight (kg)/height (m)2 ) scores were generated based on height and weight measurements and were used to calculate BMI percentiles. Age- and sex-specific BMI percentiles were calculated using the 2000 CDC Growth Charts; overweight was defined as a BMI > 85th percentile on the basis of a standardized reference criteria (Kuczmarksi et al., 2000).

Dieting

Girls' self-reported dieting attempts were assessed at 9-, 11-, 13-, and 15y using a dichotomous yes/no item, “Have you ever dieted?” Girls were told that they should think of a diet as “whenever you eat less or exercise more in order to lose weight.” Anyone who reported a “yes” response at any time point was coded a “yes” at all subsequent time points due to the survival-curve nature of the emergence of dieting. Daughters were classified as ‘early dieters’ if they first reported dieting by age 11, as adolescent dieters if they first reported dieting at 13 or 15 or as ‘never dieted’ if they did not report dieting by age 15. Responses to “have you ever dieted?” were confirmed by weight loss behaviors reported on an adapted French Weight Loss Scale (French, Perry, Leon, & Fulkerson, 1995).

Statistical Analyses Plan

All data analyses were performed using SAS version 9.2 (SAS Institute Inc., Cary, NC). Descriptive statistics were computed for parental (maternal, paternal, and combined) encouragement of dieting, daughters' dieting, and daughter BMI percentile. Chi-square was used to test the relationship between maternal and paternal encouragement to diet. Statistical significance was defined as p≤0.05.

The primary aim of this study was to assess whether parental encouragement predicts the emergence of daughters' reports of early dieting (by 11y) and dieting during adolescence (between 11y and 15y). Dieting was assessed as a binary variable: e.g., if daughter first dieted (vs. did not diet) by 11y, or if daughter first dieted between 11y and 15y (vs. did not diet). As such, logistic regression was used to predict the emergence of both early dieting and the emergence of dieting between 11y and 15y. In all logistic regression models, odds ratios and 95% confidence intervals were reported. In addition, to account for the role of weight status on dieting, daughter BMI percentile at 9y (baseline) was included as a stable covariate in all models. Mother education, father education, mother BMI, father BMI were tested individually as covariates in a logistic regression model with early dieting as the outcome and daughter BMI percentile as a stable covariate. The latter was included in all models because we wanted to identify additional covariates that were statistically significant while in the presence of daughter BMI percentile, however no additional covariates were significant and thus were not entered in the following models. Models were run separately for maternal and paternal encouragement to investigate the independent contributions of maternal and paternal encouragement on the emergence of dieting. For the model predicting early dieting, a cumulative score of maternal encouragement at 9y and 11y, representing the consistency of maternal encouragement (range: 0-2), was entered as the predictor. Next, this model was repeated and adjusted for daughter BMI percentile at 9y. The same steps were repeated to test for the influence of paternal encouragement at 9y and 11y. Lastly, for the model predicting the emergence of dieting between 11y and 15y , a cumulative score of maternal encouragement at 9y, 11y, 13y, and 15y, representing the consistency of maternal encouragement (range: 0-4), was entered as the predictor. This model was repeated and adjusted for daughters' BMI percentile at 9y. The same steps were repeated to test for the influence of paternal encouragement, and combined parental encouragement (neither, either, both). In the models predicting dieting that emerged between 11y and 15y, daughters who reported dieting by 11y were excluded to restrict the models to daughters whose dieting emerged after 11y. As a result, there are fewer families in these models than there were in the early dieting models. Daughters who responded “yes” to “have you ever dieted?” but did not report engaging in any of the listed weight loss behaviors, were removed from the data and the data were reanalyzed. Removing these daughters did not change the results, and thus these daughters remained in the analyses.

The secondary aim was to determine if parental encouragement predicts change in daughters' BMI percentile from 9y to 15y, and if these effects differed by when dieting emerged (early dieting vs. dieting during adolescence). To do this, the sample was split into two groups based on when dieting emerged: emergence of dieting by 11y, and emergence of dieting between 11y and 15y. A third group was created for girls who reported having not dieted from 9y to 15y. Next hierarchical linear regression (HLR) models were run separately for each dieting group. HLR was chosen to allow for the estimation of unique R2 estimates for parental encouragement. In each model, daughters' BMI percentile at 9y was entered in step 1, which permitted us to examine change in BMI percentile from 9y to 15y. In step 2, the consistency of maternal encouragement from 9y to 15y (range: 0-4) was entered as the main predictor. Lastly, these models were rerun with paternal encouragement as the main predictor.

Results

Background, daughters' dieting, and parental encouragement characteristics

Sample daughter dieting and parental encouragement characteristics are shown in Table 1 and reveal that the percentage of daughters who reported that they had ever dieted increased steadily from 9 y to 15 y. About 30% of girls reported early dieting (by 11y) and nearly half of girls reported dieting for the first time during adolescence; more than three quarters of girls reported dieting by 15y; 30% of the girls were overweight at 9y, decreasing to 21% at 15y. Daughter BMI percentile at age 9 was significantly positively correlated with higher levels of both maternal encouragement to diet (r =.56, p < .0001) and paternal (r = .58, p < .0001) encouragement to diet. Similar patterns of associations between concurrent daughter BMI percentile and maternal/paternal encouragement to diet were found at daughter ages 11, 13, and 15. Both maternal and paternal encouragement to diet differed by daughters' weight status at 9y; 69% of overweight 9y daughters were encouraged to diet by their mothers, compared with only 10% of 9y normal weight daughters. Similarly, 73% of 9y overweight daughters were encouraged to diet by their father, compared with only 13% of 9y normal weight daughters. Maternal and paternal encouragement of dieting were significantly correlated (r = .61, p < .0001) at daughter age 9, but there were families in which only one parent reported encouragement to diet. As shown in Table 1, parental encouragement was the highest among early dieters. Of the early dieters, 44% were encouraged by both parents. All daughters who received encouragement to diet from both parents reported dieting during the study, and 91% of the girls who were encouraged to diet by one parent were dieters.

Table 1. Descriptive demographics, daughters' dieting, and parental encouragement.
Total Sample (n=167) Early Dieters (n=55) Adolescent Dieters (n=77) Did not diet by 15 (n=35)
Daughter BMI percentile
 at 9 64.5 (27.1) 78.9 (22.1) 60.9 (26.1) 51.3 (27.0)
 at 15 61.3 (25.1) 72.3 (23.6) 60.4 (22.7) 48.6 (25.8)
% with maternal encouragement
 by 11 21.0 45.5 12.8 5.6
 by 15 32.3 N/A 20.5 13.9
% with paternal encouragement
 by 11 20.1 45.3 13.2 0
 by 15 27.9 N/A 26.3 2.8
% with combined encouragement
 by 11 14.0 36.9 6.6 0
 by 15 20.7 N/A 14.5 2.8
Open in a new tab

Early dieters reported dieting for the first time at 9y or 11y; adolescent dieters reported dieting for the first time at 13y or 15y. Parental encouragement measured at daughter 9-, 11-, 13-, and 15y. Percent daughters with maternal/paternal/combined encouragement represents parent report of encouragement at least once during the time period

Daughter BMI percentile and early maternal and paternal encouragement predict daughter early dieting

As shown in Table 2, both early maternal and paternal encouragement were independent predictors of the emergence of daughter early dieting behavior (by age 11) and remained significant predictors after controlling for BMI percentile at 9y. Daughter BMI percentile at 9y was a significant independent predictor of early dieting in both the maternal and the paternal encouragement models, and remained significant after adding parental encouragement. The interaction between parental encouragement and daughter BMI percentile was not significant. Daughters who were encouraged to diet early by their mother were approximately twice as likely to report early dieting than daughters who were not encouraged to diet. Daughters who were encouraged to diet early by their fathers were approximately twice as likely to report early dieting than daughters who were not encouraged to diet.

Table 2. Predicting the emergence of daughters' early dieting and adolescent dieting from maternal and paternal encouragement of dieting, adjusting for BMI percentile at age 9.
Early Dieting Adolescent Dieting
Maternal (n=174 ) Paternal (n= 169) Maternal (n=112) Paternal (n=110)
Daughter BMI percentile 1.03 (1.01, 1.04)** 1.03 (1.01, 1.04)** 1.01 (0.99, 1.03) 1.01 (0.99, 1.02)
Daughter encouraged by:
 Mother 1.90 (1.08, 3.35)* 1.48 (0.79, 2.76)
 Father 2.15 (1.18, 3.91)* 3.10 (0.92, 10.42)
Open in a new tab

Early dieting refers to the emergence of self-reported dieting by 11y. Adolescent dieting refers to the emergence of dieting after 11y but by 15y. Daughters who reported dieting by 11y were excluded from the models examining the emergence of dieting during adolescence. Daughters' BMI percentile was measured at age 9y. Parental encouragement measured at daughter 9-, 11-, 13-, and 15y (only 9- and 11y used to predict early dieting) and represents the number of times the mother/father reported encouraging dieting. Data presented as odds ratios with 95% confidence interval in parentheses.

*

p < .05,

**

p < .01,

***

p < .001

Maternal and paternal encouragement does not predict the emergence of dieting during adolescence

As shown in Table 2, in contrast to the findings for early dieting, maternal encouragement of dieting was not a significant predictor of the emergence of daughter dieting during adolescence (between 11y and 15y) before (p > .05) or after (p > .05) adjusting for BMI percentile. Paternal encouragement to diet was a significant independent predictor of the emergence of daughter adolescent dieting (p < .05), but was no longer significant after adjusting for daughter's BMI percentile (p > .05).

Combined parental encouragement predicts early dieting, but not dieting during adolescence

As shown in Table 3, the measure of combined parental encouragement to diet was a significant independent predictor of early dieting, by 11y (p < .001). Similar results emerged after adjusting for daughter BMI percentile. Relative to cases in which neither parent encouraged dieting, after adjusting for BMI percentile, daughters who were encouraged early by both parents were 8 times more likely to report the emergence of dieting by 11y. In contrast, findings in Table 3 show that neither combined parental encouragement to diet nor daughter's BMI were significant predictors of the emergence of dieting in adolescence. The interaction between daughter BMI percentile at 9y and combined encouragement was not significant.

Table 3. Predicting the emergence of daughters' early dieting and adolescent dieting in families where neither parent, either parent or both parents encouraged their daughter to diet, adjusting for daughters' BMI percentile at age 9.
Early Dieting (n= 169) Adolescent Dieting (n=110)
Daughters' BMI Percentile 1.02 (.998, 1.04) 1.01 (.99, 1.02)
Dieting encouraged by:
Neither parent ref ref
One parent 1.99 (.66, 5.96) 1.66 (.46, 5.88)
Both parents 8.30 (2.32, 29.68)** 5.34 (0.60, 47.25)
Open in a new tab

Early dieting refers to the emergence of self-reported dieting by 11y. Adolescent dieting refers to the emergence of dieting between 11y and 15y. Daughters who reported dieting by 11y were excluded from the models examining the emergence of dieting during adolescence. Parental encouragement measured at daughter 9-, 11-, 13-, and 15y (only 9- and 11y used to predict early dieting). The “neither” group was used as the reference group for comparisons.

Data presented as odds ratios with 95% confidence interval in parentheses.

*

p < .05,

**

p < .01,

***

p < .001

Parental encouragement to diet predicts greater increases in weight status from 9y to 15y among daughters who report dieting

Parental encouragement to diet predicted increases in BMI percentile from 9y to 15y among daughters whose dieting emerged by 11y or between 11y and 15y, but not among daughters who did not report dieting by 15y. In early dieters, maternal encouragement (β = 6.2, p < .01; R2 = .11), but not paternal encouragement (p > .05), significantly predicted an increase in BMI percentile from 9y to 15y. Early dieters were predicted to increase 6.2 BMI percentiles per unit increase in maternal encouragement to diet. In daughters whose dieting emerged during adolescence, both maternal encouragement (β = 4.2, p < .05; R2 = .03) and paternal encouragement (β = 4.4, p < .05; R2 = .03) were significant predictors of an increase in BMI percentile from 9y to 15y. Adolescent dieters were predicted to increase 4.2 and 4.4 BMI percentiles per unit increase in maternal and paternal encouragement to diet, respectively. In daughters who did not report dieting by 15y, neither maternal nor paternal encouragement was a significant predictor of the change in BMI percentile from 9y to 15y.

Discussion

This study investigated the influence of maternal and paternal encouragement to diet on daughters' early dieting and dieting during adolescence. In this sample, dieting among girls was prevalent from 9 to 15y. For some girls, dieting developed early, by age 11. Early encouragement of dieting by both mothers and fathers predicted greater risk of early dieting. In contrast, neither maternal nor paternal encouragement predicted the emergence of dieting during adolescence. Parental encouragement to diet predicted increases in girls' BMI percentiles between the ages of 9 and 15, but only among girls who reported dieting early or during adolescence. The findings indicate that parental encouragement to diet may have unintended negative effects, by promoting dieting and increased weight status.

Although self-reported dieting is normative among girls by adolescence, there is limited evidence suggesting that the intergenerational transmission of ideas about dieting and dieting practices, and the emergence of dieting, begin much earlier: 5-year old girls are already aware of dieting practices (Abramovitz & Birch, 2000), and report dieting attempts by middle childhood (Sinton & Birch, 2005). While not directly addressed in the current study, parents are models of strategies for weight loss that daughters may emulate; parents can influence their daughters by modeling maladaptive eating behaviors and by expressing concern about their own body dissatisfaction. There is a strong familial link between mothers' and adolescent daughters' weight concerns (Pike & Rodin, 1991) and levels of dietary restraint (Hill, Weaver, & Blundell, 1990), and between mothers' disinhibition and daughters' disinhibited eating (Cutting, Fisher, Grimm-Thomas, & Birch, 1999). In the current study, both maternal and paternal encouragement to diet were significant independent predictors of early dieting, and remained significant after controlling for daughter BMI percentile. In the only previous study investigating parental encouragement to diet on dieting behavior in childhood, Thelen and Cormier (1995) noted that there was a significant correlation between both maternal and paternal encouragement to diet and daughters' reported dieting frequency. The current findings are consistent with this result and extend these findings to address whether parental encouragement to diet predicted the initiation of daughters' dieting. Findings from the current study support the idea that while mothers play a central role in the transmission of information about dieting (Abramovitz & Birch, 2000), fathers can also play an important role in the development of daughters' dieting behavior.

Despite the fact that parental encouragement to diet persisted and increased as the daughters became adolescents, parental encouragement did not predict the emergence of dieting during adolescence. This is in contrast to prior research suggesting that parental encouragement predicts dieting during adolescence (Dixon et al., 1996; Strong & Huon, 1998); however, in those studies, the authors did not measure when dieting emerged or distinguish between early dieters and adolescent dieters. In the current study, daughters who reported early dieting, prior to adolescence, were excluded from the models examining the emergence of dieting during adolescence. Due to our relatively small sample size, a larger sample is needed to confirm study findings. For example, it is also possible that parental encouragement to diet does not enhance adolescent girls' already heightened risk of dieting; parental encouragement may become less influential during adolescence as influence from peers and from the media becomes more normative (Eisenberg, Neumark-Sztainer, Story, & Perry, 2005; Levine, Smolak, & Hayden, 1994; Levine, Smolak, Moodey, Shuman, & Hessen, 1994), though this has not been directly studied in the present study. Daughter weight status was not a significant predictor of the emergence of dieting during adolescence in the current sample. This may be because it is common for many girls, regardless of their weight status, to try to achieve the thin ideal, as reported by past studies (Neumark-Sztainer et al., 2002). Our finding that three-fourths of girls reported dieting by age 15 agrees with those previous findings.

Girls who were encouraged to diet by both parents were 8 times more likely to report early dieting relative to girls who were not encouraged to diet. The cumulative risk hypothesis suggests that exposure to multiple risk factors increases the risk of an outcome (Appleyard et al., 2005). When applied to our findings, it may be that girls' exposure to encouragement to diet from both mother and father increases the risk of dieting, over and above having one parent encourage dieting. In our sample, all girls who were encouraged to diet by both parents reported having dieted by age 15, with the majority of girls reporting having dieted by age 11. This implicates encouragement to diet from both parents as a very strong predictor of daughter early dieting.

As expected, girls with higher BMIs were more likely to be encouraged to diet both in childhood and in adolescence. While this result has not yet been shown in children, this is consistent with previous research showing that levels of maternal and paternal encouragement are higher among overweight adolescent girls (Fulkerson, 2002). Parents who are concerned about their child's obesity proneness are more likely to exert control over their child's eating (Costanzo & Woody, 1985) which might explain why parents are more likely to encourage overweight girls to diet. This study provides new information indicating that parental encouragement to diet predicted increases in BMI percentile from 9y to 15y, but only among girls who reported initiating dieting attempts. Maternal encouragement predicted an increase in BMI percentile for early dieters, and both maternal and paternal encouragement predicted an increase in BMI percentile for adolescent dieters. While parents may be encouraging their daughter to diet because they are concerned about her weight status, findings from this study indicate that encouragement to diet may help support weight gain over time, which is in opposition to the intended purpose of encouragement to diet. However, since not all other potential influences were included as predictors, additional work is needed to confirm this finding. Additional studies with larger samples could improve the predictive effect of the encouragement to diet on change in weight, as the R2 is significant but small in the current sample. One reason that parental encouragement to diet might not be a successful in helping children lose weight is that levels of inhibitory control have been associated with dieting success (Jansen & Vandenhout, 1991), and levels of self-regulation and inhibitory control are still developing in pre-adolescent girls (Hooper, Luciana, Conklin, & Yarger, 2004). This suggests that early attempts at dieting might not be successful, and thus encouraging these girls to diet may be problematic.

The current study has several strengths. Our findings extend prior research and demonstrate the predictive relation between early maternal and paternal encouragement to diet and girls' early dieting in childhood. These findings add to the literature by providing information on the influence of parental encouragement to diet on the emergence of dieting during childhood and adolescence. In addition, the longitudinal data available in the current study allowed us to evaluate both the independent and combined influence of maternal and paternal encouragement to diet on daughters' dieting. The current study is not without limitations. One main limitation is the main predictor variable (maternal/paternal encouragement of dieting) and the main outcome variable (dieting) are both subject to self-report bias, as some may be embarrassed by the nature of the question. Another limitation is that the measure of dieting used in this study does not capture reasons for dieting other than for weight loss. The sample was primarily non-Hispanic white two-parent families with middle to high incomes, which limits the generalizability of the findings to other groups at elevated risk for obesity as well as to mother-son or father-son dyads. Another limitation is that other factors that may support the emergence of dieting, such as media and peer influence, were not examined and thus cannot be ruled out potential contributing factors to the emergence of dieting.

In summary, maternal, paternal, and combined parental encouragement to diet predicted an increased likelihood of the emergence of daughters' early dieting in childhood, independent of weight status, but did not predict the emergence of daughters' dieting in adolescence. While dieting is a normative behavior, the current study adds to a growing body of research that dieting in childhood and adolescence, particularly in girls who were encouraged to diet by their parents, can lead to later weight gain. Less is known about the physical and psychological health risks associated with starting to diet early, prior to the onset of adolescence, with limited research suggesting that early dieting may have similar health risks as dieting during adolescence. Further, less is known about why parents encourage their child to diet, future work should examine parental characteristics that contribute to a parent's choice to encourage their child to diet, such as the parent's weight status and their own dieting history. However, more work is needed to determine alternatives approaches concerned parents can use. Recent research suggests that rather than using controlling feeding practices, parents who are concerned about their child's weight status should focus on modeling healthy behaviors (Neumark-Sztainer et al., 2010; Pearson, Biddle, & Gorely, 2009); this would be a good starting point for developing alternative approaches to encouragement to diet.

Highlights.

  • 30% of the current sample reported dieting by 11 y

  • Both normal weight and overweight girls were encouraged to diet by their parents

  • Parental encouragement to diet predicted greater risk of dieting by 11y

  • Parental encouragement to diet did not predict the emergence of dieting after 11y

  • Parental encouragement to diet may promote increased weight status

Acknowledgments

This research was supported by NIH HD32973 and USDA Grant # 2011-67001-30117

Footnotes

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