Relationships Between Maternal Factors and Weight Loss Attempts Among Urban Male and Female Adolescents Living in Soweto, Johannesburg, South Africa

Abstract

South Africa is undergoing rapid urban transition favoring ideals of thinness, which increases eating disorders risk for female adolescents, whereas older women continue to uphold corpulence as a female cultural value. This study aimed to assess the potential conflicting relationship between urban male and female adolescents' weight loss attempts (WLA) and maternal body image norms within households. Methods: The study included a longitudinal sample of motheredaughter and mothereson pairs from the Birth to Twenty Plus Cohort (N ¼ 1,613), using data collected at 13, 17, and 22 years. Sociodemographic characteristics, eating attitudes, WLA, and body mass index were assessed in mothers and their offspring. Relationships between maternal factors and offspring's WLA were assessed using both logistic regression and structural equation modeling. Results: More females had WLA compared with their male counterparts at 13, 17, and 22 years. Multivariable models showed an independent positive association between maternal household socioeconomic status and boys' WLA at 13 years, whereas independent negative associations were found between mothers' body mass index and boys' WLA at 17 and 22 years. Mothers' age and sons' WLA at 22 years showed an independent positive association. No association was found between maternal factors and daughters' WLA. Conclusions: Strong gender-differentiated intergenerational patterns were observed between maternal factors and offspring's WLA from early adolescence to early adulthood. The lack of relationship between IMPLICATIONS AND CONTRIBUTIONPublic health interventions must help adolescents and their families better understand the multiple factors influencing their attitudes and behaviors around eating and body image so as to promote healthy weight status and minimize eating disorder risk. Conflicts of interest:The authors have no conflicts of interest to declare. Disclaimer: Publication of this article was supported by the Bill & Melinda Gates Foundation. The opinions or views expressed in this article are those of the authors and do not necessarily represent the official position of the funder.

Centering Gender in Our Clinical, Public Health, and Research Programs

“…From Cohen et al's [3] analysis of data from the Birth to Twenty Plus cohort study in South Africa, we also observe differing patterns of weight loss attempts by gender and their association with maternal factors. Boys' behavior is highly correlated with their mothers' attempts, but there is no association between girls' and mothers' behaviors.…”

“…Three of the manuscriptsdfrom Brazil, South Africa, and the U.S. [1,3,5]dexamine weight control and body image. Studies in these markedly different areas of the world show similar findings: parental perceptions and messages about weight have an impact on weight management and body image.…”

“…Six of the seven articles tackle unique issues in different countriesdBrazil [1,2], South Africa [3], Zambia [4], and the U.S. [5,6]dusing longitudinal data sets. The seventh paper, from Nigeria and Tanzania, uses cross-sectional data and describes associations [7].…”

Association Between Maternal Lifestyle and Risk of Metabolic Syndrome in Offspring—A Cross-Sectional Study From China

“…Though the mechanisms underlying were not elucidated, accumulated evidence has shown that parenting style and practices may contribute to the weak mediation effect of offspring's lifestyle (31,32). And in westernized context, there were differences regarding lifestyle perception and management in teenagers and their parents (33). In addition, adolescents of this age spent most of their time at school, and they were susceptible to the external environment beyond family (34), and the influence of peers become more influential during adolescence while the impact of mothers and other family members was attenuated (35).…”

Adolescence and Gender Equality in Health

“…Cohen et al. [12] found that although the sons of heavier mothers in South Africa were less likely to try to lose weight, there was no association between mothers' body mass index and daughters' weight loss attempts, suggesting a generational shift among women to ideals of thinness. Chae et al.…”