High school students who use indoor tanning also have higher rates of unhealthy weight control behaviors - such as taking diet pills or vomiting to lose weight, reports a study in the April Journal of Developmental & Behavioral Pediatrics, the official journal of the Society for Developmental and Behavioral Pediatrics. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.

The association between indoor tanning and unhealthy weight control methods may be even stronger for male than female adolescents, according to the new research by Stephen M. Amrock, SM, and Michael Weitzman, MD, of New York University School of Medicine. Their results suggest that, in addition to being a major risk factor for melanoma, indoor tanning might identify a group of teens at increased risk of eating disorders.

Indoor Tanning Linked to Unhealthy Weight Behaviors...

The researchers analyzed nationally representative survey data on nearly 27,000 high school students. About 23 percent of females and 6.5 percent of males reported indoor tanning within the past year. For older teens, indoor tanning was even more common: 33 percent of females and 11 percent of males aged 18 years or older. ("Indoor tanning" excluded spray-on tans.)

Students who reported indoor tanning were also more likely to report various unhealthy weight control behaviors over the past month. These included fasting for over 24 hours; taking pills, powders, or liquids; or vomiting or taking laxatives to lose weight.

With adjustment for other factors, females who used indoor tanning were 20 percent more likely to report fasting, 40 percent more likely to report vomiting or taking laxatives, and more than twice as likely to report taking weight-loss pills, powders, or liquids.

For males, the associations were even stronger. Males who used indoor tanning were more than twice as likely to fast, four times more likely to use pills, powders, or liquids, and seven times more likely to report vomiting or laxative use.

...With Possible Link to Eating Disorders in Teens

The survey added to previous evidence linking indoor tanning to negative body image. Females who used indoor tanning were more likely to perceive themselves as normal weight, yet more likely to say they were trying to lose weight.

Indoor tanning is a preventable cause of melanoma, which is increasing at epidemic rates. Previous research has suggested that people who use indoor tanning have skin or body image concerns and are more likely to engage in other risk behaviors.

While the study can't show a definitive link to eating disorders, it does suggest that teens who use indoor tanning have higher rates of unhealthy weight control behaviors linked to eating disorders. Negative body image may also contribute to high rates of indoor tanning among adolescents, although the mechanism of the association may differ for males versus females.

The researchers suggest that screening adolescents for indoor tanning could serve a double purpose: addressing a major risk factor for skin cancer as well as identifying teens at risk for unhealthy weight control behaviors. "Greater attention to these issues by pediatricians may help reduce the number of adolescents risking potentially deadly consequences," Amrock and Weitzman conclude.

In an accompanying editorial, David C. Schwebel, PhD, of University of Alabama at Birmingham further discusses the possible associations among tanning, risk-taking behaviors, and eating disorders in teens. "Poor body image is associated with both indoor tanning behavior and eating disorder behaviors," he writes. While doctors and parents can play a role in talking to teens about the risks of indoor tanning, Dr Schwebel believes that more communities and states should enact laws to prohibit minors from using tanning salons.