BRIEF REPORT Unhealthy Weight Management Practices and Non-medical Use of Prescription Drugs Heather B. Clayton, PhD, MPH, 1 Zewditu Demissie, PhD, MPH, 1,2 Richard Lowry, MD, MS, 1 Elizabeth A. Lundeen, PhD, MPH, 3,4 Andrea J. Sharma, PhD, MPH, 2,5 Michele K. Bohm, MPH 6 Introduction: Non-medical use of prescription drugs (NMUPD) has reached epidemic proportions in the U.S. With approximately one in five high school students engaging in NMUPD, it is important to understand behavioral correlates. Methods: Data were combined from the 2011 and 2013 cycles of the Youth Risk Behavior Survey, a nationally representative, cross-sectional survey. After restricting the analytic sample to students who reported a weight loss goal of either staying the same weight or losing weight, logistic regression models were used to estimate adjusted prevalence ratios and 95% CIs for associations between unhealthy weight management practices (UWMPs) and lifetime NMUPD. Individual UWMPs— fasting; taking diet pills, powders, or liquids without a doctor’s advice; and vomiting or taking laxatives—and total number of UWMPs were examined. Data were analyzed in 2016. Results: UWMPs were more prevalent among female students (21.1% vs 10.7% for fasting; 7.5% vs 5.2% for taking diet pills, powders, or liquids; and 7.6% vs 3.2% for vomiting or taking laxatives). Significant associations between individual UWMPs and NMUPD and between the number of UWMPs and NMUPD were observed. Discussion: UWMPs were associated with NMUPD. Health educators in the school setting, as well as other health professionals who provide services to an adolescent population, can focus on healthy weight management strategies, and other substance-specific messages. Conclusions: The association between UWMPs and NMUPD may reflect a constellation of problem behaviors exhibited among some adolescents. Am J Prev Med 2016;](]):]]]–]]]. Published by Elsevier Inc. on behalf of American Journal of Preventive Medicine INTRODUCTION A pproximately 17% of students in grades 9–12 have engaged in non-medical use of prescription drugs (NMUPD). 1 Motivations include pain relief, getting high, improving concentration, and weight loss. 2–7 NMUPD for weight loss is concerning, as both NMUPD and unhealthy weight management practices (UWMPs; i.e., fasting, vomiting, using diet pills, or laxatives) are associated with adverse health and behav- ioral outcomes. 8–10 Associations of UWMPs and other disordered eating behaviors with substance use behaviors among adolescents have been observed, 9–18 but evidence for the association between UWMPs and NMUPD is limited. Studies among college students have suggested an association between UWMPs and NMUPD (specifically stimulants), 2,3,19,20 but no study has investigated the From the 1 Division of Adolescent and School Health, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia; 2 U.S Public Health Service Commissioned Corps, Rockville, Maryland; 3 Division of Nutrition, Physi- cal Activity and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia; 4 Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia; 5 Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia and the 6 Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Preven- tion, Atlanta, Georgia Address correspondence to: Heather B. Clayton, PhD, MPH, Division of Adolescent and School Health, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Mailstop E-75, Atlanta GA 30329. E-mail: hhc9@cdc.gov. 0749-3797/$36.00 http://dx.doi.org/10.1016/j.amepre.2016.09.015 Published by Elsevier Inc. on behalf of American Journal of Preventive Medicine Am J Prev Med 2016;](]):]]]–]]] 1