Weight control behaviors are a common and widespread practice among adolescents, especially girls. Theoretical models have suggested that dieting can be part of a constellation of unhealthy problem behaviors or be associated with healthful behavioral changes. Therefore, weight control practices could be viewed as either health-promoting or risk-taking behaviors. The purpose of this study was to assess the prevalence of dieting among South Carolina adolescents and to investigate potential clusters of risk behaviors associated with different patterns of dieting. Extreme dieters (i.e., adolescents using vomiting and diet pills) were hypothesized to be at greater risk for risky behaviors and less likely to engage in healthy behaviors than their moderate and nondieter counterparts. The study utilized data from the 1999 South Carolina Youth Risk Behavior Survey. A total of 4636 students in 58 stratified and randomly selected high schools responded to the survey, for a school response rate of 82% and a student response rate of 83%. Weighted statistical procedures were performed using SAS version of SUDAAN. Univariate and bivariate analyses were used to describe the sample and examine differences on important measures. Logistic regression was conducted to determine odds ratios (ORs) and confidence intervals (CIs) for health-compromising behaviors among adolescents who used weigh-control methods as compared with those who did not use these methods by sex and race. The final sample size included 4187 adolescents (54% females, 53% Whites). White females had higher prevalence rates for all weight control methods than White males, whereas Black males reported higher prevalence rates of diet pills use (6.6%) and vomiting (6.9%) compared with Black females (5.8% and 6.1% respectively). Almost one fifth (19.2%) of the adolescents were classified as extreme dieters, 43.2% as moderate dieters, and 37.2% as nondieters. Extreme dieters were more likely to use alcohol, cigarettes, marijuana, attempt suicide and less likely to practice vigorous exercise. Moderate dieters were less likely to use cigarettes, marijuana and more likely to engage in vigorous exercise, with differences across gender-race categories. Results were consistent with previous studies, in that the weight control behaviors are associated with several other important health behaviors, and differences exist between adolescents who use extreme weight loss methods and moderate dieters or nondieters. Additional research using more sensitive measures and more frequent assessments of dieting efforts, physical activity and factors influencing these behaviors is needed. The results have relevance for developing multicomponent programs for adolescents.Keyword(s): health promotion, high school issues, youth-at-risk