Experts agree that talking about the need to diet and lose weight is one of the most unhealthy, counterproductive things a parent can do for a teen who is struggling with weight issues.
Now, new guidelines from the American Academy of Pediatrics formally endorse those findings. In order to prevent obesity and eating disorders, parents should focus less on diets and the scale and emphasize family togetherness and exercise for fitness, not weight loss. The AAP included both obesity and eating disorders in their recommendations because these often share unhealthy behaviors such as dieting, bingeing and having a dissatisfied view of one’s body.
Obesity in adolescents has quadrupled in the past 30 years; in 2012, 21 percent of young people aged 12 to 19 were obese. Teens who are obese are more likely to have bone or joint problems, as well as sleep apnea. They’re also more likely to develop prediabetes, which can lead to Type 2 diabetes. On top of that, teens who are obese are more likely to grow up to become obese adults who will face heightened risks for diseases including cancer and stroke.
Tweens and teens make up the bulk of eating disorder hospitalizations. In 2012, children aged 10 to 17 years old accounted for more than 90 percent of all hospitalizations for children with eating disorders, according to data from the Agency for Healthcare Research and Quality (AHRQ) Healthcare Cost and Utilization Project (HCUP). The AAP report was compiled, in part, over growing concern about the unhealthy way teens are trying to lose weight.
Here are six takeaways from the report, published in the journal Pediatrics. These recommendations are for both doctors and parents, and they apply to all teens — not just those with weight problems.
What not to do:
Never encourage dieting.
Dieting packs a double whammy because it’s a risk factor for both obesity and eating disorders. Girls who weren’t obese but dieted in the ninth grade were three times were likely to be overweight by 12th grade, compared to girls who didn’t diet. And young people who severely reduced their caloric intake and skipped meals were 18 times more likely to develop an eating disorder than those who didn’t diet. Even just moderate dieting increased a teen’s risk of developing an eating disorder fivefold.
”A 3-year-old may not be worried if she’s a bit overweight, whereas an adolescent may try unhealthy weight-loss methods like fasting or diet pills and end up in a vicious circle of more weight gain,” explained lead author Dr. Neville Golden, a pediatrics professor at the Stanford University School of Medicine, in a statement.
Don’t comment on your child’s weight, or even your weight.
What you say matters; teens who talk about weight with their parents are also more likely to diet, binge eat and have unhealthy weight control behaviors, but this risk lessens if the subject matter is about healthy eating behaviors.
No matter how well-intentioned or seemingly benign you think your comments are, studies show that comments parents make about either their own weight or their child’s weight is linked to a child’s risk of being overweight and developing an eating disorder.
It’s important to note here that a teen doesn’t have to look excessively thin for a parent to be concerned that they might have an eating disorder, said Golden.
“This is a dangerous category of patient, because they’re often missed by physicians,” he said. “At some point, these patients may have had a real need to lose weight, but things got out of control.”
Never tease teens about their weight.
This seems obvious, but bears repeating since a significant minority of overweight teens say they’ve experienced weight-related teasing from friends or family members. Cruel taunts about weight increase a child’s risk of both being overweight and developing eating disorders, and the pain can last into adulthood.
Dianne Neumark-Sztainer, a researcher who focuses on teen health and nutrition, previously told HuffPost that parents should make their homes a sanctuary where kids feel safe from weight-related teasing.
“Our children need to know that they can tell us what happened without receiving advice on how to lose weight,” she said.
What to do instead:
While eating meals together as a family has not been shown to reduce obesity rates, it does improve the nutritional content of a child’s diet and it allows parents to model healthy eating behaviors in front of their children, the report said. One study found that families who eat meals together seven or more times per week eat more fruits and vegetables compared to families who never eat together, and for the kids, this increased intake of fruits and veggies persisted into young adulthood. Another study found that eating family dinners most days during the previous years seemed to protect kids from binge eating, dieting and purging behaviors.
Focus on a balanced diet and exercise ― not weight loss.
Encourage healthy body image by encouraging kids to eat healthfully and exercise for fitness ― not for weight loss. Teens who have these positive influences are more likely to report being happy with their bodies and less likely to say they had weight-related concerns. Kids who are dissatisfied with their bodies, on the other hand, are more likely to develop eating disorders, diet and have lower levels of physical activity.
Create a healthy home environment.
While it may seem from the AAP recommendations that a parent is more hemmed in about what they should or shouldn’t say to encourage a healthy lifestyle in children, the truth is that what a parent does says volumes about the best way to approach eating, exercise and body image.
The report says that parents can create a healthy food environment at home by buying and serving fruits, vegetables, whole grains, beans and water, while keeping artificial sweeteners, sugar-sweetened drinks and refined carbs away. Parents can also encourage physical activity by keeping TVs out of children’s bedrooms. Indeed, health interventions for both obesity and eating disorders are most effective when the whole family is involved in the treatment — not just the child who needs help.
CORRECTION: A previous version of this story reported that eating disorders caused more than 90 percent of hospitalizations in teens. This is mistaken, and we regret the error.