Experts think there’s a fairly straightforward way to reduce both obesity and eating disorders in teens: Stop harping on weight or dieting.
And the change has to start with parents and doctors. That’s the message of new guidelines from the American Academy of Pediatrics, which the group says should be applied to all teens, not just ones with weight problems.
Neville Golden, M.D., professor of pediatrics at the Stanford University School of Medicine and a lead author of the guidelines, said they were developed in part out of growing concern that some teens are using unhealthy methods to lose weight, including fasting or vomiting, or taking diet pills or laxatives. These teens have disordered-eating patterns but if they’re not excessively thin, they may not fit the “image” of an eating-disorder patient and could be missed by physicians, Dr. Golden said in a release.
But on the other end of the spectrum, obesity is still a concern: Rates have started to decline in children while remaining steady in adolescents. Promoting healthy weight is a delicate balance.
The recommendations, published in the journal Pediatrics, include five evidence-based strategies: Three are things to avoid, and two are behaviors to promote. Neither parents or doctors should encourage dieting, parents should avoid commenting on weight — either their child’s or their own — and, relatedly, they should never tease teens about their weight. In short, fat-shaming and calorie-counting are both bad.
Instead, families should eat meals together regularly, and parents should encourage following a balanced diet and exercising for fitness, not weight loss, to help their kids develop a healthy body image. Dr. Golden said it’s not clear why family meals can help prevent weight problems, but he thinks that it could be because teens can see their parents modeling healthy eating behaviors — assuming they’re healthy, that is.
Dr. Golden noted that body dissatisfaction is a known risk factor for both eating disorders and obesity and said that “mothers who talk about their own bodies and weights can inadvertently encourage their kids to have body dissatisfaction, which we see in half of teen girls and a quarter of boys.” But teens who are relatively satisfied with their bodies report that their parents and friends follow healthy lifestyles for the sake of fitness and health, not weight loss.
External factors aside, it seems that if parents don’t want their kids to have body issues, they need to address any of their own first.