Over the past 30 years, the rate of childhood obesity has more than doubled, and the rate of adolescent obesity has quadrupled.
Eating disorders (EDs) are the third most common chronic condition in adolescents, after obesity and asthma. Most adolescents misinterpret what “healthy eating” and engage in unhealthy behaviors, such as skipping meals or using fad diets in an attempt to “be healthier,” the result of which could be the development of an ED.
In cross-sectional studies, adolescents who are overweight have been shown to engage in self-induced vomiting or laxative use more frequently than their normal-weight peers.
Some adolescents who were overweight or obese previously can go on to develop a full eating disorder.
In 1 study in adolescents seeking treatment of an ED, 36.7% had a previous weight greater than the 85th percentile for age and sex. Initial attempts to lose weight by eating in a healthy manner may progress to severe dietary restriction, skipping of meals, prolonged periods of starvation, or the use of self-induced vomiting, diet pills, or laxatives. Initial attempts to increase physical activity may progress to compulsive and excessive exercise, even to the point at which the teenager awakens at night to exercise or continues excess exercise despite injury.
Dieting is counterproductive to weight-management efforts. Dieting also can predispose to EDs. In a large prospective cohort study in students 14 to 15 years of age followed for 3 years, dieting was the most important predictor of a developing ED. Students who severely restricted their energy intake and skipped meals were 18 times more likely to develop an ED than those who did not diet; those who dieted at a moderate level had a fivefold increased risk.
New Recommendations From American Academy of Pediatrics.
The new recommendations include five evidence-based strategies that pediatricians and parents can use to help teenagers avoid both obesity and eating disorders, and apply to all teens, not just those with weight problems.
Three recommendations focus on
Behaviors to Avoid:
- Parents and doctors should not encourage dieting. Its significant to note that teens who diet in ninth grade are three times more likely than their peers to be overweight in 12th grade
- Avoid “weight talk,” such commenting on their own weight or their child’s weight. Make a list of positive affirmations. Pick one, look at yourself in the mirror and say it morning and night for 21 days. The affirmation will become a part of you!
- Never tease teens about their weight.
Two recommendations focus on
Behaviors To Promote:
- Families should eat regular meals together. Family meals protect against weight problems. The mechanism isn’t certain, but it may be partly due to the opportunity for teenagers to see their parents modeling healthy eating.
- Parents should help their children develop a healthy body image by encouraging them to eat a balanced diet and to exercise for fitness, not weight loss.
An adolescent trying unhealthy weight-loss methods like fasting or diet pills may end up in a vicious circle of more weight gain.