Girl on scale holding stop sign

Why Pediatricians and Parents Should Wait to Talk Weight with Teens

A new American Academy of Pediatrics (AAP) report recommends that doctors and parents stop talking about weight with teens. Instead, they should focus on supporting healthy lifestyle choices in order to reduce adolescent obesity and eating disorders.

The study, Preventing Obesity and Eating Disorders in Adolescents, reframes how to think about working with teens on these topics. It offers ideas for ways to guide and support teens who may be experiencing these issues. According to the report, childhood obesity has doubled over the past 30 years, and adolescent obesity rates have quadrupled.

An article in The Chicago Tribune states that 34% of 12-19 year olds are now overweight or obese and eating disorders are the third most common chronic condition in adolescence, with obesity and asthma taking the top two places.

The AAP report says that when children are obese, they are more likely to be obese as adults. Children and adolescents who are obese are at much higher risk for a host of health issues throughout their lives.

childhood_obesity

With obesity rates at unprecedented levels, clearly the usual ways of addressing this issue are not working. Pointing out the fact that children and teens are overweight does little more than make them feel worse.

Although being overweight carries with it the increased risk of health issues, using these diseases as scare tactics for losing weight is also not helpful and simply creates more anxiety around an already fraught subject. As Dr. Robert Lamberts, a medical blogger quoted in the New York Times says, “Our culture of accusation and shame simply makes obese people hate themselves. If you hate yourself, why should you want to take care of your body?”

Instead of shaming or scaring young people into losing weight, doctors and families can try taking the more supportive role outlined in the AAP report.

The AAP report identified a set of behaviors common to both obesity and eating disorders in adolescents.

3 behaviors that can promote problems are:

  1. Dieting
  2. Talking about weight, including family members talking about their own weight or talking to the teen about his or her weight
  3. Being teased about weight by others

2 behaviors that can prevent problems are:

  1. Eating family meals together
  2. Developing a positive body image

So, if pediatricians and parents should stop talking directly about weight with kids, how can they address an issue that desperately needs attention?

4 Ways Pediatricians Can Help Parents Prevent Obesity and Eating Disorders In Kids

  1. Encourage families to eat meals together (this allows parents to provide healthy choices and monitor their teen’s relationship with food)
  2. Remind parents to be positive role models for their kids with healthy food choices
  3. Suggest parents limit kids’ daily screen time and increase kids’ exercise and activity levels
  4. Recommend parents stop talking about weight with kids, but discuss a healthy lifestyle instead

5 Ways Pediatricians Can Help Kids Prevent Themselves From Developing Issues With Weight Or Eating Disorders

  1. Discourage dieting, skipping meals, or using diet pills
  2. Promote healthy eating choices
  3. Encourage a positive body image
  4. Ask if there is a history of weight teasing or bullying, and address any issues with the whole family
  5. Watch for warning signs of an eating disorder (e.g. calorie restriction, meal skipping, compulsive exercise, intense fear of weight returning, body image distortions) when a patient who needed to lose weight begins to lose it rapidly

The AAP report also found that when pediatricians used Motivational Interviewing (MI) techniques when working with patients on these issues, they had a greater success rate.

When MI was used, patients lowered their BMI by 3.1 more points than when no special approach was taken. Motivational Interviewing helps patients talk about the need for change in an accepting and nonjudgmental way, and when they are ready it helps them formulate a plan for that change. Instead of trying to impose change on a patient who may be resistant or not ready, MI helps the patient find their own motivation for change. For example, instead of telling a patient they are overweight and need to start an exercise plan, MI can help the patient talk about the weight issue from their perspective, and find their own reason and inherent drive to make a healthy lifestyle plan.

By redirecting the conversation from the number on the scale, to the bigger conversation on what fosters a healthy lifestyle, pediatricians and parents can play an active role in alleviating the epidemic of obesity and eating disorders in young people across the country.