A Stanford University Medical Center study has found out one approach that can prevent both obesity and eating disorders in teenagers.
Scientific evidence summarised in the new recommendations shows that physicians and parents can ward off problems at both ends of the weight spectrum by avoiding focusing teens' attention on weight or dieting, and instead encouraging a healthy, balanced lifestyle.
The guidelines were developed in response to growing concern about teenagers' use of unhealthy methods to lose weight. Teens who use these methods may not fit doctors' or parents' image of eating-disorder patients, since most are not excessively thin.
However, their quick, substantial weight loss can trigger medical consequences seen in people with anorexia nervosa, such as an unstable heart rate.
"This is a dangerous category of patient because they're often missed by physicians. At some point, these patients may have had a real need to lose weight, but things got out of control," said lead author Neville Golden.
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 behaviours to avoid dieting and "weight talk," commenting on their own weight or their child's weight.
Two recommendations focus on behaviours to promote eating regular meals together, and 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.
"Scientific evidence increasingly shows that for teenagers, dieting is bad news," Golden said, adding, "It's not unusual for us to see young people who have rapidly lost a lot of weight but are not healthy; they end up in the hospital attached to a heart monitor with unstable vital signs."
Negative comments about weight can also be detrimental to a teen's health, which the lead author explained as, "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."
Such dissatisfaction is associated with lower levels of physical activity and with use of vomiting, laxatives and diuretics to control weight.
The new advice is important in part because, although childhood obesity rates have begun to drop, obesity rates in adolescents have not declined.
Helping teens maintain healthy weights without veering toward obesity or an eating disorder is more challenging than it is for young children.
This study has been published in Pediatrics.
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