When
teenagers are overweight, parents and doctors should encourage a healthy
lifestyle rather than worry about the number on the bathroom scale, the
American Academy of Pediatrics (AAP) says.
In new
guidelines that address both teen obesity and eating disorders, the AAP says
adults should move away from "weight talk," and instead help kids
have a healthy relationship with food and their bodies.
"We need to focus on health and healthy behaviors, rather
than the number on the scale," said Dr. Neville Golden, the lead author of
the new recommendations. He is a professor of pediatrics at Stanford
University's School of Medicine in California.
The AAP
has long had guidelines on both childhood obesity and eating disorders. But the
new report addresses both together because they are connected, Golden said.
Most teenagers diagnosed with eating disorders such as anorexia
and bulimia were not overweight to begin with, according to Golden. But, he
said, some overweight teens do develop eating disorders when they try to lose
weight.
In an effort to shed pounds, Golden said, some kids turn to
risky tactics such as fasting, using diet pills and laxatives, or excessive
exercise.
To help ward off those problems, parents and doctors should
steer teenagers away from the idea of "dieting," the AAP said.
One reason is that dieting doesn't work, Golden pointed out.
Studies have shown that teens who go on diets are more likely than their peers
to become overweight.
What's more, Golden said, dieting can go too far -- with kids
severely limiting calories or using other unhealthy weight-loss tactics.
And part of the concern, he noted, is that overweight teens who
develop eating disorders can be easy to miss -- because they're not excessively
thin.
But kids who rapidly lose weight can develop complications often
seen in anorexia -- such as an unstable heart rate and low blood pressure, the
AAP warned.
Marjorie Nolan Cohn is a New York
City-based registered dietitian and spokesperson for the Academy of Nutrition
and Dietetics.
She
agreed with the overall message of the AAP guidelines, which were published
online Aug. 22 inPediatrics.
"Having kids go on a 'diet'
isn't going to help," Cohn said.
What does help, she said, is
ensuring the kitchen is stocked with healthy foods, having family meals
whenever possible, and encouraging kids to have a positive body image.
How can parents promote a healthy
body image? For one, they can be mindful of their words, both Golden and Cohn
said.
It might seem "obvious"
that family members shouldn't tease or criticize kids about their weight, Cohn
noted. "Unfortunately," she said, "a lot of people don't realize
that."
And it's not only what parents
say about their kids that matters. "What you say about yourself and other
people is important, too," Golden said.
Cohn agreed. "If kids hear
their mom saying nasty things about her own body, they do take that in,"
she said.
Instead of commenting on kids'
weight, the AAP said, parents and doctors should talk about the importance of a
balanced diet and getting regular exercise.
But, it should also go beyond a
conversation. Parents should "lead by example," Golden said, and take
a look at their own lifestyle habits.
The AAP recommended having family
meals as often as possible. That's because studies have found that kids who sit
down to eat with their family tend to eat more healthy foods, and are less
likely to diet or take "extreme" measures to lose weight.
"We don't really know why
family meals are beneficial," Golden said. "It may be because parents
are 'modeling' healthy eating. Or maybe it gives parents and kids a chance to
talk, which is important, too."
SOURCES:
Neville Golden, M.D., professor, pediatrics, Stanford University School of
Medicine, Stanford, Calif.; Marjorie Nolan Cohn, M.S., R.D.N., spokesperson,
Academy of Nutrition and Dietetics.
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