One of the many challenges parents of teenagers face is ensuring that their child grows up with a healthy body image. Despite the rise of the body acceptance and body positivity movements, diet culture often prevails both in pop culture and on social media — be it the media storm surrounding Kim Kardashian's super-fast Met Gala slim-down or the prevalence of stars touting restrictive detox diets. It's no wonder, then, that according to a 2020 study published in JAMA Pediatrics, teens today are more concerned with losing weight than previous generations. So what is a parent to do if their own teenager tells them they want to go on a diet?
The official word from experts? Don't encourage your teen to diet — no matter their size.
According to the American Academy of Pediatrics (AAP), encouraging any teenager to lose weight can cause harm. That doesn't mean parents can't help their teens feel better about their bodies and themselves if they say they are struggling to do so. The AAP recommends that pediatricians, as well as parents, should focus on health-promoting behaviors, such as eating a wide range of nutritious foods and exercise, rather than prescribing weight loss, calorie restriction or a specific set of diet rules. Encouraging healthy behaviors can combat potential physical health issues caused by a poor diet or lack of movement but can also prevent a teen from developing an eating disorder — something that dieting puts them at risk of.
In a 2016 study, dieting was one of the most important predictors in determining whether adolescents may develop an eating disorder. Samantha DeCaro, director of clinical outreach and education for the Renfrew Center, a residential eating disorder treatment center, says that while it's normal for teenagers to want to diet due to the onslaught of pressure from the diet and fitness industries, it's important that parents don't encourage dieting behaviors.
"Working with folks who have eating disorders in eating disorder recovery, many of them will say that their eating disorder was triggered on the day they started a diet," she tells Yahoo Life. "Dieting is a high-risk behavior, given that eating disorders are one of the most deadly psychiatric disorders in the DSM-V, second only to opioid use disorder."
Outside of eating disorder risks, she says, "teens' bodies are rapidly changing."
"They need lots of good nutrition to keep up with extracurriculars and academics to fuel their brain and body," DeCaro explains. "And so dieting can be really, really harmful for a teenager, especially when the dieting is not rooted in some kind of medical allergy or intolerance."
Registered dietitian Kara Lydon agrees, adding, "Adolescents actually need more nutrients than adults because they gain at least 40 percent of their adult weight and 15 percent of their adult height during this period. Dieting makes getting enough nutrition nearly impossible and can lead to delayed growth and development."
Dr. Rachel Goldstein, a pediatrician and adolescent medicine specialist at Stanford Medicine Children's Health, tells Yahoo Life, "Any recommendation for a teen to lose weight should be thoughtful with a clear understanding of the goals for weight loss. For example, we know that youth at higher weight are at risk for developing medical conditions like diabetes and high blood pressure. For some, weight loss as a result of changes to their diet and exercise may be recommended. That being said, when recommendations focus only on achieving a certain weight, they run the risk of reinforcing a lot of the potentially harmful messages out there about eating and body image. Health care providers should start by understanding the teens relationship with food and their body. From there, the focus should be on eating in a way that fuels their body — ideally with input from a dietitian if possible — and engaging in physical activity in a way that is enjoyable and meaningful."
There is also evidence that diets simply don't work for long-term weight loss — which can lead to a frustrating cycle that only further harms one's relationship with their body and food.
"Weight loss diets are notoriously challenging at any age. Long-term results are rarely good. If a teen wants to lose weight by dieting, the first question should focus around their health, not their weight," Dr. Nina Shapiro, author of The Ultimate Kids' Guide to Being Super Healthy, tells Yahoo Life. "If they are overweight to the point where their doctor has raised concerns related to health, such as high blood pressure, high cholesterol, exercise intolerance and sleep apnea, then it becomes a focus around lifestyle and healthy habits, not simply a diet to lose weight."
Lydon says that parents can help their children feel better about their bodies and make healthy lifestyle choices. However, the focus has to be away from weight loss.
"If it's accessible to them, parents should embrace an 'all foods fit' approach where no foods are off-limits in the house and food is seen as neutral, neither good nor bad," she says. "This can help teens to have a healthy relationship with food, one where they are encouraged to listen to their own hunger/fullness cues, and notice how eating different foods makes them feel."
Lydon says parents can "serve as a role model to having a healthy relationship with food" by eating a wide variety of foods and eating for nutrition as well as enjoyment and satisfaction.
"Parents can also practice using neutral language around food, avoiding terms like 'junk,' 'good,' 'bad,' 'clean,' 'dirty,' 'unhealthy' and 'healthy," she says.
DeCaro also stresses that while many pediatricians will follow guidelines and not prescribe weight loss for health, parents need to be advocates for their teens should their doctors tell them that weight loss is the answer to their health issues. Weight stigma, she says, is still "rampant" in the medical field, despite research saying we can’t know someone's health based on their weight.
"I would encourage parents to find doctors, as well as mental health providers, who operate from a size-inclusive lens and who are familiar with the research that tells us that weight is not a very accurate measure of our health," DeCaro says. "We've been told over and over again that 'weight gain is bad, being fat is bad,' but the more recent research that has come out is telling us that we can't predict someone's health status based on their size alone. Given that prescribing weight loss is such a high risk intervention … it really isn't in the child's best interest to be prescribed a weight loss plan."
Lauren Smolar, vice president of mission and education at the National Eating Disorder Association (NEDA), tells Yahoo Life that parents shouldn't "be afraid to advocate" for their children.
"Ask a doctor for additional clarification and express concerns about the consequences weight loss may have for your teen. Are there alternative approaches for the issue they are treating?" she says. "If you feel that your teen's doctor is not recommending the right approach for their medical issues, consult a second opinion and share your concerns with how losing weight might affect your teen's mental health."
If your teen insists that weight loss is what they need, Smolar says talking with them about their motives can be an important first step.
"Approach the topic with curiosity rather than judgment," she says. "What is the reason the teen feels like they want to lose weight? Are they in need of additional support from a mental health professional and/or struggling with their body image? Acknowledge and empathize if societal pressures might be playing a role."
If you or someone you know is struggling with an eating disorder, call the National Eating Disorders Association hotline at 1-800-931-2237.
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