Eating
Disorders
Teens and Dieting a Losing Proposition
(April 2, 2004) -- Dieting, like dating and driving, is a time-honored ritual
for many American teens.
But it's often not a productive -- or even healthy -- one.
New research suggests teens who diet frequently tend to gain more weight each
year than children who don't diet. One likely explanation: Many teens resort to
diets that greatly limit what and how much they can eat. Then they abandon those
food plans with a vengeance,
overeating and regaining all the lost weight -- and often more.
"Most people who diet tend to regain the weight. In children, we're really
seeing that this is happening at a young age," says Alison Field, an assistant
professor of pediatrics at Harvard Medical School and co-author of a recent
study on teens and
dieting.
The findings come amid growing concern about childhood obesity and the
attendant health threats, which include the potential for heart disease,
diabetes and cancer as the children grow into adulthood. The prevalence of
overweight has increased by 100 percent among U.S. teens in the last two
decades. And almost 14 million children -- 24 percent of the population aged 2
to 17 -- are obese, with an additional 8.6 million children at risk for obesity,
according to federal statistics.
But the answer to the weight epidemic isn't restrictive or fad diets. What's
needed are
lifestyle changes. Programs that teach teens and preteens
how to eat nutritiously,
get enough exercise and cut down on TV and computer time are much better avenues
to lifelong weight control, experts say.
The "boomerang effect" of dieting and then regaining the weight is well-known
to many adults who've tried to shed pounds. But it's also a very real problem
for teens, according to the Harvard study that was published last fall in
Pediatrics . The researchers studied the eating habits of nearly 15,000 girls
and boys who were between 9 and 14 at the start of the study in 1996.
Twenty-five percent of the girls and 13.8 percent of the boys said they dieted
often when the study began.
As the researchers tracked the children for three years, they found the kids
who dieted actually gained more weight on average than those who didn't. The
dieters picked up about two pounds per year, compared to the non-dieters.
Frequent dieting may alter the metabolism so it doesn't work as quickly. Or
it may lead teens on restrictive diets to abandon them and
start eating too
much, experts say.
Whatever the explanation, nutritionists concur that restrictive diets aren't
the answer.
"Get away from the mentality of a diet," Bettye Nowlin, a registered
dietitian from Calabasas, Calif., and a spokeswoman for the American Dietetic
Association, tells teens trying to slim down. "Try to put the focus on
healthy eating and
lifestyle changes."
"If they are exercising and eating proper diets, they should lose weight,"
she adds.
When Nowlin counsels teens, she tells them to watch portion sizes. And rather
than eliminate favorite high-fat foods, she urges teens to classify them as
"sometime" food. French fries, for instance, might be a once-a-week "sometime"
food. "And when you have them, get the small size," she suggests.
Marilyn Tanner, a registered dietitian who runs a program for overweight
teens at St. Louis Children's Hospital, urges a similar approach. She doesn't
mention "dieting" when working with kids.
"By the time they come to us they have already dieted and continued to gain
weight," says Tanner, a pediatric dietitian at the Washington University School
of Medicine in St. Louis and a spokeswoman for the American Dietetic
Association.
"Our program is a lifestyle program," she says. "We concentrate on goals they
can strive for, such as less inactivity."
"The kids wear pedometers," she adds. "We find out what their baseline steps
are [each day] and add 100 steps or more."
"We don't promise they will lose weight, but tell them what to do to eat
healthier," Tanner says. "We weigh them in, but it is their option to see what
the number is. Our goal is to stop the gain. Our kids are slightly overweight,
such as 10 pounds, to obese."
During the 10-week program, the kids learn the basics of nutrition, such as
proper portion sizes, which can go a long way toward weight control. "A serving
of rice is one-third of a cup," Tanners says. "Some kids get those big white
containers [from Chinese carryout restaurants] for fried rice."
They also learn about calories and a goal to shoot for daily, such as 2,000,
depending on their height, weight and activity levels. "Some kids drink the
equivalent of 1,000 calories a day in soda," she says.
"We encourage five [servings] a day of fruits and vegetables. We tell them to
watch their fat intake," Tanner adds.
Once they follow the program for a while, she says, many "grow into their
weights." But not all of them do. If that's the case, they can work on weight
loss once the healthy
habits are ingrained.
The "healthy habits first" approach will eventually pay off, Tanner says, and
hopefully help teens control their weight for a lifetime.
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