August 29, 2016

Watch your words when talking about weight

The American Academy of Pediatrics (AAP) just released new guidelines to prevent both obesity and eating disorders in America's youth.

These chronic diseases are among the top three that plague children and adolescents in the U.S. About 30% of children and adolescents in the U.S. are now overweight or obese and nearly 3% have been diagnosed with an eating disorder.

The nation's obese youth continue to become more obese despite stable prevalence and more and more children are being diagnosed with eating disorders, especially teens who are just trying to "eat healthier." When trying to achieve healthier weight, these at-risk populations find themselves on a very slippery slope with good intentions. Additionally, teens often use drastic and dangerous weight loss strategies including severe dieting, diet pills, purging and excessive exercise to get the results they desire.

The AAP believes that the focus of conversation should be on a healthy lifestyle rather than on weight. These guidelines provide key recommendations for both families and clinicians to consider in the prevention, management and treatment of obesity and eating disorders.

Key recommendations

  • Ditch diets. Dieting is defined as caloric restriction with the goal of weight loss. Diets are inappropriate for children and adolescents because they can restrict necessary energy, vitamins and minerals for healthful growth. They also perpetuate a harmful mentality that can damage a child's relationship with food.

  • Watch your words. Weight talk and teasing, or comments made about an individual's personal weight or the weight of another, is associated with increased risk of obesity and eating disorders. Well-intended words can be harmful if miss-heard. About 30% of both male and female adolescents report weight teasing at home and school. The AAP encourages clinicians and families to focus their attention on healthy lifestyle behaviors instead of weight. At the UW Health Pediatric Fitness Clinic, we believe that weight is simply a product of habits, and by encouraging healthful habits one can achieve a healthier weight.

  • Play detective. The guidelines recommend facets of motivational interviewing when discussing sensitive topics at home. This style of communication is other-centered and uses open-ended questions to navigate talk about change. Motivational interviewing is a fantastic method for investigating why a child does not desire to engage in healthful habits, how they feel about their body or health, as well as, to learn more about their life at school and to probe for bullying or teasing.

  • Look out for red flags. About 50% of teenage girls who are normal weight and 25% of teenage boys are dissatisfied with their bodies despite being a normal weight. These numbers are higher in overweight teens. Therefore, it is critical to monitor red flag behaviors associated with eating disorders and disordered eating such as dieting, designating foods as "bad" and "good" using diet pills, skipping meals, etc.

  • Make meal time a priority. Family meals provide an opportunity for families to model healthful behaviors, communicate and share a healthy meal. Children who eat with their families three to five times each week eat better, get better grades, have a stronger family identity and fewer behavioral problems than those who do not practice meals as a family. There is no doubt that family meal time is protective of both obesity and eating disorders.

Overall, the new guidelines from the AAP refocus our attention on the nuclear family as a breeding ground for both health and disease. They call attention to how we approach these sensitive subjects with our children and teens and encourage us to remember that actions speak louder than words and it may be better to model the desired behavior than to talk about it.

Consider the UW Health Pediatric Fitness Clinic as a resource for supporting your family's quest for achieving or maintaining better health.