During the teen years, when the body is rapidly changing, it is very common to be concerned about your weight and the shape of your body. For decades, the various media outlets have portrayed the ideal woman as pencil thin, a goal that most females can never attain. The media have also described scores of different diets. While the list of diets is too long to mention, it includes the South Beach diet, the blood-type diet, Weight Watchers, the Subway diet, Nutrisystem, Jenny Craig, the paleo diet, and the low-fat diet. They entice teens, and a host of other people, into different ways to drop the pounds. And, people on diets do lose weight. However, when they stop the diet, they tend to regain the weight, often adding even more pounds.
And, there are many teens who need to lose weight. According to the American Heart Association, about one in three teens is overweight or obese. In the United States, childhood obesity is now the top health concern of parents. Today, teens are being diagnosed with high blood pressure, type 2 diabetes, and elevated levels of cholesterol. The extra pounds also take a psychological toll. Severely overweight teens are at increased risk for low self-esteem, negative body image, and depression. 1
In a study published in 2013 in the journal Circulation, researchers from several locations in the United States examined elements of cardiovascular health in 4,673 teens between the ages of 12 and 19 years from the 2005 to 2010 National Health and Nutrition Examination Surveys. The majority of the respondents were non-Hispanic white, non-Hispanic black, or Mexican American. The researchers found that high numbers of the teens had excellent blood pressure readings and did not smoke. They also did fairly well on blood glucose levels. However, females had fewer “ideal” total cholesterol levels than males and fewer “ideal” levels of physical activity than males. Only a small percentage of both males and females had an “ideal” diet. About two-thirds of all the teens had an “ideal” body mass index (BMI). The researchers noted that the “low prevalence of ideal cardiovascular health behaviors” in teens in the United States, especially physical activity and dietary intake, will contribute to a number of future health problems. 2
So, there is obviously a need for large numbers of teens to lose some weight. But, there are healthier ways to lose weight and not-so-healthy ways to lose weight. Healthier ways to lose weight include increasing the intake of fruits, vegetables, and whole grains; reductions in the intake of fat; and moderate increases in exercise. Unhealthy weight loss methods include fasting, skipping meals, self-induced vomiting, diet pills, smoking cigarettes, and excess exercising. These behaviors are associated with a host of different medical and psychological problems such as nutritional deficiencies, particularly iron and calcium; menstrual irregularity; osteopenia; anorexia; and bulimia nervosa.
In a study published in 2012 in the Journal of Adolescent Health, researchers from Minneapolis and New York City examined the long-term effect on BMI of unhealthy dieting and weight control. The cohort consisted of 1,902 middle- and high-school adolescents who participated in Project EAT (Eating and Activity in Teens and Young Adults). This study followed students from Minneapolis and St. Paul for 10 years. Among the females, 37.8 percent reported persistent dieting and 43.7 percent noted continuous use of unhealthy weight control behaviors, such as eating little and skipping meals. These figures were, respectively, 10.3 percent and 18.7 percent in males. Still, when compared with the women who did not diet or practice unhealthy weight control behaviors, the women who engaged in these behaviors had higher BMI values when the study ended. So, the teens who practiced unhealthy dieting were heavier than the teens who did not. In fact, the researchers noted that “the large magnitude of the BMI increases associated with the use of these behaviors was a matter of concern.” 3
In a study published in 2012 in the journal Eating Behaviors, researchers from Pennsylvania and New Jersey wanted to determine if there was an association between unhealthy dieting behaviors and depression. The cohort consisted of 198 young adults with a mean age of 24.8 years. Forty percent of the men were overweight; 25 percent were obese. Among the women, 22 percent were overweight and 8 percent were obese. All the participants completed questionnaires on health behaviors and attitudes. The researchers found that men and women with high BMIs were more likely to engage in both healthy and unhealthy dieting than the men and women with lower BMIs. In addition, women with symptoms of depression engaged in more unhealthy dieting practices and fewer healthy dietary practices. No such link between diets and depression was found in men. The researchers commented that “the association between depression and dieting behaviors among women, but not men, highlights the psychological nature of dieting for women.”
In a cross-sectional study published in 2010 in the Journal of Adolescent Health, researchers from Minneapolis used the previously mentioned Project EAT survey to learn more about how friends of teens influenced their dieting and disordered eating behavior practices. A total of 2,516 teens provided data in 1998-1999 and at follow-up in 2003-2004. They provided information on their own chronic dieting, unhealthy weight control, extreme weight control, and binge eating; they also gave input on their friends’ experiences with these behaviors. At baseline, one-third of the participants reported that their friends were “not at all” involved in dieting; 8.8 percent reported that their friends were “very involved.” Females who reported more friends involved with dieting were more likely to report their own chronic dieting, extreme weight control behaviors, and binge eating five years later. Among the males, similar associations were seen in extreme weight control behaviors. In fact, the males who had friends who used extreme weight control behaviors at baseline were almost four times as likely to practice these behaviors five years later. The researchers noted that their work “is among the first longitudinal studies to demonstrate the influence of friends on disordered eating behaviors in a large and diverse sample of male and female adolescents.” The researchers concluded that parents need to heighten their awareness about the dieting practices of the friends of their children. Schools need to conduct interventions within peer groups. And, healthcare providers need to ask more questions about the eating patterns of their patients’ friends. “Ideas for dealing with peer behaviors—such as ignoring them, realizing they are not behaviors to adopt, or even raising one’s concerns with a friend—can be discussed and explored with the adolescent.” 6
1. American Heart Association, www.heart.org.
2. Christina M. Shay, Hongyan Ning, Stephen R. Daniels et al., “Status of Cardiovascular Health in US Adolescents: Prevalence Estimates from the National Health and Nutrition Examination Surveys (NHANES) 2005-2010,” Circulation 127, no. 13 (2013): 1369-76.
3. Dianne Neumark-Sztainer, Melanie Wall, Mary Story, and Amber R. Standish, “Dieting and Unhealthy Weight Control Behaviors During Adolescence: Associations with 10-Year Changes in Body Mass Index,” Journal of Adolescent Health 50 (2012): 80-86.
4. Katie Loth, Melanie Wall, Chien-Wen Choi et al., “Family Meals and Disordered Eating in Adolescents: Are the Benefits the Same for Everyone?” International Journal of Eating Disorders 48, no. 1 (2015): 100-110.
5. Jerica M. Berge, Rich MacLehose, Katie A. Loth et al., “Parents’ Conversations About Healthful Eating and Weight,” JAMA Pediatrics 167, no. 8 (2013): 746-53.
6. Marla E. Eisenberg and D. Neumark-Sztainer, “Friends’ Dieting and Disordered Eating Behaviors Among Adolescents Five Years Later: Findings from Project EAT,” Journal of Adolescent Health 47 (2010): 67-73.
Amrock, Stephen M. and Michael Weitzman. “Adolescent Indoor Tanning Use and Unhealthy Weight Control Behaviors.” Journal of Development & Behavioral Pediatrics 35, no. 3 (2014): 165-71.
Berge, Jerica M., Rich MacLehose, Katie A. Loth et al. “Parents’ Conversations About Healthful Eating and Weight.” JAMA Pediatrics 167, no. 8 (2013): 746-53.
Eisenberg, Marla E., and Dianne Neumark-Sztainer. “Friends’ Dieting and Disordered Eating Behaviors Among Adolescents Five Years Later: Findings From Project EAT.” Journal of Adolescent Health 47 (2010): 67-73.
Gillen, Meghan M., Charlotte N. Markey, and Patrick M. Markey. “An Examination of Dieting Behaviors Among Adults: Links with Depression.” Eating Behaviors 13 (2012): 88-93.
Hirth, Jacqueline M., Mahbubur Rahman, and Abbey B. Berenson. “The Association of Posttraumatic Stress Disorder with Fast Food and Soda Consumption and Unhealthy Weight Loss Behaviors Among Young Women.” Journal of Women’s Health 20, no. 8 (2011): 1141-49.
Loth, Katie, Melanie Wall, Chien-Wen Choi et al. “Family Meals and Disordered Eating in Adolescents: Are the Benefits the Same for Everyone?” International Journal of Eating Disorders 48, no. 1 (2015): 100-110.
Mooney, E., H. Farley, and C. Strugnell. “A Qualitative Investigation into the Opinions of Adolescent Females Regarding Their Body Image Concerns and Dieting Practices in the Republic of Ireland.” Appetite 52 (2009): 485-91.
Neumark-Sztainer, Dianne, Melanie Wall, Mary Story, and Amber R. Standish. “Dieting and Unhealthy Weight Control Behaviors During Adolescence: Associations with 10-Year Changes in Body Mass Index.” Journal of Adolescent Health 50 (2012): 80-86.
Shay, Christina M., Hongyan Ning, Stephen R. Daniels et al. “Status of Cardiovascular Health in US Adolescents: Prevalence Estimates from the National Health and Nutrition Examination Surveys (NHANES) 2005-2010.” Circulation 127, no. 13 (2013): 1369-76.
American Heart Association. www.heart.org .