Ask the expert about overweight teens
Posted on June 2nd, 2008 – 8:15 AMBy Josephine Marcotty
Dianne Neumark-Sztainer is a mom and an expert on what drives a lot of parents nuts — adolescents and their eating habits. She is a professor of epidemiology at the University of Minnesota and the lead researcher on a study published today that looks at what happens when parents of overweight kids tell them to go on a diet. They are more likely to stay fat. You can read about the study and the university’s Project EAT project here.
She will be here on BodyTalk today to answer questions from readers about the epidemic of overweight and obesity in teenagers and what parents can do.
She is also the author of a book called “I’m, Like, SO Fat,” which provides advice and guidance for parents on how to help their teenagers (productively) with eating and exercise in a weight obsessed world. The motto of her book she says is “Do more. Talk less.” That means you have to walk the walk you want your kids to walk. Yes, easier said than done. That gets us back to the whole do more talk less thing.
Her study published today, based on surveys of Minnesota adolescents and their parents, found that half of the parents whose kids are overweight don’t know it. That’s pretty par for the course, she says, butn itn turns out their kids might be better off. The parents who do know that their kids are too heavy often do the wrong thing by telling them to go on a diet. That tends to backfire, she found.
But she has a lot of useful, practical advice on what parents can do to help their kids. So ask her a question, and check back this afternoon.
14 Responses to "Ask the expert about overweight teens"
Good morning, Dr. Neumark-Sztainer,
I recall a time (around Jr High) when seemingly everyone was rail thin (that period when kids go through their height growth spurt without gaining an ounce.) When my friends and I were 12 or 13 (all of us girls) we were stick thin except for one or two girls whose moms whispered that they had “gland problems.” Those girls struggled on diets starting at 13 and continue now at 40.
My question is - is it part of a healthy growth curve for a child to hit a time when he or she is all skin and bones before filling out during later puberty? My concern is my eldest (10 years old), who is not fat by any means, has friends who are stick thin while he is more of a solid kid - not even stocky, but definitely a fuller build than his bony friends. I have always assumed that all healthy children have a two or three year stage when they look scary thin and that the kids who never go thru that phase are destined to become heavy in adulthood. I have no concerns about my child’s diet or exercise level. Some of his videogame addicted friends are much thinner than he is, however!
I have a question about the opposite effect… when parents say a kid should go on a diet and that leads to eating disorders. How does one counter that? Especially if it’s a boy with the disorder and there are no options for him?
Also, if I have concerns about my families eating habits, what is a polite but effective way to challenge them?
Dear Cee,
The one thing that we can say for certainty about adolescents and their growth is that variety is normal. Different kids will grow at different rates and will often look differnt to their peers. Not everyone will go through a “skin and bones” stage. Parents that are concerned (and it sounds like you are not) should check with their family physician.
Dear Beezus,
One of the reasons that we don’t want to talk about diets is that they can be a first step toward an eating disorder and, as you note, boys are not immune. There is more and more attention to the occurrence of eating disorders among males within the field of eating disorders. Most of the eating disorder treatment programs will treat boys and if there are concerns, it is best to look for treatment sooner rather than later.
Regarding your family - I think the best thing to do is to try to make the home environment one in which it is easier to make healthy food choices. It is OK to talk about healthy eating, but important to avoid turning it into an area of conflict.
Good luck!
Dianne, my question about the results of your study is whether it’s dieting itself that leads to unhealthy weights, or whether it’s a kid’s reaction(whatever that may be) to a parent’s encouragement to diet that causes problems. It’s a hard thing to figure out, I know, but does any of your research help you understand what’s going on there? JM
Hi Josephine,
Good question. I can’t really tell from our findings since our study only examines the associations and can’t tell us anything for sure about causality. But, based on a compilation of studies, it is probably a mixture of both. We know that teens who diet end up gaining weight over time. This may be, partially, due to the fact that when teens diet, they tend to cycle between dieting and binge eating. They also tend to engage in behaviors such as skipping breakfast…rather than engage in behaviors such as eating more fruits and vegetables. But, we also know from the literature, that parental comments about weight are associated with a number of negative outcomes in kids such as poorer body image and unhealthy dieting. So probably a mixture of both. Thanks for the great question!
I have to say that, as someone who was very overweight from age 5 through high school, I would have appreciated more support from my parents in helping me to eat well and lose weight. I was miserable because of my weight and the teasing and rejection from my classmates. I find it astounding that so many parents don’t even know it when their children are overweight. If everyone, including most family doctors, are reluctant to discuss this issue, then health problems that will ensue are going to be massive. It’s one thing to harangue your child - that surely won’t work. But I can’t believe not discussing it at all is the answer. SS
Good point Sandy,
One thing that I advise parents is to wait for their child to bring up the topic of weight and then take their lead. Kids who are teased about their weight need to be able to discuss this with their parents and to know that they have their parents support. As you note, we found in our research that overweight teens really appreciate their parents’ support in the face of weight mistreatment. Furthermore, it is certainly appropriate for parents to explore ways that their children would like to receive help in making healthier food choices or being physically active. So when a child talks about his/her concerns about weight, a parent can ask, “How can I be helpful?” In this way, the child is taking the lead. This is just a very brief answer and I write a lot more about it in my book.
Dianne: My 17 yr daughter is overweight. Prior to becoming sick in Jan 08 she was losing weight. Due to her constant abdominal pain (seen by many different specialists) she cannot walk much let alone exercise. Due to pain, she was admitted to Mercy Hosp four days ago. The pain was not resolved however, before she was discharged the pediatrician showed her a growth chart and told her she was obese and that she needs to exercise more & eat healthy. Do you really feel that his advice will be heeded, especially since she is so sick or do you think that he should have known a better way to deliver his comments?
I hit puberty when I was 11, I had breasts overnight and weight gain, as well. I was teased by my entire family and called nasty names by them and some of my siblings friends too. I was not allowed to eat certain foods such as sugary foods or butter. When I was home alone I would binge and gorge myself on anything I could find, sometimes melting down chocolate chips to get my “fix.” When you are told repeatedly what a fat pig you are and humiliated at the dinner table every night & that you should really go on a diet… guess what- you will be fat forever. I have not been able to move on from this and actually dieted in my early 20’s and lost 40 pounds, only to gain it and more back quickly. I am now in my 40’s and still battle with the binging on a regular basis. Any suggestions that would help me are appreciated. I would love to have the lap band surgery but don’t know if it is a long term fix or if everything would be same as it always has been. This has affected my entire life and how I have lived it.
I think the most helpful and meaningful posts are those that come from individuals (or parents) who have lived thru or are dealing with this issue in “real life.”
I do notice at my sons’ school a startling number of 4th and 5th grade girls (ages 9, 10, 11) with developed breasts and hips. I know there are 4th graders who already have their period. I recall most of us developing in 7th grade, not 4th. I need to adjust my perspective and views (I have a preschooler daughter) about this issue and understand that breasts/hips/belly weight might appear suddenly and earlier than I might have expected. I’ll admit I assumed that the girls in this category ate too much fat or were too sedentary. (I’m admitting this at the risk of being flamed - I know!)
I think it is critical for us parents to listen to the words of Vicki (above) about how words and actions can affect a person in a lifelong manner. As parents we need to be careful about this no matter how much hand-wringing [about our kids’ weight/habits/looks] we might do in private!
Q1. What were the average starting and ending BMIs for the overweight boys encouraged to diet and for the overweight boys that were not encouraged to diet?
Q2. What were the average starting and ending BMIs for the overweight boys whose parents knew they were overweight and for the overweight boys whose parents did not know they were overweight.
Q3. Was there any attempt to breakout “encouraged to diet” into finer categories such as “suggested” vs. “nagged”?
Q4. Of the 200 kids surveyed again, how many were boys? Of the boys surveyed again, how many were encouraged by the parents? Of the girls surveyed again, how many were encouraged by their parents?
Q5. Was the 22 percentage point difference for boys and for girls statistically significant?
I was only supposed to be online for one hour (from noon to 1:00) today but I just checked and saw there were a few questions that came on afterwards, so here are some short answers…
Kim, I would think that your daughter will need some more support so I would either go back to the physician at Mercy or talk with your family physician about a more structured framework for helping her make some behavioral changes. Good luck to your daughter and I hope she feels better.
Vicky, Unfortunately you are not alone! I would suggest looking into treatment for your ongoing binge eating. There are a number of excellent eating disorder programs in the Twin Cities (including the Emily Program, Methodist Hospital, and the U of M). These programs are not just for teenagers but also see many adults. Best of luck to you.
Cee, You are right - girls are developing earlier and there is great variety among older children and teens in their rates of development. I agree with you that we need to be careful about what we say in front of our children about these sensitive topics.
Milo, you may want to see the full article that was published in Pediatrics, which includes answers to your questions. You can email my assistant who can send it to you (kornblum@epi.umn.edu).
Thanks for your questions and to all those who posted comments on the Star Trib website. I have learned a lot from you.
Dianne, thanks for spending time here. I learned a lot of from all of you. JM
