Dieting May Promote Weight Gain in Kids

Children and Teens who Diet May Gain Weight Rather than Lose It

From the WebMD Archives

Oct. 6, 2003 -- Children and teens who constantly go on and off diets to lose weight may actually end up gaining extra pounds in the long run.

A new study shows that girls who were frequent dieters gained about two extra pounds per year, and boys who were dieters gained more than two extra pounds per year compared with nondieters.

Researchers say the findings show that putting overweight children on restrictive diets not only doesn't help them lose weight, but it also promotes unhealthy eating habits that can last a lifetime.

For example, the study showed that girls who were frequent dieters were 12 times more likely than nondieters to engage in binge eating, and boys who dieted were seven times more likely to become binge eaters.

Children and Dieting Don't Mix

For the study, researchers followed a group of 8,200 girls and 6,770 boys for three years starting in 1996. They were 9 to 14 years of age. Participants filled out annual questionnaires about dieting, weight change, exercise, and eating habits.

Researchers found that nearly 30% of the girls and 16% of the boys were dieters at the start of the study. During the three-year follow-up, the study showed that dieters consistently gained more weight than nondieters, with dieters gaining an average of nearly two more pounds per year more than nondieters.

The results appear in the October issue of Pediatrics.

Dieters were also much more likely to engage in binge eating, defined as eating large amounts of food in a short period of time and feeling out of control in the situation -- such as eating an entire box of cookies and feeling that you couldn't stop even if you wanted to.

"What we think is happening is that the more frequently they dieted, the more frequently they would binge eat or overeat in between these dieting episodes, and that would lead to their weight gain," says researcher Alison Field, ScD, assistant professor at Harvard Medical School.

Field says this study is among the first to look at the long-term effect of dieting in children and teens, and the findings show that it's wrought with many of the same problems that affect adults who try to lose weight with the latest fad diet.

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"Diets are very hard to stick with because most people pick a diet that's going to make them really lose weight and notice changes very rapidly," Field tells WebMD. "Unfortunately, what we really should be recommending is something where you're not going to see the results as quickly, but it's easier to adhere to."

That means making smaller, more modest changes, like changing from a 20-ounce bottle of Coke to a 12-ounce can, or changing from eating super-sized portions to normal-sized portions.

Dieting Alone Isn't Enough

Pediatrician Michael Wasserman, MD, says the findings aren't surprising, because losing weight takes more than just dieting in both children and adults.

"The answer is not that diet is bad, but that changing your lifestyle is a better way," says Wasserman, who works at a child weight-loss program at the Ochsner Clinic Foundation in New Orleans.

"It has to be a multifactorial change in how you live. You just can't change one piece of it, you need to change whole day-to-day lifestyle that the youngster goes through," Wasserman tells WebMD.

But Wasserman also points out that 90% of the study participants were white and they all were children of nurses who participated in the Nurses Health Study II, so the results might not apply to the entire population.

Even so, the study highlights the need for parents to strike a healthy balance between encouraging healthy eating habits and not making food an emotional issue, which could lead to potentially dangerous binge eating or eating disorders.

Smart Ways to Help Kids Lose Weight

How to help children and teens lose weight is a problem more and more parents are facing today as the prevalence of overweight children has risen by 100% in the last 20 years. Currently about 15% of children and adolescents are overweight or obese.

Research also shows that children who are overweight or obese have a 90% chance of being overweight as an adult, and that's why experts say it's important to help children develop healthy habits as early as possible. Having obese parents also increases the risks that the child will be obese.

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Registered dietitian Rachel Brandeis offers the following tips to help children (and their parents) attain and maintain a healthy weight:

  • Get moving. Increasing physical activity to burn more calories is the best way to encourage weight loss in children. Turn off the TV or computer and get them involved in any type of sporting activity.
  • Offer a variety of healthy foods. Limit sugary snacks, sweets, and other sources of empty calories, such as potato chips.
  • Don't label foods. Labeling a food as "bad" is likely to make that food more appealing to children and might lead to overeating or binging when it becomes available at home or elsewhere.
  • Avoid "family style" meals. Plating foods in the kitchen gives parents more control over portion size and helps children learn what a kid-sized portion should look like.

Brandeis says it's also important for parents to set a healthy example for their kids with their own eating habits.

"Children model parent's behaviors. So if parents are constantly talking about being on a diet, and saying, 'I can't eat this, I can't eat that,' children pick up on those patterns as well," Brandeis tells WebMD.

"Food should just be healthy," says Brandeis, who is a spokeswoman for the National Dietetic Association. "There's room for treats, there's room for empty calories, but if your child is struggling with a weight issue ... don't make food such a big issue."

WebMD Health News Reviewed by Brunilda Nazario, MD on October 06, 2003

Sources

SOURCES: Field, A. Pediatrics, October 2003; vol 112: pp 900-906. News release, Brigham and Women's Hospital. Alison Field, ScD, assistant professor at Harvard Medical School; Brigham and Women's Hospital and Children's Hospital Boston. Michael Wasserman, MD, general pediatrician, Ochsner Clinic Foundation, New Orleans. Rachel Brandeis, RD, spokeswoman, American Dietetic Association.

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