Kids Who Often Diet Are Most Likely to Get Fat

From the WebMD Archives

Nov. 15, 2000 -- Want to make your children fat? Try putting them on frequent diets or nagging them about finishing their broccoli. An unhealthy focus on food -- often learned from parents -- leads to childhood obesity, according to findings announced at the recent meeting in Long Beach, Calif., of the North American Association for the Study of Obesity.

It's not that diets don't work for overweight children and teens. But when normal-weight kids diet, the result often is just the opposite of what is intended.

"We think periods of dieting are interspersed with periods of binge eating, and that's what's responsible for the weight gain," Alison E. Field, ScD, tells WebMD. "One of the important things is that people think dieting is a rite of passage among girls. We need to encourage moving away from the dieting mentality to taking in fewer calories and becoming more physically active -- not a diet, but a lifestyle change."

Field's team at Harvard Medical School and Brigham and Women's Hospital in Boston studied more than 10,000 boys and girls aged 9 to 14 from 1996 to 1998. They found that boys were more likely to be overweight than girls -- but that girls were far more likely to diet to lose weight, even if their weight was normal.

To see what was going on, the researchers enrolled nearly 4,000 of the children in a follow-up study. They found that normal-weight preadolescents and teens who dieted often were much more likely to become overweight than those who did not diet. The dieters also were more likely to report binge eating.

"Our data did suggest that girls who were overweight benefited from dieting," Field says. "But you don't want these girls singled out -- it is important for the whole family to become involved. All children should be encouraged to take up more activity, to find an activity they enjoy."

Parents have more of an effect on children's eating habits than they realize -- and in different ways than they might think, says Donna Spruijt-Metz, PhD. The University of Southern California researcher's team studied more than 100 black and white boys and girls from Birmingham, Ala. They found that the parents of the fattest children were most likely to try to pressure their children to eat the right foods.

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"Foods you are pressured into eating become less attractive," Spruijt-Metz tells WebMD. "Modeling is really important. There is abundant evidence that the mother's body mass and the child's weight are closely related. So if you want your kid to eat broccoli, you have to eat broccoli. You've got to be open-minded. Kids are not stupid."

Field also stresses the importance of parental modeling. "For girls but not boys, the higher the mother's weight change over two years, the higher the daughter's risk of being overweight," she notes.

Neither researcher blames just one parent. "We aren't saying everything is the mother's fault -- it might be the mother who pressures the kid, but it's the dad who drives the shopping list," Spruijt-Metz says. "It's important to make the right foods available to kids."

Exactly when a family needs to make a change may not be entirely obvious -- at least to family members. A study by University of Chicago researcher Anjali Jain, MD, finds that obese mothers often don't think of their overweight children as overweight. Instead of looking at whether their kids are of normal weight for their size, Jain found that overweight mothers tend to focus on practical problems, such as not fitting into clothes, playground teasing about being fat, or limitations on physical activity. Even then, they tend to see their children as "thick" or "solid."

"Defining 'overweight' in children the way we doctors traditionally do may not have meaning for some women," Jain tells WebMD. "It's important for the doctor to step into the mother's shoes and see how they view the problem. Mothers in our study thought as long as their child was active, he or she was not overweight. So to sit down with them and form decisions about what to do with this kind of active child may be more helpful than labeling the child as overweight."

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