TEEN HEALTH:
Did Your Teen's New Year’s Resolution Involve Dieting?

by Dr. Ann L. Engelland

(January 7, 2004) Logging onto AOL in January brings frequent reminders about waistlines and the latest diet fads. Teens see this pitch and add it to the inventory of media information that is pushing them to change their bodies for a happier, sexier, more successful and maybe healthier “New You!”

If your pre-teen or teen is expressing new concerns about his or her weight, there are a few guidelines for assessing the safety and appropriateness of the concern. There are few households where the adults wouldn’t benefit from some dietary shifts and improvements. Some common sense principles may help you and your child achieve reasonable goals. Making this a family commitment is often a good idea that ensures everyone’s success.

What would be the warning signs that a teen’s dieting is misguided or inappropriate?

• The desire to lose weight seems more motivated by emotional than health factors. “I’m not popular because I’m fat.” Or “If only I could get rid of my stomach I’d be happy.”
  
  
• The teen signs on to a drastic change in lifestyle. “Mom, I’ve decided to become a vegan in 2003.” Not only is a vegan diet (void of all animal products, including cheese and eggs) very difficult to do in a healthy manner, it is usually high in calories and unlikely to be successful.
  
  
• You are quite sure that your daughter is at a normal weight and do not think dieting is necessary or safe. If any degree of struggle or disagreement arises between you over this issue, it is best to turn to a professional who can assess the teen’s weight and health status and explore the psychological and emotional motivating factors in order to provide guidance.
  
  
• You see evidence that your teen is using caffeine, laxatives, diet pills or is vomiting to control intake and weight.
  
  
• You see a marked increase in concern over fat content of food, accompanied by scrutiny of food labels, avoidance of previously favorite foods, and “fear of fat.”
  
  
• You note an uncharacteristic and perhaps unsustainable level of physical exercise that accompanies his/her new resolution. In an era when most American teens are not getting enough exercise and spending too much time in front of various screens, there are still many who use excessive exercise as a tool for weight loss and body changes that may not be appropriate.

What are some common sense guidelines that can be introduced into your home that will benefit most family members?

• Increase the amount of calcium in the diet: calcium fortified OJ, skim or 1% fat milk (even with some flavoring); greens such as collard and kale can be added to soup. The elimination of carbonated beverages from the home goes a long way to encouraging milk consumption. Teens need at least 1300 mg of Calcium each day to ensure strong bone growth that will serve them for a lifetime. Have calcium supplements or Tums available at home.
  
• Stop stocking crackers, cookies, candy, chocolate chips, fatty, and salty foods.
  
  
• Try moving to “brown” foods: whole grain breads, whole grain oatmeals, nuts, and brown rice (or mix it half and half with white rice) are examples. Try ethnic meals that involve rice and beans. Remember portion control here or you will lose your credibility with the “dieter.”
  
  
• Explore breakfast options. Almost any non-sugar food is better than leaving home on an empty stomach. Ask around for popular ideas. Offer to get up and make pancakes or oatmeal. Try “dinner at breakfast” with a re-heated chicken cutlet.
  
  
• Have fresh fruit and veggie options easily available: easy-peel clementines (expensive, yes, but better than chips or crackers), celery stalks to dip in peanut butter, carrot sticks (healthier than the “baby” carrots), Navel oranges, delicious pears, fresh fruit salad in a bowl in the fridge.
  
  
• Explore what your child is doing for lunch at school. Often the options are limited to tempting unhealthy ones like fries, chicken fingers, and packages of chips. Offer to participate in making a brown-bag lunch once or twice a week. Point out the money-saving aspect to your teen and the yummy, comforting options like PB and J and put it on multigrain bread.
  
  
• Remind your child about the calories (and caffeine) in large popular coffee drinks. For instance a Starbucks Venti white chocolate mocha(with whole milk and whipped cream) has 600 Calories and 15 grams of saturated fat!
  
  
• Try to have a family meal at least three times a week. There are many good reasons for this but if you are worried about your child’s eating habits there is no better way to monitor and model for them.

If your child is an athlete, encourage a high protein snack after school before practice to help curb the evening appetite and to improve performance. Protein bars, a small pack of trail mix, or a yoghurt are all good options.

If worries about weight loss or unreasonable body image issues persist, schedule your teen’s pre-college or pre-camp check up early. If you are seeing your regular pediatrician who will be swamped at this time of year, call ahead and give him or her a “heads-up” on your concerns. Other parents may want to have their child seen by a specialist in adolescent medicine for whom questions of nutrition, body imaging and exercise are routine and usually explored in depth.

Dr. Engelland has a practice in Mamaroneck devoted to Adolescent Primary Care. She can be reached at 698-5544. Have a teen health question? Use the form below to send it to Dr. Engelland. Please note: Dr Engelland cannot respond privately to individual queries online. Comments are welcome and anonymous questions may be answered in future columns. Serious medical problems should be referred to your own physician.

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