Do Obesity Treatments for Youth Lead To Eating Disorders?

One-fifth of all school-aged children in the United States are obese – triple the rate measured in the 1970s.

If you think about this carefully, you realize its staggering implications. People who are obese are more likely to experience a broad range of health problems including diabetes, breathing problems, cancer, heart disease and joint problems. They are more likely to be victims of bullying, have low self-esteem and experience depression. And they are more likely to be obese as adults, which is linked to more of the same health problems.

Research tells us there are some interventions that help young people to lose weight and keep it off.  The most successful studies are lifestyle interventions, which encourage kids to focus on healthy eating, physical activity and reduce screen time. There is also some clear evidence that a traffic light diet – in which foods are classified red (eat only a few times a month), yellow (eat only once or twice a week) and green (eat every day) – is an effective way to teach kids about healthy eating when youth get guidance from a dietitian or clinician.

But what are the consequences of putting a kid on a diet? In the past, research has demonstrated that fad dieting and other unhealthy ways to control weight lead to more unhealthy behaviors surrounding food. But a systematic review published this month in the journal Obesity Reviews came to a different conclusion.

The review includes 36 studies with a total of more than 2,500 subjects ages 8 to 16. The studies followed youth who participated in a weight loss intervention which lasted anywhere from six months to six years after the program to find out if the intervention led to any unhealthy eating behaviors.

The review found that youth who participated in structured and supported weight-loss interventions that included healthy eating, physical activity and support from both professionals and parents were less likely to develop unhealthy behaviors including bulimia, binge eating and emotional eating. The longer the interventions lasted, the less likely youth were to develop later problematic behaviors.

The general conclusion is that these programs are successful because they teach youth about nutrition as a part of an overall healthy lifestyle – something they can carry with them well into the future. Youth who participated in the study interventions reported that they understood nutrition better, were more likely to eat regular meals and were more likely to feel good about themselves. This is in contrast to trying to follow a diet plan without support from health care professionals, and without focusing on physical activity and emotional well-being.

The take home message: Structured, supported weight-loss interventions are the best strategy to help young people who are obese to lose weight and lead healthy lifestyles.