Study: When Talking to Kids About Obesity, Focus on Foods, Not Body Shapes

When their parents talk to them about their weight, adolescents are more likely to develop unhealthy eating behaviors. Better to focus on talking about healthy foods


PROBLEM: Over a third of U.S. children are overweight or obese, the latter of which the American Medical Association now says is a disease. Meanwhile, anorexia is considered "the third most common chronic illness among adolescents." Given all that, to say that "parents may wonder whether talking with their adolescent child about eating habits and weight is useful or detrimental" is probably understatement.

METHODOLOGY: Researchers at the University of Minnesota drew data from two surveys, one which looked at eating behavior in adolescents and another which evaluated aspects of their family environment that might contribute to this behavior. In all, they received responses from 2,793 public school students with an average age of 14, and from 3,709 parents and caregivers.

RESULTS: Dieting was most common in adolescents whose parents talked with them about their weight. This could be anything from just "having a conversation" about their size to mentioning that they should eat differently or exercise in order to lose or keep from gaining weight. However, disordered eating -- defined as taking unhealthy measures to control their weight (fasting, laxatives and diet pills, throwing up, etc) or binge eating -- was also highest among those same children.

Among adolescents who weren't overweight, for example, 35.3 percent of those whose mothers talked about weight were on a diet, as compared to 22.6 percent of those whose mothers emphasized healthy eating. "Extreme" unhealthy eating behaviors occurred in 5.9 percent of the former and only 1.6 percent of the latter.

Focusing on healthy eating had the opposite effect: dieting, but also disordered eating,     occurred in about 40 percent of overweight adolescents whose mothers talked about healthy eating, in 53 percent of those whose mothers did not, and in 64 percent of those whose mothers only talked about their weight.

The associations were similar for conversations initiated by fathers. Having just one parent talk about either weight or healthful eating was enough to affect the adolescents' odds of developing eating problems.

IMPLICATIONS: The vast majority of eating disorders first begin in adolescence, and kids appear vulnerable to any mention of their weight by their parents, even when it's (presumably) supportive in nature. Of course dieting, when done right, is a desirable outcomes in kids who are overweight, but that equal percentages of overweight children were dieting and engaging in unhealthy weight loss behaviors might mean that emphasizing weight isn't the best way to get them to change their habits. Meanwhile, emphasizing healthful eating appears to positively impact adolescents' behavior, so far as it's associated with a lower prevalence of eating disorders. It would seem that what we need to know next is whether that's enough to help them maintain a healthy body weight.

The full study, "Parent Conversations About Healthful Eating and Weight," is published in the journal JAMA Pediatrics.