Dieting in Adolescence Flashcards
What proportion of teenage girls and boys are dieting?
Should this affect your practice?
Lots
41-66 % of girls
20-31% of boys
Because dieting is common, you should screen for it in your regular check ups
What is the definition of dieting?
Intentional, often temporary, change in eating to achieve weight loss
What are some examples of extreme dieting? (6)
Self-induced vomiting laxative use diet pill use Chronic dieting (>10 years) Fasting Skipping meals
What are some recommendations of healthy living, that can be used as dieting options
Increasing fruit, vegetable and whole grain intake
Moderate reduction in fat intake
Increasing exercise
What are some individual risk factors for dieting?
Female self perception of overweight and unhappiness with body image Low self esteem Obesity Low sense of control over life Mental health issues Vegetarianism Early Puberty Chronic illness (DM, asthma, ADHD, epilepsy)
NB weight itself is not a risk factor except for obesity (dieting occurs in all weight groups), neither is socioeconomic class or ethnicity
What are some family factors that contribute to dieting?
Low family connectedness Absence of positive adult role models Parental dieting Parental endorsement or encouragement to diet Parental criticism of child's weight
What are some environmental factors that contribute to dieting?
Weight related teasing
Poor involvement in school
Peer group endorsement of dieting
Involvement in weight related sports (dance and gymnastics)
What are some of the adverse physical consequences of dieting?
Nutritional deficiencies - especially iron and calcium
Growth deceleration - caused by energy deficiency
Menstrual irregularities
Bone health
Purging consequences
Progression to anorexia nervosa (18x increased risk)
Paradoxical effect with weight gain over time
What are some of the adverse psychological consequences of dieting?
Food preoccupation Irritability Fatigue Distractability Worsen baseline mental health, especially poor self-esteem
Does dieting cause anorexia nervosa?
There is conflicting data.
Some studies show an increased risk x 18
Some studies, especially adult studies, show no increased risk or association
What risk behaviours are more common in dieting adolescents?
Smoking
Unprotected sex
Drugs
What should you advise teenagers who want to diet?
Dieting does not usually end up with weight loss
Eat as per Canada food guide
Discourage: fad dieting, fasting, skipping meals and supplements
Advise to be wary of weight loss schemes such as pills, vitamin shots, meal replacements
Encourage teenagers to accept realistic weights for themselves
Is there evidence to support particular weight loss strategies?
No there is a paucity of evidence on effective interventions for obese children. There is no evidence that commercial weight loss programs are safe or effective for children or teenagers
