Obesity in adolescents - support for families

Introduction

Weight problems are common among adolescents in Australia.  At least one in four young people in Australia are overweight or obese. If you think your adolescent may be above a healthy weight, they should be correctly assessed by a health professional as their weight could be causing other health problems. Your local GP/paediatrician will be able to measure their growth and level of development and provide advice.

Talking to young people about their weight can be difficult. Tips for talking about weight with adolescents include

• focus on healthy behaviour changes. Remind adolescents about positive changes
• get the whole family involved. Teenagers are best able to make changes when they feel well-supported, not “targeted”
• unless advised by a health professional, focus on health/healthy lifestyle, rather than weight loss
• avoid labelling people as fat, chunky or obese. Use phrases like: “not a healthy weight for their age” or “above average weight.”
• help improve your teen’s self-esteem. Praise them, give compliments and encourage qualities not related to their appearance
• avoid negative-sounding comments like: “don’t you think you should…” or “you shouldn’t be having that.” Teens interpret this as nagging and are less likely to do what you want them to do
• be mindful of negative commentary about your own body
• if your teen makes an unhealthy food choice, don’t make a big deal. Wait until the right time to talk about what they could have done differently
• teens may eat to combat stress, boredom or for comfort. Talk to your teen about their feelings so they are less likely to emotionally eat
• feeling “fat” is usually about something else.  Adolescents may not be able to say they are feeling insecure, worried or down on themselves.  Talk to them about how they are feeling – other than “fat”
• encourage teens to talk about any bulling or teasing about their weight and encourage self-esteem in other areas
• avoid fad diets. They can lead to disordered eating, poor self-esteem and more weight gain overtime

The main factors that can influence weight for adolescents are their food intake and physical activity. Parents can support their teen to make healthy choices by providing suitable foods and drinks in the home, discussing healthy options for outside-the-home, and being a healthy role model.

Changing your lifestyle to achieve a healthy weight isn’t as hard as it may sound. Your family can reach healthy goals by changing a few unhealthy habits.  Goals should be small, realistic and involve the whole family.

Tips for a healthier lifestyle:

• limit screen time to less than two hours per day
• eat together once a day as a family and turn off devices
• spend at least 60 minutes outside every day (playing or being active)
• choose water as your main drink: fruit juice, cordial and soft drinks should only be occasional treats
• eat breakfast every day
• swap all full-cream dairy foods for low-fat options
• eat more fruit (two serves/day), vegetables (5 serves/day) and nutritious snacks
• do not skip meals. Eat at regular times (three main meals + 2-3 optional healthy snacks per day) - this will regulate appetite
• limit takeaway food and high-fat snacks
• use low-fat cooking methods
• learn how to read food labels (e.g. look for products with less than 10g of fat per 100g)
• encourage your teen to eat slowly and chew food well
• aim to fill half the plate at main meals with salad or vegetables. If your teenager says they don’t like vegetables/salad, do not substitute with other foods
• plan your shopping list around healthy meals. Avoid high-energy snack foods such as chocolate, potato chips, lollies, and sweet biscuits regularly
• choose whole grain-based breads, pasta and breakfast cereals, as they are more filling than processed white varieties
• don’t keep unhealthy food choices in the house
• include regular, portion-controlled treats once or twice per week: this gives a balance between good nutrition and overeating
• when dishing out dinner, aim for ½ plate of vegetables or salad, ¼ protein (i.e. red meat, fish, chicken) and ¼ carbohydrate (i.e potato, rice or pasta)
• encourage your teenager to be involved in cooking or preparing meals for the family: maybe they could cook a meal once a week
• encourage your teenager to take lunch to school, rather than buying from the canteen 

Physical activity is important for a healthy lifestyle.  Exercise helps maintain a healthy weight, while also keeping your teen’s bones, heart and lungs strong and healthy.

The Australian guidelines for physical activity are:

• one hour of physical activity per day
• less than two hours of screen time per day

Physical activity can be incidental and accumulate across the day or organised like sport. Both forms promote a healthy weight; however, ‘lifestyle’ exercise is usually easier to stick to longer term. 

Tips to increase physical activity include:

• find a time that fits into your daily routine. e.g. before/after school or after dinner.  By finding an available time, it is harder to find excuses
• build up to more vigorous exercise. Start with 10 minutes and each time, add more time so you get up to 60 minutes most days
• teens should do at least 60 minutes of moderate/vigorous physical activity every day to keep them fit and healthy - this means they are “huffing and puffing”
• try some extra “incidental activity” like walking to and from school, doing household chores and walking up stairs
• keep screen time to less than two hours per day
• include structured sports like soccer, footy, trampoline, swimming, netball, martial arts gymnastics and dancing
• encourage teens to use an app or an active watch to measure steps and aim for 10,000 steps each day
• offer pocket money for active jobs like walking the dog, washing the car and gardening
• put up a basketball or netball hoop
• buy inexpensive play equipment such as totem tennis, badminton or a skipping rope
• make the most of daylight savings and go for a regular, family walk
• on warmer days, visit the beach or swimming pool

If your teen has been advised to lose weight, the whole family can make small changes. Adolescents need support to lose weight – they can’t do it without you. If everyone in the family makes healthy food choices and is more active, then it is easier to be consistent. 

Things to consider:

• the food you offer and the brands you buy make a huge difference to you and your teen’s health. Consult with your dietitian when making new, healthy food choices
• teenagers learn from your example. When you make changes, they are more likely to copy you. That’s why it is critical for parents/carers to model healthy behaviours
• teens may not be motivated to lose weight. Never rely on willpower alone; instead, change the environment for everyone
• ensure teens are living in a healthy environment. Keep tempting food such as cakes, biscuits, soft drinks and chocolate away from the house and stock up with healthy foods and snacks
• implement family rules about how much screen time each person has every day, ensuring it is limited to less than two hours a day
• to encourage activity, do things together as a family such as walks, bike rides or picnics on the weekend

The length and the quality of your teenager’s sleep can affect their weight, and vice versa. Sleep and weight are strongly connected in adolescents - not getting enough sleep can change how hormones work, leaving you more likely to have a bigger appetite and gain weight.

It can also be hard to stay positive and focused on making healthy lifestyle changes if you are not getting enough sleep. Getting extra sleep can often help teenagers who are obese to lose weight.

Things to consider:

• daily exercise helps sleep. It is best to avoid rigorous physical activity within one hour of sleep time
• encourage your teen to be consistent with sleep and wake up time. Adolescents should not stay up too late or sleep in, even on weekends
• encourage teens to have a period of time to wind down before bedtime with a shut-down of all electronic devices
• do not have a television, game console, or computer in the bedroom
• as a family, talk about the need to develop better sleep habits and put some strategies into action

If you have concerns about your teen’s sleep, speak with your doctor. It is particularly important to talk to your doctor if teens are snoring or sound like they are having difficulty breathing when asleep.