'Do more, talk less' to help heavy teens slim down

NEW YORK (Reuters Health) - Parents of overweight teens who recognize that their kids are too fat don't take steps to help them to eat more healthily or to be more active, but they do push them to diet -- and this pressure is likely to backfire, a new study shows.

Parents who are concerned about their child's weight should do more and talk less, Dr. Dianne Neumark-Sztainer of the University of Minnesota, Minneapolis, told Reuters Health. "Serve more fruits and vegetables, have more family meals, find ways to be more physically active, turn off the TV," said Neumark-Sztainer, the author of "I'm Like So Fat: Helping Your Teen Make Healthy Choices About Eating and Exercise in a Weight-Obsessed World" (Guilford, 2005).

"Possibly more important is to talk less about weight and dieting," she added. "Teens are very sensitive about these topics, and are very likely to take a parents' well-intentioned comments as criticism. Parents are for the most part trying to help their children, it's just a sensitive issue."

Concerns have been raised that parents often don't realize when a child is overweight, Neumark-Sztainer and colleagues note in the June issue of the medical journal Pediatrics.

They analyzed information obtained from 170 parent-child pairs in which the child was overweight.

For girls, 54% of parents classified them correctly as overweight, while the rest thought their daughter's weight was "about right." Among boys, 40% of parents said their sons were overweight.

Parents who saw their children as overweight were no more likely than those who didn't to eat meals as a family or make fruit and vegetables available at home and serve them at dinner.

They were also no less likely to eat fast food at family meals; watch TV during meals; stock the pantry with soft drinks, candy and salty snacks; or encourage their children to be more active or to eat a healthier diet.

Fifty-seven percent of these parents said they encouraged their children to diet to control their weight, compared to about 33% of parents who didn't think their children were too fat.

But for both boys and girls, being encouraged to diet roughly tripled their likelihood of still being overweight 5 years later.

Past research has shown that teens who diet may actually be more likely to gain weight over time, Neumark-Sztainer noted; kids who diet tend to binge-eat more often, skip breakfast, and use other less healthy, and less effective, weight control strategies, she explained.

"We want to place less emphasis on informing parents about their child's weight status and more emphasis on providing parents with the skills and the support that they need to make their home environments healthier and more conducive to healthier weight management," Neumark-Sztainer said.

SOURCE: Pediatrics, June 2008.