Ep. 30 Fear Of Eating Disorders And Weight Loss in Teens

Are we inadvertently fostering eating disorders in teenagers striving for a healthy weight?  
I present here a study that followed 97 teenagers aged 14-18 over a year, looking at the impact of a program on their insulin resistance, liver fat percentage, blood pressure, cholesterol levels, and eating behaviors. 

A comprehensive, multidisciplinary approach to teen weight loss—one that promotes overall healthy habits and lifestyle changes instead of solely focusing on weight may be the key to this transformation.

Dr Gourgari is a pediatric endocrinologist, certified in obesity medicine expert and weight loss coach for teens with more than 15 years of experience. She helps teens build healthy habits that last, so they can feel happier, be more confident and love their body again .

To get a free copy of 30 healthy and easy recipes for teens that are high in protein, visit
https://lifestyleforteens.com/recipes

To learn more about the LIFT Program, visit lifestyleforteens.com/program

Transcript

Speaker 1: 1:04

This is the Lifestyle in Weight Loss for Teens podcast. If you are a mom and want to help your child who is struggling to lose weight, you are in the right place. If you are looking for healthy lifestyle tips, dr Gorgary is here to help you understand the science around safe weight loss in teens and children, because what works for adult weight loss is not always the best for children. This podcast is for educational purposes only. Dr Gorgary does not provide medical, psychological or nutrition therapy advice. You should not use this information to diagnose or treat any health problems without consulting your own medical practitioner and now your host, dr Jenny Gorgary.

Speaker 2: 1:49

Hello, welcome to another episode of the Lifestyle in Weight Loss for Teens podcast. This is Dr Jenny Gorgary, and today I decided to present to you a research study that I think is going to maybe ease your mind around the risk for creating more eating disorders in teenagers when they try to get to a healthy weight. The reason I decided to present this is because I often hear from families that they are scared their teenager may develop an eating disorder. Oftentimes they don't even want to touch the topic of doing anything about it because families are scared that this may create more problem than trying to solve one problem, which is the way to create another problem, which is eating disorder. So there has been done a lot of research around this topic and this is just one of the studies I found and I wanted to present to you.

Speaker 2: 2:55

So the main idea, of course, is that we don't want to focus on just a diet. I discussed that on previous episodes, how diets in general don't work for kids. I don't think they work for anyone, to be honest. But if you haven't heard episode 26, you can go back and listen to that about the dieting myths in teenagers, lifestyle14scom. But besides not focusing on the weight, we want to approach this concept by getting into overall healthy habits and healthy lifestyle. That will eventually have the weight as good side effect. It will be a byproduct of doing all those healthy changes. Eventually the weight will come off, but if nothing is done and we just keep ignoring the problem, it's just going to get worse and worse. So it is important to choose a program that has what we call a multidisciplinary approach and it's not only focusing on the weight but looks the teenager as a whole human being and approaches different aspects, which includes healthy diet, healthy exercise, sleeping well, learning how to handle emotions. So one of the most common eating problems and abnormal behaviors in regards to eating with same teenager is bulimia, which means that teenagers can have regular episodes where they're overeating a lot, to the point that they feel stomach pain, they feel disgusted and then they can even induce vomiting after those episodes of overeating, because they're doing this in an effort to get rid of the food that they ate and save their stems from their calories. Or they may start to exercise a lot to burn calories to make up for the food that they ate. And they are constantly concerned about their weight. Their don't like their bodies, which obviously, all these behavior create an unhealthy relationship with food. So this is a real concern and I do understand it, and it is a significant reason to make sure we approach the topic of going to a healthy weight in a healthy way and use a professionally guided approach to do that.

Speaker 2: 5:48

So this particular research I'm going to present to you today the actual title of the manuscript is Multidisciplinary Approach to the Treatment of Obesity Lessons Effects on Cardiovascular Risk Factors, inflammatory Profile and Neuro-Andocrine Regulation of Energy Balance. It was published in the International Journal of Endocrinology. Leading author is Ana Raimunda D'Amaso. So this research examined a lot of things, but I'm just gonna choose a few things out of this research that, in my opinion, I think are most important and most relevant to what I just said about trying to maintain a healthy lifestyle and teaching teenagers how to maintain a healthy lifestyle in a way that will not make the abnormal eating behaviors worse. So what this group of great researchers did is they asked teenagers that they were between the ages of 14 to 18 years of age to participate in this program, and it was a long program it lasted a year and I want to say that this is not an easy study to do because oftentimes, while people may start very enthusiastically to participate in a program, they often forget about it or give up and don't follow the recommendations on a regular weekly basis. So they only used at the end of their analysis of the results. They only used results for those adolescents that actually participated in 75% of all the program, and there were like about 20 people that drop out of this program, which is in some ways expected because they can have job or financial problems or school problems and different things that get in the way. But there was still like 75% of teenagers that participated and so it was a total of 97 teenagers, 56 girls and 41 boys.

Speaker 2: 8:11

So researchers asked them to measure blood tests. So they measured, they wanted insulin levels and they did some fancy calculations to really estimate what is their risk for future diabetes. So we call this insulin resistant, so they calculated their insulin resistance. They also looked at the percentage of their fat around their liver, because that is one another complication of having a healthy weight is that you can have fat around your liver and that can cause fatty liver and future problems with the liver. So they looked at that. They also looked at their blood pressure. They look at their cholesterol levels and they also asked them questions that had to do with evaluating what is their eating behavior at the beginning of the program. So they are validated questionnaires that they use.

Speaker 2: 9:12

So they were looking to see what's the percentage of kids that had bulimia disorder. They also asked them to participate in regular physical activity. That physical activity was constituted of 60 minute sessions, 30 minute aerobic exercise and 30 minute resistance exercise, for a total of 180 minutes per week. This is a total of three hours per week and I'm going to say, I'm going to say here this is lower than the recommended amount, right? Like the American Academy of Pediatrics recommends getting at least one hour of physical activity, which I understand may not always be feasible, in this study, the physical component of the physical activity was actually three hours, which tells you that you don't necessarily need to do from the beginning all the recommendations. But even a smaller amount, like they did in this study, is maybe helpful.

Speaker 2: 10:18

Now, in terms of their nutritional advice, what they asked them to do was to follow the recommended levels of dietary approach based on their height, their weight and their age, and they calculated based on a macronutrient component of about 45 to 65% carbohydrates, 25 to 35% of fat and 10 to 30% of protein. Once a week, the adolescents were going to classes where they were taught on different topics that were related to how they could improve on their food choices and they were all receiving consultations about their food and what they should eat better, what they should do better so they can improve their eating habits. So the researchers also look for different psychological issues, potentially like problems with low self-esteem, with body image, with moodiness, and they were meeting weekly in a one year therapy support group to discuss different issues around those topics, so the teenagers would feel supported in their journey. So this is the main structure of this program. I would say it was very well organized and structure and it lasted about a year, as I mentioned. And, of course, what are the results? Which is the exciting part?

Speaker 2: 11:56

I am happy to say that, after putting all this effort and remember this is the results only on the teenagers that attend at least 75% of the program, which means they were the ones who were actually dedicated to the program and were going to the classes, were going to the meetings, were doing what they were supposed to do for the most part, even though they probably were not perfect, they found that the different variables in terms of their insulin resistance, their cholesterol, their blood pressure, their weight circumference they improved. So the waist circumference improved from 62% that was initially abnormal to 14%. The insulin resistance was high in 83% of teenagers and then after the therapy it went down to 40%. And also the same thing for, as I mentioned, the blood pressure. Their sugar abnormal sugar was high in 13% of the teenagers went down to 5% after the intervention.

Speaker 2: 13:17

And the one thing I wanted also to bring up is the binge eating problem, which was identified in 6% at the beginning of the program and at the end of the program a binge eating was down to 2%. So not only it did not increase this abnormal behavior, but it improved significantly. So I guess the take home message I would like to give, based on this study, is that very well carefully designed multi-disciplinary team that approaches healthy lifestyle in teenagers in a well organized way, that targets healthy habits and not just focus on weight but targets healthy nutrition, exercise and psychological aspects and relationship with food, can have beneficial effects without creating more eating disorders problems. So don't be scared to actually intervene and do something. Just be careful on what program you want to choose. So that's all I had for you today. I hope this was helpful to you and I will be with you next week. If you find this episode helpful, feel free to share it with someone you know, if you enjoyed listening to this podcast.

Speaker 1: 14:56

I invite you to come check out the Lift program. It's Dr Gorgary's 12 week coaching program for teens and their moms, where we take all this information, we apply it to your daily life and we work together so your teenager learns how to create a healthy lifestyle so they can feel happier, more confident, less stressed and love their body again. Visit the website at lifestyleforteanscom and click on the work with me and free resources to learn more about this program and get free health to start this journey right away. Thanks for tuning in and we'll catch you in the next episode of Lifestyle and Weight Loss for Teens.