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Tricks to help teens maintain a healthy weight

New book titled, 'Weight Loss Confidential,' by dietitian Anne Flether, encourages teens to shed excess pounds with advice from other teens.

For some teens, losing weight can feel like a do-or-die situation. But a new book encourages them to take the lead in shedding excess pounds in a sensible way with advice from those who’ve been there. Author and registered dietitian Anne Fletcher, and her son, Wes Gilbert, whose own battle of the bulge inspired her to write "Weight Loss Confidential:  How Teens Lose Weight and Keep It Off — And What They Wish Parents Knew," were invited to discuss the book and teen weight loss on TODAY. Here’s an excerpt:

As with all my books, "Weight Loss Confidential" was in my head for years before it came to be. You see, I have a child who became overweight — not just a little, but a lot. By the end of eleventh grade, my oldest son weighed 270 pounds — a weight far too heavy for the well-being of his psyche and his large-boned 6'2" frame.

Wes’s weight problem started when he was in sixth grade, and he gained steadily as he turned from the athletic interests of his elementary school days to the sedentary pursuit of high school debate championships.

Despite my expertise in the area of weight management, little I said or did made any difference in the habits that led Wes to pack on the pounds. And when he would attempt to cut back, his peers, many of whom could eat whatever they wanted without gaining weight, made fun of him.

I first got the idea for this book from an experience Wes had at a summer academic camp when he was thirteen. While standing in the cafeteria line, he noticed that the kid in front of him was ordering his salad dressing on the side and reaching for a can of diet soda instead of regular.

Wes asked him why, since he was so thin. “Oh, yeah?” the boy replied as he pulled out a photo of himself when he was at least 40 pounds heavier. “Everyone in my family eats like a slob, and I didn’t want to be like them!”

Wes and the boy proceeded to share weight management tips — something neither one had ever been able to do before with other kids the same age: “Did you know that kids are less likely to make fun of you if you drink Fresca, since the word ‘diet’ isn’t in its name? Did you know that if you dip the tips of your fork in a thick salad dressing instead of dumping all the dressing on top of your salad, you can get the taste without a lot of calories?”            

When Wes shared this experience, the realization struck me: Teens typically don’t listen to adults — their parents, dietitians, or other health care professionals — but they do listen to each other. Who better to help teenagers manage their weight than young people who have done it themselves?

Thus, the seeds were sown for this book, but more important, hope was kindled in Wes that he’d eventually be able to slim down. Even though he didn’t lose weight until years later, he now says, “I remember thinking, ‘If this kid with overweight parents and negative influences could do it, so can I.’ Now 21, Wes has kept off 60-plus pounds for three years — a journey he began during his senior year in high school.

What This Book Is—and What It’s Not
This book is not a one-size-fits-all prescription for teen weight loss, nor is it intended for teens who want to lose five or ten pounds to look better. Rather, it’s a book about healthy weight management for overweight teens and their families — written from the perspective of young people who used to be overweight and who found a variety of sensible means to arrive at a weight that’s right for them. (These teens don’t necessarily fit society’s definition of “thin,” but they’re healthier and happier than they used to be.) Weight Loss Confidential is not only about how the teens got to a just-right weight; it’s also about how they stay there.              

The teens and their parents share firsthand insights into what works and what doesn’t in weight management. I’ve pored over the latest research studies on the issue and interviewed countless experts, distilling the best of what’s out there and putting it all together to come up with sound advice for overweight young people — all the while keeping their best interests in mind from a health and a psychological standpoint. I’ve also considered the very real concerns that teens face in wanting to fit in with their peers and in feeling pressured to look like the skinny models and celebrities they see in magazines and on TV — at the same time that they’re trying to cope with an environment that encourages us all to sit around and eat too much.              

In the three years that it’s taken me to research and write this book, I’ve learned that there aren’t many well-designed studies on what works for overweight children and teens. In fact, most of the good studies have involved younger children rather than adolescents, and most have involved relatively small numbers of young people. And state-of-the-art child obesity treatment programs generally do not have high success rates. Moreover, a recent review of studies on interventions to prevent child obesity concluded that many were not effective in preventing weight gain.              

With more and more children and teens becoming overweight, it’s clear that we need to think about this problem in a new way — perhaps by listening more closely to what young people themselves have to say.

A Controversial Subject
Although I’d been thinking about this book since 1997, I held off on writing it in large part because talk about weight loss for teens even if the teens are truly overweight isn’t considered politically correct in some circles. Some experts don’t think we should even talk about weight loss for teens. A number of them subscribe to the “fatness (or size) acceptance” or the “health at every size” philosophy. They suggest putting less emphasis on appearance and on what the scale says and more on healthful eating and increased physical activity, then accepting the weight that results — even if that means a teen remains overweight.              

Although we need to continue to work on changing the stigma associated with being overweight, we can’t afford to ignore the very real problems of overweight teens or what the teens who have succeeded at weight loss have to say. In the United States, 1 out of 3 children and adolescents ages two through nineteen is overweight or at risk for being overweight. Indeed, the proportion of children and adolescents who are overweight has tripled in the past three decades, and the numbers continue to rise. Similarly, in the past two decades, weight problems have nearly tripled in Canadian children, and societies that never had weight problems have become part of what’s called a global obesity epidemic. As a result, overweight teens face health issues that were virtually unheard-of in young people until recently.              

Although some children do outgrow their weight problems, most do not. Several studies suggest that up to 8 out of 10 overweight teens will become obese adults. Both groups are at increased risk for a number of health problems.              

When I first became a dietitian, type 2 diabetes, a weight-related health problem, was called adult-onset diabetes because it was seen only in adults. This problem is increasing in young people, particularly in minority teens, including African Americans, Hispanic Americans, and Native Americans. A growing number of kids also are developing conditions such as high blood pressure and high blood cholesterol, both of which increase the risk of heart disease. According to a report in the New England Journal of Medicine by renowned child weight expert William Dietz, M.D., Ph.D., about 6 out of 10 overweight children and teens have at least one of these risk factors. More and more children have other weight-related ailments, such as sleep apnea, which is a nighttime breathing problem.              

As the teens in this book make clear, our society isn’t kind to overweight people. Taylor S. says, “Regardless of how they may appear on the outside and how content they might seem to be, the majority of overweight teens deal with a lot of emotional anguish. It will almost always be hidden, but it’s there.” After being reduced “to the point of tears” because of teasing, Taylor lost 100 pounds when he was sixteen, and he’s kept the weight off for about four years.

Only If It Comes from Them
As the stories of the teens and parents in this book suggest, children of any age should never be given the message that their weight determines their value; they need to be loved without conditions. Over and over, both teens and parents told me that the incentive for arriving at a healthier weight has to come from within the teen, not from the parents.              

Taylor S. says, “If a teenager is really concerned with losing weight and has good reason to believe he’s overweight, don’t tell him he’s fine just the way he is. Let him know he’s loved unconditionally. However, if he feels he needs to change something about himself, within reason, he has every right to do it and needs to be supported 100 percent.”              

Tom C.’s mother says, “We should not have told him he looked good when he did not. He eventually resented us for lying to him.”                         

The strategies in Weight Loss Confidential are intended for teens who have already shown some interest in changing, not for parents to use to persuade teens that they should change, by saying, in effect, “Look, this is what you need to do.” It presents options that teens may choose to attempt or reject — suggestions to be tried on for size.              

The good news is that many teens — like Wes, Taylor, and Tom — have found an approach that has worked for them to arrive at and stay at a weight that’s right for them. And they’ve done it without compromising their mental or physical health. I invite you to listen to these teens’ stories.

Copyright © 2006 by Anne M. Fletcher. Reprinted by permission of Houghton Mifflin Company.