Teenagers and Health: How to Encourage a Teen to Maintain a Healthy Lifestyle

I wrote this post following an interview I gave to Kol Yisrael, Israel's public radio service, on Reshet Aleph, on Tami Torovitz's program on 24.01.12. Listen here (click "Tav," the Hebrew letter, and listen from 25:00, immediately after the conversation with Dr. Tzachi Ben Zion).

A story: Yonit attends coaching in a support group for parents of children with inflammatory bowel disease. Her teenage son has Crohn's disease, diagnosed a year ago. Yonit is educated and very aware of healthy nutrition. She says she takes care to cook healthily, reduces the fat she adds to food, bakes without margarine, and tries hard to teach these principles to her household. It all sounds very good. Her son, she says, does not always listen and also eats things that are not very good for him. Such as what, I asked? For example, he takes a handful of gummy candy before lunch. Where does he get gummy candy? I buy sweets to have at home, Yonit answers. Silence falls over the group. All eyes turn to me. Naturally, I ask Yonit why, with all her awareness of healthy food, she regularly buys gummy candy and other sweets for the house.

Then Yonit describes the trauma of her childhood without sweets at home. In her parents' house, they ate only meals, with fruit and sandwiches between them. She says this meant that when her mother hosted guests and served cookies and sweets, the children would wait for the parents to get up to leave so they could pounce on the refreshments. Yonit promised herself that this would not happen in her home. Today she finds herself trying to keep her son away from unnecessary sugar and food coloring, creating tension between them.

Our patient is part of an entire family system. This is especially true for a child or teenager. When a teenager comes for nutritional treatment, I work with the parents first. Through them, I explore the atmosphere around food and the messages they convey, which usually determine how their children behave around eating.

We can learn a great deal about family relationships by examining eating arrangements: whether the family eats together, who participates, who chooses the menu, who cooks, who sets the table, and who clears it. In some families, children eat before all the adults sit down. What message does that convey? Did the parents pressure the child to eat when younger? Are contradictory messages being sent? For example, a grandmother arrives with sweets. A moment after the hugs and kisses end and all the grandchildren have received snacks or candy, she looks critically at her eldest granddaughter and comments on her weight gain. This sends a confusing message that may make it very difficult for the girl to cope with her changing body and build a healthy body image.

So what can be done? First, remember that setting an example is the best way to teach. Dear parents, start noticing the messages about food in your home. A father sits down at night and finishes half a package of pita bread with hummus and cola or beer. A child with obesity who receives a diet plan from a health fund dietitian will find it very difficult to maintain changes in eating behavior, even if they want to, because the household does things differently.

A mother is preoccupied with diets. Food is presented as an enemy: "We do not bring enemies into the house, so I will not buy a cake." Words compare physical activity to "punishment": "I ate a lot yesterday, so I have to atone for my sins. I will exercise twice as much today." Her children are very unlikely to want to exercise for pleasure…

How, then, can we encourage teenagers to adopt a healthy lifestyle? Some suggestions:

1. Talk to your child when they are in a good mood. Try to understand their attitude toward their body and their feelings about eating. Notice that this conversation comes from genuine interest, not from a wish to lecture.
2. If they show interest, you can explore what they would like to do to feel physically better.
3. If they are interested in sports for fitness or bodybuilding, encourage them. Find out what they enjoy and which kind of activity would be fun. Remember: there is no right or wrong sport. What you enjoy is what you stick with!
4. If your teenager wants to lose weight, do not rush straight into quick diets. First, encourage them to choose an activity they enjoy. Most weight problems result from lack of movement. Teenagers spend many hours at the computer or television, and a sports class twice a week for 1 hour can be a good start.
5. Regarding food, explain the harm of crash diets, the importance of balanced nutrition during adolescence, and the need for vitamins and other nutrients. Encourage them to begin changing their diet by examining their eating. You can suggest a food diary as a useful tool for identifying patterns. Communicate that you trust them, that this is their responsibility, and that they can improve their eating. It is also important to encourage them when they have "slipups": say that this is legitimate, that it is a long and difficult process, and that they can always get back on track.
6. The first essential stage in balancing eating is to examine and reduce fast food: snacks, junk food, and eating while watching television.
7. Raise your teenager's awareness of the connection between their eating, physical activity, and body. Identify what motivates them, whether appearance, fitness, sporting achievements, or something else, and use this to encourage continued change. Without judgment or put-downs, but with plenty of compassion and ongoing examination of family eating patterns, you can help your teenager build a more active, healthier lifestyle.

This is general news information and is not a substitute for personal advice from a doctor or dietitian.