Solving Your Teen's Weight Problem -- with Erika Schwartz, MD

WebMD Live Events Transcript;Event Date: Thursday, September 23, 2004

By Erika Schwartz, MD
WebMD Weight Loss Clinic - Live Events Transcript

If you have questions about your health, you should consult your personal physician. This event is meant for informational purposes only.

As parents we may not be able to change our teens' tastes in fashion and music, but their health is another matter. On Sept. 23, 2004, we discussed the special concerns of overweight teens and the role of hormones in mood, growth, and energy level, plus how you can help your child avoid the pitfalls of dieting. Our guest was Erika Schwartz, MD, author of The Teen Weight Loss Solution.

Support for this University course is provided by Blue Cross Blue Shield of Massachusetts.

Welcome to "Kids, Pounds, and Playgrounds." Your instructor is Erika Schwartz, MD, author of The Teen Weight Loss Solution: The Safe and Effective Path to Health and Self-Confidence. Today we'll be talking about helping your weight-challenged teen. Support for this WebMD University course is provided by Blue Cross Blue Shield of Massachusetts.

Teens and weight -- how much is really a weight problem and how much is a body image problem with teens?

A few things to realize about defining weight:

  • We all forget that genetics affect how we look.
  • We have our culture to keep in mind, and what our culture considers "ideal."
  • Then there's reality.

What we want to teach our teens is how to balance those three issues. Our society, unlike the Middle Ages, when being chubby was considered ideal, places a high prize on thin rather than average, but not everybody can be thin.

We need to learn to become aware of what's reasonable and create reasonable expectations for our teens. We will not be able to create reasonable expectations unless we take into consideration our genetics, our way of life, and teach awareness to our teens so they learn to feel good about themselves rather than constantly striving for something that's unrealistic.

For kids who are still growing, does a restricted diet pose problems?

Absolutely. As the kids' bodies grow, the balance of nutrients is extremely important. That balance will tip every time we put in junk or restrict what they're eating, from a standpoint of calorie and amount of food.

Ideally, parents, being able to evaluate the amount of physical activity and the way of life of their teen, should provide a healthy balance of protein, carbohydrates, fats, and fiber. We have to be realistic in our expectation of what happens outside the house. Your teen will eat junk; your teen will drink soda; your teen will drink alcohol.

That doesn't make this a hopeless situation, it only encourages you to set a good example and to take responsibility for providing the best food and the best balance at home. If home is a haven, both emotionally and food-wise, your teen will do well. The commitment is high, but the rewards are even higher.

Are teens more susceptible to ending up with eating disorders when going on a diet?

Yes. Diets don't work. Diets don't work for adults, diets don't work for teens. The rollercoaster a diet sets a human on creates a confusing and unhappy world. The reason diets don't work is because they restrict and they focus on issues that they cannot correct. So when you want your daughter to feel good about herself, restricting her diet will only serve to undermine her own self-esteem.

Food cannot be made the focus of your teen's life and a diet accomplishes just that. Food is a necessity that should be made a part of life, but not the focus. Extremes don't work, and when you do one extreme, which diet represents, you throw your teen into the other extreme, which is eating disorders. So balance is the name of the game.

The whole idea of dieting has to stop, because it will literally kill our teens. It's killed the adults, because that's all we talk about, we go on one fad after another. Food has to be part of the fabric of society, it has to be a cultural thing. You sit at the family table for dinner, it's not about the diet, it's about the conversation, the emotional bonding that goes on between people. That is critical. And dieting, the way of life of dieting, robs ourselves of that.

Studies that have looked at eating habits of cultures where obesity is very minimal have discovered a few important points. In those cultures:

  • people eat smaller portions
  • they do not snack
  • they don't eat fast foods
  • eating is a social bonding experience
  • they don't eat on the run; they don't stuff their faces

How can I talk with my daughter about her overeating without hurting her feelings? I'm not looking for a skinny model daughter, but she eats too much and is gaining weight.

"My daughter always says she's fat, but she isn't. Help!"

I address this issue in detail in my book Teen Weight Loss Solution. There are a lot of ways to help your daughter see herself, become aware of her eating habits, and provide her with the support needed without destroying her or hurting her feelings.

If you learn to listen to your daughter and let her tell you about herself, she will offer you openings where you can kindly address the eating issues. Let her bring it up. I am sure she's aware of it herself, but she is not sharing her concerns with you because she's afraid of your reaction. For more detail, read my book. It's full of specific examples of mothers and daughters in my practice and how they solved the same issues successfully.

My teen sons eat like horses. This is okay during football season when they are most active, but out of football season, it causes them to gain weight. What can we do to help them?

You can continue encouraging them to stay physically active while they're in off season. Keeping them at a high level of physical activity will keep them healthy and keep their weight under control.

My daughter always says she's fat, but she isn't. But my telling her that she isn't doesn't seem to make ay difference to her. Help!

Your daughter is exactly like every daughter that I have in my practice. In my book I go over many stories of the same situation, but although your daughter is typical of most teens her age, she is also unique. There is no other person in this world like your daughter.

So what you need to do is become an expert on your daughter. You can use the examples and the advice that works on others, but you need to find the specific answer that works for your daughter. Your daughter has to start feeling good about how she looks. Your daughter doesn't need you to tell her she's thin, she needs you to tell her she's great at everything else that she does. Your daughter needs to receive encouragement in all the positives in her life.

Eventually, she'll believe she's thin enough. Be patient and give her time and support.

Teens seem to be walking bags of hormones! How do teen hormones affect their weight?

You finally got to the core of the issue! Everything your teen does is somehow connected to their hormone balance.

At puberty, sex hormones, which have been sleeping since birth, wake up. When they wake up, everything changes. We notice how sex hormones affect the outside: boys become men; girls become women. We don't realize how dramatically sex hormones affect the inside. If the hormones are in balance, your teen could probably eat a lot of junk and never gain a pound. If the hormones are not in balance and the genetics are against them, they have to become savvy and careful with what they eat in the very beginning.

Balancing hormones is easy if you're aware of their existence and their impacts. Again, my book has more information on this subject.

The first step is for you, the mother, to become aware and understand. As you become more aware and get a better grasp at what's happening with the hormones and how the hormones are affecting weight, personality, way of thinking -- essentially everything -- you can start gently pointing out the connection.

The more you become a gentle teacher to guide the teen to better understand her own body, the less likely she is to develop problems during her teen years or the rest of her life. We address hormone problems at menopause, but we don't realize or address them in teens. If we learn how to address them in teens and teach our teens how to react and how to understand symptoms of hormone imbalance, they will have a whole lifetime of balance and they'll never be on the rollercoaster of dieting, or get steam-rollered by menopause.

It's critical for both the parent and teen to understand the role of hormones and to address issues of hormone imbalances from the very beginning.

So, can someone actually control their hormone levels through diet?

Absolutely. Or rather you can moderate, modify and help balance your hormones, and the outcome of this balance will be an improved sense of well-being and better weight balance.

If you eat junk, you're sending your hormones into a downward spiral, which translates into:

  • weight gain
  • headaches
  • bloating
  • mood swings
  • depression
  • sleep problems
  • hot flashes
  • night sweats -- you name it!

When you eat balanced proteins, fiber, complex carbohydrates, and good fats, in small, numerous healthy meals, your hormones thrive. They're in balance, and you can say goodbye to most of those pesky symptoms, and so can your teen. You are what you eat. Your hormones are what you eat.

My daughter's young, her cycles aren't regular, and she is freaking out about her fluctuating weight. Any ideas on what my daughter can do about weight fluctuations during monthly cycles?

Your daughter is lucky. You understand the connection between your daughter's weight changes and the changes in her hormone balance.

I work with natural/bio-identical progesterone that I give teens the week before their period to diminish the bloating and the mood swings. The results, in more than 500 teens, are remarkable.I also work with a few vitamins and supplements to help them balance their hormones and eliminate the drastic reactions to the hormone fluctuations.

You are correct when you say that periods are irregular for the first few years after they start. That's totally normal and you don't need to worry about your teen having irregular periods, you just need to worry about her feeling good. Eventually, as the cycles become ovulatory, the periods start to regulate themselves. Giving birth control pills to regulate the periods may not be the answer to your teen's problem. Birth control pills override your teen's hormonal system and may, in the long run, create long-lasting, negative effects.

Working with natural/bio-identical progesterone for short periods helps balance the teen's hormones, control the moods and weight, and has not been associated with any negative long-term effects. Birth control pills, while they will prevent pregnancy, do not protect from sexually transmitted diseases and will only give a false sense of security, take away the need for responsibility, which you don't want, you want your teen to become responsible.

My son is about 25 pounds overweight, but he's only 13. What if he grows another foot in the next couple of years? Isn't there a chance he'll grow into his weight?

Chances are that if your son eats well, is physically active, and starts becoming an adolescent, his hormones will kick in and he will grow at least a foot more and the weight will not be an issue. It is up to you to teach your son to:

  • eat good foods
  • throw away the junk
  • become physically active

Your gift to him should be healthy, balanced life.

There are boys in my school who try to be huge because they are on the football team, but I know most of them will never be pros or probably even play in college. Should the coaches be encouraging these guys to eat like they do? It seems unethical to me.

It's a great question. You are questioning the ethics of a whole high school culture. I'm 100 percent with you, I believe if you care about the kids, you care about the well being of the teens and their successful reach to adulthood, so you may have to put the interest of the school second.

And you are right, most boys will not become pro football, pro baseball, pro whatever, most girls will not become pro cheerleaders Pushing them to extreme weight gain or loss to promote the school's interests is unfair and unkind.

If all parents provided the right support to their teens to say no, maybe the schools will have to follow suit. While it is easy to blame an outside source for our teen's weight problems we must remember that:

  • we must take full responsibility for the outcome
  • we must never give up in the example we set
  • we must never give up the support we provide our teens

Now that I have a much healthier way of eating, how do I get my kids to buy into it as well -- without food battles?

Congratulations! All we have is today and tomorrow. You don't have to get into fights with your kids. All you have is time to set the good example that you're already setting. Watch them and let them watch you, and they will follow you. Be patient with them and don't waiver from the course you're on. Good luck.

Dr. Schwartz, any final words for us?

While there is an epidemic of obesity among teens in the US today, it is not a tragedy that has to end with diabetes, heart disease, and other horrible chronic problems.

Instead, it is a wake-up call to all parents to take responsibility for helping their teens lead a more healthful balanced life from the very start.

The Teen Weight Loss Solution will serve you as a foundation for never having an obese teen again. I invite you to join my online community, if you have any questions, are interested in sharing your stories, or learning tips on how to make life better for yourself and your teens. I look forward to hearing you. The online community is

Thanks for joining us, members, and thanks to Erika Schwartz, MD. For more information, please read her book The Teen Weight Loss Solution: The Safe and Effective Path to Health and Self-Confidence.

©1996-2005 WebMD Inc. All rights reserved.


Weight loss occurs in the belly before anywhere else. See Answer

Health Solutions From Our Sponsors