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Weight Watchers teen program prompts criticism about promoting negative body image
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Families working together toward shared health and fitness goals would appear to be an unequivocal “win-win” in terms of developing good habits and spending quality time together. This type of positive, healthy lifestyle change for the entire household is the stated objective of an upcoming Weight Watchers promotion aimed specifically at teenagers.
“Weight Watchers intends to be a powerful partner for families in establishing healthy habits,” the company announced in a recent press release. “During the summer of 2018, Weight Watchers will offer free memberships to teenagers aged 13 to 17, helping the development of healthy habits at a critical life stage.”
Despite a 2017 report from the CDC that more than 20% of U.S. teenagers aged 12 to 19 years have obesity, the Weight Watchers plan was swiftly met with criticism and concern across the internet. These critics fear that the Weight Watchers program will encourage teenagers to put an undue and unhealthy emphasis on physical appearance and dietary restriction.
“Teens are at a point where they are developing their lifelong habits and looking at their relationships with food,” Susan Weiner, MS, RDN, CDE, CDN, owner of Susan Weiner Nutrition PLLC and an Endocrine Today Editorial Board Member, said in an interview. “Whether it’s counting calories, counting points or choosing from a food list, it’s restrictive rather than intuitive, rather than being mindful. … Being restrictive at this age may not lead to a good outcome in later years.”
Weiner said such restrictive diets may place stigma and shame on children who otherwise might not have any problems.
Mindfulness vs. restriction
As a registered dietitian and certified diabetes educator, Weiner has been helping people develop healthy eating habits for 25 years. She said, during that time, she has come to learn that what are commonly known as “diets” are not an effective route for teenagers.
“When people go on a restrictive diet, they’re not focusing on their emotional health or what may be driving them to overeat. When you’re counting something rather than simply enjoying food, there’s a definite chance that you won’t be getting adequate vitamins, minerals, protein,” she said.
This dearth of important nutrients is especially harmful to growing teens, as is the message of emphasizing quantity over quality, Weiner said.
“Of course, there are a number of health concerns associated with being overweight, such as prediabetes and type 2 diabetes. Lab values and health assessments should be monitored, and healthy habits and positive body image encouraged. Overly restrictive diets may set one up for a cycle of weight loss and regain, which may exacerbate these health issues,” she said.
Weiner said, in her practice, she does not advocate setting a goal weight at the outset. Instead, she teaches mindful eating, which involves being aware in the moment, savoring the flavors of foods, and listening to the body’s satiety signals.
“When you are mindful of your body’s needs, you naturally come to appreciate a healthy portion because you are in tune with your body’s hunger and fullness cues,” she said.
Another piece of this intuitive approach is to accept one’s own body, rather than aspiring to unrealistic standards set forth by the fashion and beauty industries, Weiner said.
“I want more young people, and of course, adults too, to focus on what’s good about their bodies, what’s beautiful about their bodies, because what we’re seeing in magazines is not real,” she said.
A lifestyle change
Despite the criticism of Weight Watchers’ entry into the teen market, representatives of some respected medical societies are grateful for a new approach to addressing pediatric obesity.
“For those of us who are in the field, there are precious few options for kids who want to change their weight status in a healthy way,” Christopher Bolling, MD, chair of the American Academy of Pediatrics Section on Obesity, told Endocrine Today. “A lot of our doctors are out in rural settings, where there just simply aren’t even dietitians, let alone children’s hospitals who can help them deal with significant obesity. We try to support efforts to deal with obesity in a healthy way.”
Bolling said the American Academy of Pediatrics Section on Obesity, together with The Obesity Society, released a joint policy statement in November addressing weight bias in children. The statement, which emphasized the need for acceptance and nonjudgment, discusses the stigmatization and discrimination obese children often face.
“By the same token, though, some of these kids have illnesses — they have precursors to type 2 diabetes, and some have type 2 diabetes. They’re having heart changes; they have orthopedic changes. They have poor quality-of-life indicators. When you ask them, they’re not happy.”
Bolling said he strongly agrees that eating disorders are a concern in the teen population, but he does not consider programs like Weight Watchers to be gateways into eating disorders.
“I don’t think we do kids any favors by not giving them healthy options,” he said. “If kids want to change their weight status and you don’t give them any options, some of them just stop eating, which is a dangerous thing to do.”
He said he has heard and read comments describing Weight Watchers as “a crazy point system,” and is baffled by such remarks.
“If you really look at what the Weight Watchers diet program is, it’s really rooted in the American Diabetes Association diet,” he said. “This is a very well-tested diet. It’s not a fad diet. I don’t even call Weight Watchers a diet; it’s more of a lifestyle change. It’s about thinking about food differently, and you’re never supposed to go off it.”
In late 2017, Weight Watchers added several new items to its “zero points list” of healthy foods that can be eaten in unlimited quantities. Bolling said he believes that the diet is not about deprivation but about healthy balance.
“There’s unlimited fruits and vegetables, unlimited lean proteins,” he said. “We’re trying to get kids to eat healthily. Weight Watchers isn’t right for everyone, it’s not a panacea, but we need all hands on deck. The epidemic isn’t getting any better.”
Family support
Bolling said he has no relationship with Weight Watchers, but he did once approach the company about the potential for an adolescent program, with the goal of helping teens in his practice who needed substantial nutritional counseling. Some of these teens had expressed an interest in participating in Weight Watchers with a parent on the program, he said. However, no adolescent program was available.
“Weight Watchers basically told me they had tried this in the past, but that it hadn’t worked very well because it was usually driven by parents — the parents get the kids to do it, and the parents just drop them off,” he said. “A big piece of Weight Watchers is the personal motivation to do it. If it’s based on external sources, it doesn’t work.”
Lack of parental support is a major predictor of adolescents’ failure on a weight-loss program, Bolling said. The new teen program not only encourages parental involvement and support, but also requires that parents be present at the Weight Watchers meetings.
“It’s not rocket science — you’ve got to have family buying the right foods and supporting you,” he said. “You can’t have one person on the plan and everybody else on something else.”
Weiner warned that parents who place their children on restrictive diets are trying to help their kids to live more healthfully, but often instead establish a vicious cycle of deprivation and poor self-image. If the child is unable to lose or maintain the desired amount of weight, she said, parents feel like failures.
“Parents really believe they’re doing the right thing,” she said. “The program is appealing because it’s free, but the reality for kids aged 13 to 17 years is that it’s going to set them up to feel blamed, ashamed or guilty. It’s a message that their body doesn’t look good.”
Weiner added that simply counting points also fails to address underlying issues that may be causing children to gain weight, such as bullying.
“It’s deeper than just restricting intake and monitoring scale weight.” she said. “We need to consider whether these kids are unhappy, or having problems at school. Although it’s a measurement that we use for certain things, scale weight is not something that should be emphasized for teens because we want them to feel good about themselves.”
Bolling said he believes that if done properly, programs like Weight Watchers can help teens without promoting poor body image or eating disorders.
“In that conversation I had with Weight Watchers, they said, ‘If you have patients, refer them. Give us the goal weight and the parameters to work around. Make sure the family is ready to do this, and we’re more than happy to take them,’” he said. “I’m pleased with it as long as there is medical supervision, that we’re not triggering any eating disorder and the families are involved. We don’t want parents to do this for the wrong reason, or treat the program like punishment for one child.”
Weiner said she would prefer to see families teach their children to enjoy a wide variety of healthy foods and make food preparation an activity the family can do together. For example, participating in grocery shopping can allow kids to discover new and healthy foods, and learning to cook the foods might give them a new sense of achievement and confidence. Sharing in this process also opens the possibility of discussing attitudes around food and body image. Most of all, she said, it can be fun.
“I’ve had families say, ‘You’re not going to believe this. John made dinner. My teenager made dinner,’” she said. “Of course, they still don’t want to clean up the kitchen afterward.” – by Jennifer Byrne
References:
Hales CM, et al. NCHS Data Brief. 2017;288:1-8.
Pont SJ, et al. Pediatrics. 2017;doi:10.1542/peds.2017-3034.
Weight Watchers announces strategic vision to make wellness accessible to all, inspiring healthy habits for real life [press release]. Weight Watchers International; Feb. 7, 2018. Available at: www.weightwatchersinternational.com/file/Index?KeyFile=392090462. Accessed Feb. 28, 2018.
For more information:
Christopher Bolling, MD, can be reached at bolling.cf@gmail.com.
Susan Weiner, RD, CDE, can be reached at susan@susanweinernutrition.com.
Disclosures: Bolling and Weiner report no relevant financial disclosures.