Issue: August 2018
July 02, 2018
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Fewer teens with overweight, obesity attempting to lose weight

Issue: August 2018
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Photo of Jian Zhang
Jian Zhang

The percentage of American teens with overweight and obesity who have tried to lose weight has decreased between 1988-1994 and 2009-2014, according to research published in JAMA Pediatrics. This decrease was observed in both boys and girls.

“Paralleled with the dramatically increasing prevalence of obesity during the study period, more and more adolescents compared themselves to others with heavier body weight, which would serve to maintain a positive image of their own,” Jian Zhang, MD, DrPH, associate professor of epidemiology at Georgia Southern University told Infectious Diseases in Children. “When more than one-third of adolescents have overweight or obesity, it may be cognitively hard for adolescents to view overweight as abnormal.”The researchers examined data from adolescents between the ages of 16 and 19 years in the National Health and Nutrition Examination Survey for the 1988-1994 (n = 1,298), 1999-2004 (n = 2,697) and 2009-2014 (n = 1,496) survey years. These data demonstrated that overweight and obesity prevalence increased in the U.S. between 1988-1994 and 2009-2014 (22.09% [95% CI, 18.20%-25.98%] to 34.03% [95% CI, 30.64%-37.41%]).

Although the prevalence of overweight and obesity has increased within the study period, Hawkins and colleagues observed that fewer teenagers with either condition had attempted to lose weight (33.68% [95% CI, 29.19%-38.17%] vs. 27.24% [95% CI, 24.17%-30.31%]).

Of the adolescents with overweight, a significant decrease from 33.36% in 1988-1994 (95% CI, 58.71%-14%) to 23.41% in 2009-2014 (95% CI, 31.31%-15.51%) was observed in the number of boys attempting to lose weight. More teenage girls with overweight attempted to lose weight in 1988-1994 (80.24% [95% CI, 91.35%-69.13%); however, this percentage fell to 54.19% in 2009-2014 (95% CI, 63.21%-45.17%).

Teen standing on scale
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After adjusting for race and/or ethnicity, family income and BMI percentile, the researchers saw a 36% drop in boys attempting to lose weight between 1988-1994 and 1999-2004 (percentage ratio = 0.64; 95% CI, 0.41-1.01) and an additional 44% drop in 2009-2014 (percentage ratio = 0.56; 95% CI, 0.33-0.94). Hawkins and colleagues observed no significant additional decrease in the percentage of girls with overweight attempting to lose weight.

Furthermore, the researchers observed a decrease in the percentage of teenagers with obesity attempting to lose weight. According to the survey data, 67.51% of boys between 1988-1994 tried to lose weight (95% CI, 84.05%-50.97%). This number decreased to 42.4% in 1999-2004 (95% CI, 50.78%-34.02%). However, Hawkins and colleagues observed an increase in the number of boys with obesity attempting to lose weight by 2009-2014 (60.58%; 95% CI, 70.87%-50.29%).

Girls with obesity saw decreases between all survey years, from 69.5% (95% CI, 86.56%-52.45%) to 64.2% (95% CI, 72.83%-55.56%) between 1988-1994 and 1999-2004. By 2009-2014, 58.55% of girls with obesity attempted to lose weight (95% CI, 69.94%-47.15%).

“While honest and open dialogue between pediatricians and teens is encouraged, we must be mindful that having overweight or obesity has been stigmatized,” Zhang said. “It is extremely important that the findings of our current study be translated into action in a correct manner. We should discuss weight with youth from a healthy lifestyle perspective rather than sticking with body weight. We are engaging in a pro-health — not an anti-obesity —campaign.”– by Katherine Bortz

Disclosures: The authors report no relevant financial disclosures.