In Obese Adolescents is diet and exercise more

effective in reducing weight, compared to just

exercise alone?

Caroline Carr

Introduction
For my topic my PICO question was in Obese Adolescents is diet and exercise more
effective in reducing weight, compared to just exercise alone? The reason why I chose this topic
and wanted to learn more about it was growing up I was overweight and had always struggled
with it in my adolescent years. When I was fifteen years old I was diagnosed with polycystic
ovary syndrome (PCOS). Along with all the other symptoms polycystic ovary syndrome causes
you to have too much insulin in your body and you have problems using it properly. Thats why
growing up I would gain weight so fast and then when I would diet I would still not lose the
weight at the pace that I wanted because I did not know that my body was not handling insulin

properly, so it was so much harder for me to lose weight than the average person. So when I
thought about this question and doing the research it made me think, if I knew this information
way back when I was a teenager I could have really lost the weight at a young age and could
have kept it off into my adult years.
None the less, Obesity in Adolescents is a major problem that is rising every day and has
many important assumptions for both the health and the wellbeing of the adolescent and society.
Adolescence is defined as the period from eleven to twenty one years of age. Obesity is defined
as equal to our greater as the 95th percentile. The easiest test that determines the impact of
obesity is the BMI test that involves a reading of the appropriate percentile of the percentile
chart. Adolescent Obesity has tripled in adolescents in the past thirty years. Adolescents aged
12-19 years old who were obese increased from 5% to 18% from 1980 to 2010. There are
significant racial and ethnic disparities in obesity prevalence among United States Children and
Adolescents. In 2007-2008 Hispanic boys, aged 2 to 19 years were significantly more likely to
be obese than non-Hispanic white boys, and non-Hispanic black girls were significantly more
likely to be obese than non-Hispanic white girls.1 Through knowing about adolescent obesity,
the health effects of obesity, eating a healthy diet, getting regular physical activity, and how
parents can help their obese adolescents are some ways that can help them reduce their weight. 2
Body
About 70-80% of adolescents that are diagnosed with Obesity will become obese as
adults in later life.3 In the United States if the trends stay current, Obesity will become the most
common cause of premature death. Obesity is the easiest medical condition to recognize, but the
most difficult to treat.

The Main Causes of Obesity are poor eating habits, not enough physical

activity, family history of obesity, low self-esteem, and family and peer problems. Low selfesteem and being made fun of at school are problems that can lead to clinical depression and can
have a negative impact on the adolescent, which can then lead to eating disorders.4 Some of the
health effects of Obesity are High Blood Pressure, Low HDL levels, increased risk for type 2
diabetes and cardiovascular disease, depression, breathing problems, and trouble sleeping. Some
adolescents may have sleep apena due to being so overweight which can cause problems with
their breathing because they are losing oxygen throughout the night during their sleep.4 Obese
adolescents are more likely to have pre diabetes which is a condition where blood glucose levels
show a high risk for the development of diabetes.1, 4Some Lab tests like the lipoprotein profile
which checks for the HDL, LDL, and blood pressure. You have the fasting plasma glucose test
which can check to see if you have type 2 diabetes. 4
How can a healthy diet impact an Obese Adolescent? For an Adolescent serve five
servings of fruits and vegetables a day. Overtime work to change the adolescents eating habits,
rather than always looking at their actual weight. If you follow this tip, this will help the
adolescent not feel so bad about themselves and might even help them with their self-esteem and
start to feel good about the progress their making. Also, start to eat more slowly this will help
you take in less bites and start to feel fuller before the meal is over with. Instead of having snacks
that are high in fats and sugars replace them with smarter choices like fruits, vegetables, and
yogurt. Control the portion size and eat fewer calories. The adolescent is still growing so make
sure they are getting all the right nutrients they need. In addition to changing the eating habits,
the adolescent could start a weight management program.5
For adolescents aged 12-18 years old who have documented health risks, and are above
the 85th percentile are recommended for the prevention plus which is stage one during the weight

management treatment plan. During this stage they encourage the adolescent to eat breakfast
every day. Increase the family meal time to five to six times a week, increase homemade meals
instead of eating fast food or junk food. Increase the family involvement and commitment to
lifestyle changes. The parents are the first ones that need to make the change. They are the ones
that are bringing the food into the house in the first place so if they are buying healthier foods
and making healthier options for meals this will help the adolescent in making sure they are
getting all the nutrients they need. The adolescent still learns from the parents eating habits so
teach them how important it is to have a healthy meal plan, and set a good example for the
adolescent. The reason most obese Adolescents gain back their lost pounds is that they tend to go
back to their old habits of eating. An obese Adolescent must therefore learn to eat and enjoy
healthy foods in moderate amount. At meals and snack time make sure the adolescent is not
drinking a lot of soda. Most adolescents drink too much soda and sweetened drinks and are not
drinking enough milk which leads them to not get enough calcium. Adolescents need 1300mg of
calcium a day so make sure the adolescent is drinking milk or eating other foods that contain
dairy. About half of peak bone mass is made during adolescence so thats why calcium is needed
to make sure their bones are growing at a normal rate. 6,7
How can Regular Physical Activity impact the Obese Adolescent? Adolescents need to
work out every day for at least an hour. It improves their strength and endurance and can help
control their weight. It also helps build and maintain healthy bones and muscles. Likewise it can
help reduce the risk of depression and anxiety and contributes to a good psychological wellbeing.
It can help reduce the risk of chronic disease, and some cancers. Additionally there have been
signs that it helps improve their grades and overall academic performance. Along with that, plan
fun activities that the whole family can get involved in. Adolescents especially girls become less

active as they move through their teenage years, so plan activities that provide everyone with
exercise and enjoyment like swimming, biking, dancing, ball sports, and other fun activities that
get the adolescent moving and off the couch.6,7
For adolescents who are in the weight management treatment plan the next stage is stage
two which is the structured weight management. For this stage adolescents work with a
counselor, and an exercise therapist if needed. Monitoring of food and the nutrition behaviors of
the adolescent and their parents is crucial part of this stage. Journals or log books may be
provided for watching their target behaviors. Stage 2 can be offered by a health care provider
with training in behavioral weight management. Monthly follow up and assessment of progress
is recommended for the adolescent, so they can take everything they need out of this stage to
help them on their journey of losing weight. Overall, exercise has many different positive
outcomes for the adolescent and they should try to exercise as often as they are allowed to and
for as long as they can. 7
What are some ways that parents can help their Obese Adolescent? If the parent is
making good choices in their diet this shows the adolescent that they care about them and want
to make a change too. The parent is the one who is bringing in the food so if they are getting rid
of all the bad food in the house the adolescent has no choice but to eat the healthier options.
Know what your adolescent is eating at school and away from home. For the obese adolescent it
is best to bring their own lunch to school instead of buying lunch that is filled with excess
amount of calories, sugar, and fat. By them bringing their own lunch to school the parent can
control what the adolescent is eating and they can monitor what nutrients they still need for the
day. Parents need to limit the adolescents screen and computer time to no less than two hours a

day. Parents of an obese adolescent can improve their childs self-esteem by emphasizing their
strengths and positive qualities rather than just focusing on their weight problem.8
Obese adolescents need support, acceptance, and encouragement from their peers, but
especially their families, and try not to make the adolescent feel different, so focus on gradually
changing the eating habits and physical activity levels, and establish healthy living. Never give
food as an award for the adolescent, rather give them new clothes, jewelry, take them to a
concert, or give them time to spend with friends. Parents can maintain the standards for meals,
snacks and physical activity and do not hesitate to limit access to screen time and sugar
sweetened beverages encourage children to drink more water. Keep healthy snacks where they
can easily find them. 8
A case study that I looked at was a study where 78 obese adolescents aged 12-16 years,
participated in a 4 week weight reduction program during the summer break. The study consisted
of a low energy diet 18% protein, 26% fat, 56% carbohydrate and physical exercises. Body
weight and body composition were measured using bio impedance method before and during
therapy as well as six months later. After the 4th week body weight, fat mass, lean body mass
decreased significantly. Six months after the therapy the mean body weight had increased but
mainly due to lean body mass.9
Conclusion

For application to dietetic practice, prevention and treatment of adolescent obesity it is

best to see a registered dietician so they can help the adolescent with their dietary and physical
activity needs. Many registered dieticians work in the treatment and prevention of the disease

through medical nutrition therapy. The registered dietician will review what you eat and youre
eating habits. They will give you a thorough review of your nutritional health, and give you a
personalized nutrition treatment plan that works best for you. For adolescents that are in the
weight management plan for stage 3 you have the comprehensive multidisciplinary intervention
where a trained registered dietician will go over the behavior change and have weekly visits for
8-12 weeks. For stage 4 its called the tertiary care intervention and this is for adolescents who
are 12-18 years old who are above the 99th percentile for obesity. Here you have a registered
dietician with a special training team and maybe the talk of having gastric bypass surgery for
weight loss.7, 10
Obesity in adolescents has increased over the years. Through eating a healthy diet and
proper physical activity, obesity in adolescents can be changed. Through weight loss adolescents
can reduce their risk for many health problems that are associated with Obesity. Also, having a
parent that is supportive and helpful can make an adolescents journey through their weight loss
not so bad. For an Obese Adolescent diet and exercise is more effective in reducing weight.
Through all the research I think it will definitely have an impact on the adolescent generation.
From changing your eating habits from junk food and fast food to actual healthy choices will
have an impact on them. I think that the obese adolescents who really want to make a change
will change their lifestyle and try to lose the weight. I know its going to be a hard road, I have
been in their shoes, and they might stumble and fall along the way but if they have the support
that they need and the resources available to them, I know for sure they can try and fight
adolescent obesity. Some of the benefits I hope this group takes from it is to reduce their risk for
cardiovascular disease, hypertension, diabetes, and to actually have lost the weight and become a

more healthier individual and actually feel good about themselves, and to live the life they have
always wanted. 10

References
1. Centers for Disease Control and Prevention. Web site.
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10. Deanna M. H, Shelley K, Lorrene R, Leslie C. From the Academy: Position of the Academy of
Nutrition and Dietetics: Interventions for the Prevention and Treatment of Pediatric Overweight
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from: Science Direct, Ipswich, MA. Accessed October 17, 2013.