Are teenagers the biggest losers in America’s obesity epidemic? An ICHP researcher weighs in

Michelle Cardel, Ph.D.
Michelle Cardel, Ph.D.

It’s tough to be a teenager.

It’s even tougher if you’re one of the 9 million American teenagers affected by obesity. In addition to navigating the usual growth spurts, hormonal swings and mercurial moods of adolescence,  these teens often must endure hurtful taunts and barbs about their weight. They also face increased risks of depression, cardiovascular disease, diabetes, and even some types of cancer.

To make matters worse, there simply isn’t much help available for teens who may want to do something about their weight but don’t know where to begin.

“Often, providers tell teens that they have obesity and simply advise them to eat less and move more in order to lose weight,” said Michelle Cardel, Ph.D., R.D., an obesity and nutrition specialist at University of Florida Health. “But we know that neither developing nor treating obesity is that simple. Both the providers and teens need more resources and options for treatment.”

In August, Weight Watchers, now rebranded as WW, released Kurbo, an app designed to help children and teenagers make healthy food choices. The app’s release sparked a national debate about whether youth should try to lose weight at all. Some worried that engaging teens in weight-loss treatment would lead them to develop eating disorders and an unhealthy fixation on their weight.

Cardel, an assistant professor in the UF College of Medicine’s department of health outcomes and biomedical informatics, said scientific evidence simply does not support the notion that medically supervised obesity interventions lead to eating disorders. In fact, comprehensive interventions actually lead to decreases in the risk and prevalence of eating disorders, she said.

Cardel believes the focus need not be on weight or a specific number on a scale. Rather, she said, “The focus should be on improving health-related behaviors, such as making healthier food choices and increasing physical activity.”

Cardel’s overview of adolescent weight management for providers appeared in the Sept. 30 2019 issue of JAMA. Her National Institutes of Health-funded research focuses on developing an effective weight-loss intervention for teenagers using acceptance-based therapy, a behavioral approach that has already been successful with adults.

According to Cardel, acceptance-based therapy focuses on improving an individual’s awareness and acceptance of negative thoughts and feelings, rather than attempting to change the thoughts and feelings themselves.

“This therapy focuses a great deal on mindfulness and self-regulation skills. It also teaches that your thoughts and feelings do not need to dictate your eating or physical activity behavior,” said Cardel.

“For example,” she said, “the therapy includes a focus on the things we can control versus the things we cannot control. We cannot control our cravings for ice cream, as cravings are a normal part of the human experience. However, we can make the choice not to buy ice cream at the grocery store. Thus, when the craving kicks in, it is easier to make the choice not to eat ice cream because it is not available in the home.”

Adolescence, she pointed out, is a crucial time for treating obesity.

“Teenagers are already undergoing tremendous physical and psychological changes as they grow and mature into adults,” Cardel said. “This is an ideal time for them to learn the healthy habits they’ll need to manage their weight and maintain good health throughout adulthood.”