Attitudinal and Behavioral Approaches to Preventing Obesity and Disordered Eating

If you think disordered eating is just about anorexia or bulimia, you are wrong. In fact, many people with obesity have disordered eating behaviors that could have developed at any point in their lives. It may seem “rational” to judge them for being “lazy”, but once you learn about the myriad of factors that influence obesity you realize that there is much more than just calorie balance going on.

So, it begs the question – what can be done to prevent disordered eating?

Here’s an evidenced based article, by an authority on adolescents, Diane Neumark-Sztainer,
Preventing obesity and eating disorders in adolescents: what can health care providers do?
J Adolesc Health, 2009, Mar;44(3):206-13.

This article describes five research-based recommendations for health care providers to help prevent both obesity and eating disorders among adolescents that they see within clinical, school, or other settings. The recommendations are based primarily upon findings from Project EAT, a large, population-based study of eating and weight-related issues in adolescents.

Recommendations include the following:

1) discourage unhealthy dieting; instead encourage and support the use of eating and physical activity behaviors that can be maintained on an ongoing basis;

2) promote a positive body image;

3) encourage more frequent, and more enjoyable, family meals;

4) Encourage families to talk less about weight and do more at home to facilitate healthy eating and physical activity; and

5) assume that overweight teens have experienced weight mistreatment and address this issue with teens and their families. These recommendations stress the importance of helping adolescents and their families focus less on weight and more on
sustained behavioral change.

I think #4 is the key recommendation, here, although all are good. Focusing on the number on a scale is stressful and takes away from the real health goals – healthy eating and physical activity behaviors for a lifetime. It also turns the negative into a positive. When has negative thinking and reinforcement ever worked? I struggle with convincing clients that the number on the scale is not the most important measure of health.

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