What are the factors that contribute to successful lifestyle change in adolescence?
How do I begin a visit with a 15 year old and her mother in my office, when the adolescent is texting on her phone, and the mother with her large soda is complaining that her daughter is “lazy” and will not take responsibility for her health?
This chapter will address the following American College of Graduate Medical Education competencies: patient care, medical knowledge, and interpersonal and communication skills.
Patient Care: This chapter will enable pediatric health care providers to help families understand the special developmental tasks of adolescents around healthy lifestyle change and the balance of independence and family support needed in order to achieve positive lifestyle change.
Medical Knowledge: Understanding how psychosocial and behavioral factors influencing disease development and maintenance pertain to adolescent overweight and obesity will enable pediatric health care providers to apply this knowledge to patient care and research in order to deliver competent services for their adolescent patients and their families.
Interpersonal and Communication Skills: This chapter will help the pediatric health care provider communicate more effectively with their adolescent patients and families in order to achieve compassionate and effective care.
As youth develop throughout adolescence, parents and other caregivers are positioned to play an ongoing role in the prevention of excess weight gain. Even with adolescent developmental shifts to greater autonomy and peer involvement, caregivers remain an important influence during this time because they are integrally involved in household food selection and can serve as critical models of healthy lifestyle behaviors.1 Researchers have linked higher engagement in adolescents’ health promoting behaviors over time to family behaviors such as greater frequency of family meals, caregiver facilitation of physical activity, and less parental talk about weight.2 Working with caregivers of adolescents to provide a healthy environment and otherwise promote healthy lifestyle behaviors is an important component of fostering healthy weight for youth.
Despite the apparent potential for caregivers to play a role in this arena, there is little research on caregiver components of adolescent overweight and obesity prevention. To date, the majority of obesity prevention programs have been school-based interventions that do not take into account broader environmental factors such as family context.3 There are a few studies that suggest that interventions which target parenting practices hold more promise than interventions with children only or those only providing nutrition and exercise education but no parenting strategies for caregivers.4 These studies have focused mainly on school-aged children rather than adolescents, but the same is likely true for older youth. In one study of middle and high school students, there were higher rates of obesity for adolescents with less parental control over their physical activity and eating habits,5 suggesting that parents do have significant influence over these lifestyle behaviors.