By adolescent medicine specialist Ellen Rome, MD, MPH
Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy
Weight gain and weight loss are often at the top of the list of questions teens ask when they come to see me. They are often confused about a healthy path to weight loss or weight gain. Here is some advice I share with them.
Weight loss: The dangers of dieting
Both boys and girls ask me about this, and I tell them that “diet” is a 4-letter word. Young people who “diet,” or restrict their food intake relative to their body’s needs, end up gaining more weight over time so that their body can live through the next “famine.”
Prolonged restricting can lead the body to try to “store up nuts for the winter” — or reach a point that is higher than their weight set point needs to be — in order to survive future times of relative starvation.
We also now have a subset of teens with a disorder that some people call orthorexia, or addiction to overly healthy eating.
Healthy eating takes on a new, potentially dangerous meaning when it deprives young brains and bodies of needed fuel or energy. Food fads — such as fat-avoidant, protein-but-no-carbs, and other trends — can actually be unhealthy for the developing brain.
Kids often don’t realize that fats are no longer the enemy. For optimal brain development, they need 50 to 90 grams of fat per day from birth through age 26 years.
The body uses carbohydrates in important ways, too. Avoiding carbs may be lifesaving for a person with diabetes who can’t maintain normal glucose levels when carb-loading. But that’s not a useful meal plan for a growing teen.
In order to build glycogen, the kind of energy you need for endurance, teens should consume carbs (in liquid or food form) within the first 20 minutes after finishing a workout that is 90 minutes or longer. Without those carbs, you cannot build glycogen.
Weight gain: Risky practices
Kids who are underweight struggle with how to put on pounds.
Some of them use protein powders, but they’re not a good option in the face of dehydration. Protein powders can cross the blood-brain barrier at different rates than free water. When the proteins cause mini-clots in the brain, it can mean a series of mini-strokes.
Creatine also appeals to some teens. It draws water out of the muscles to make body builders look big and strong. But creatine can be a challenge for the kidneys.
A safer way for kids to build muscles is with the emulsified Ensure® Plus, Boost® Plus or Boost® VHC. These provide more energy than juice boxes and work more safely than protein powders.
Food sources work, too. Homemade shakes that have easy ingredients — such as peanut butter, yogurt or ice cream, bananas, berries or other appropriate foods — may end up being less expensive while still providing great energy.
The best thing to do is partner with your pediatrician and a registered dietitian to figure out a healthy eating plan that will work for your pocketbook and your teen.