Impact of Dieting in Adolescence on Health and Well-Being

Dieting is commonly known as the intentional and sustained restriction of calorific intake for the purpose of reducing body weight or changing body shape. The prevalence of dieting in the younger generation is concerningly high with population-based studies concluding that 30% of adolescents consider themselves to be dieting. In this essay I will explore why more young people are dieting, how dieting can lead to psychological problems and how dieting behaviors can have a negative impact on health. I will also look into dieting behaviors, which seem to be effective for adolescents in a society in which binge-eating and obesity is so prevalent. I will conclude to say that, as a society, we should be careful when promoting potentially health-damaging diets and be aware of the psychological consequences of dieting.

There are many reasons why young people try to lose weight. One which is perhaps the most widely covered in the media is the rise in obesity. The NHS reported that in 2016, 26% of adults and 1 in 5 year 6 pupils were obese. Research suggests that overweight boys were three to four times more likely to diet compared to non-overweight boys, and overweight girls were twice as likely to diet. To that effect, various studies have indicated a positive correlation between obesity and unhealthy dieting behaviors.

Furthermore, bodyweight misperception is a key factor in young people trying to lose weight. A study published in the Journal of School Nursing found that adolescents who over-estimated their weight had the highest probability of reporting intentions to diet. This statistic is alarming as it highlights how skewed body image can lead to unnecessary dieting, which is potentially detrimental to one’s health. These misperceptions often stem from the influence of social media.

Social media is widely recognized to lower body-image satisfaction and increase unhealthy comparisons. In a study by the University of Pittsburgh, it was found that compared to the lowest quartile, participants in the highest quartile for social media volume and frequency had significantly greater odds of having eating concerns. These eating concerns naturally progress to dieting behaviors. Furthermore, a study by Toro et al. found that 26% of Mexican adolescents felt pressure from their peers to lose weight. Both these studies suggest that an array of pressures on adolescents were responsible for dieting.

These pressures to diet can often lead to a number of unhealthy dieting behaviors. A 2013 study reported that 10.1% of male and 22.7% of female American high school students had fasted, taken diet pills, powders, liquids or laxatives or had intentionally vomited to lose weight in the previous 30 days. As well as eating disorders, Brown et al. indicate that unhealthy dieting behaviors could act as ‘red flags’ for potential psychosocial problems in adolescence, such as suicidal thoughts and substance abuse. In terms of physical health, laxatives either increase the fluid or reduce absorption of the products of digestion in the small intestine, increasing the volume and regularity of excretion. This can cause electrolyte imbalances, chronic diarrhea and nerve damage to the large intestine. Purging - inducing a gag-reflex after eating - can also cause a loss of electrolytes, damage to the mucosal lining of the esophagus and dental erosion due to the acidity of the vomit.

Aiming to lose weight, particularly using unhealthy dieting strategies, appears to promote cycles of weight loss and gain. In a study by the Women’s Health Initiative, participants consumed, on average, 360 fewer calories per day and increased their physical activity over 8 years. Contrary to the expectation that participants would lose weight, average waist circumference marginally increased. This was due to ‘weight cycling’ and suggests that dieting is ineffective and unsustainable in the long-term. Weight-cycling is also reported to increase the risk of hypertension, insulin resistance, dyslipidemia and inflammation.

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Along with problems regarding physical health, dieting can cause significant psychological issues in adolescents. One study found a correlation between unhealthy weight-control behaviors and poorer psychological functioning in adolescent girls. In addition, a 15% decrease in the risk of depression for women who dieted infrequently was noted in a study by Kenardy. These findings could relate to the body’s increased cortisol production. Cortisol is the main stress hormone and also plays an important role in increasing the availability of glucose to cells. The combination of increased stress during dieting and a low-calorie intake leads to greater cortisol output and, subsequently, psychological strain. Furthermore, the ‘Circle of Discontent’ theory by Marks (2015) suggests that low self-esteem relating to body image leads to unhealthy dieting behaviors as a form of self-punishment. As discussed previously, depression can stem from unhealthy dieting. Depression inhibits centers of the brain required for forward-planning and positivity which further decreases the likelihood of healthy weight-loss strategies, such as cooking healthy food and exercising, occurring.

One of the most troubling impacts of dieting is the increased likelihood of adolescents developing eating disorders. Eating disorders are particularly prevalent in the younger age group and 12% of high school girls are at risk of eating disorders. Hibert et al. found that the most common onset symptom of anorexia nervosa was dieting. Dieting often stems from a negative body image which can progress to a distorted relationship with food. Disordered eating is very worrying from a health-perspective as eating disorders, such as anorexia nervosa and bulimia nervosa, can cause cardiac and renal problems, issues with digesting food, anemia and, even, infertility.

Having addressed in depth the negative implications of dieting, I will now explore diets which could improve the health of adolescents. The ‘Mediterranean diet’, for example, is mainly composed of fruits, vegetables, oils and whole grains, combined with a moderate consumption of fish and dairy and a low meat intake. A study in the Jornal de Pediatria (volume 93, issue 4) looked into the diet’s impact on the health of 11-14-year-olds. The study concluded that higher adherence to the Mediterranean diet was associated with higher health-related quality of life scores. However, there was only a 4.6% increase in health-related quality of life and, therefore, the diet may not have significant impacts on health. Results from the ‘EPIC’ study showed that a greater adherence to the Mediterranean diet significantly reduced mortality in participants. It suggested that 4.7% of male and 2.4% of female cancers could potentially have been avoided if the participants’ diet was more Mediterranean-based. Other studies have also shown a significant link between the diet and protection against depression, especially in the younger age group.

Another diet, which has been popularized by the media, is the low-carb diet. The science behind this diet theorizes that low carbohydrate, and therefore low sugar, intake will lead to increased fat burning by cells. The reduction in fat leads to rapid weight loss. However, the diet is often low in fiber, which worsens bowel health. Furthermore, the high fat intake required for this diet increases the amount of low-density lipoprotein in the blood which, in turn, increases the risk of heart disease in later life. The results from 17 studies were compiled and concluded that the risk of mortality significantly increased using this diet. The low carbohydrate diet certainly could have some short-term benefits in overweight adolescents who want to lose weight, however they need to be aware of the potential long-term risks.

Conversely, recent research has shown that non-dieting approaches may be most beneficial to the health of adolescents. Incorporating healthy behaviors into your lifestyle without restricting your diet or engaging in weight-loss behaviors seem to be more effective. Results from six randomized controlled trials indicate significant improvements in blood pressure, self-esteem and reductions in eating disorders. These healthy behaviors could include daily exercise, consuming high levels of fruit and vegetables and moderate amounts of carbohydrates and fats.

To conclude, adolescents in the 21st century are highly influenced by social media and pressures from peers and their family. While it is important to promote healthy lifestyles in a society with alarming levels of obesity, we must not neglect mental health. The media should do more to address the risks of unhealthy dieting behaviors, like fasting and vomiting, which are so appealing to vulnerable adolescents looking to lose weight quickly. Healthy diets, such as the Mediterranean diet, could potentially have a positive impact on health when combined with physical activity but I have found that dieting behaviors may not coincide with better health and weight loss. The non-dieting approach of a non-restrictive healthy lifestyle could be the answer in improving the health of adolescents.