Encouraging teens to adopt a healthy, balanced lifestyle is a more effective weight loss tool than focusing on their weight and diets, claims a new study.

New guidelines from the American Academy of Pediatrics say this single approach can prevent both obesity and eating disorders in teenagers. The guidelines, which have been published online in Pediatrics, were developed in response to growing concern about teenagers' use of unhealthy methods to lose weight.

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Some of the teens that use these unhealthy methods might not fit doctors' or parents' image of eating-disorder patients, since most aren't very thin. Their quick, substantial weight loss can trigger medical consequences such as an unstable heart rate seen in people with anorexia nervosa.

"This is a dangerous category of patient because they're often missed by physicians," said Dr. Neville Golden, professor of pediatrics at the Stanford University School of Medicine and a lead author of the new guidelines. "At some point, these patients may have had a real need to lose weight, but things got out of control."

Up to 40 percent of patients now admitted to some eating disorder treatment programs fit this easy-to-miss category, said Dr. Golden.

The new recommendations include five evidence-based strategies pediatricians and parents can use to help teenagers avoid both obesity and eating disorders. It applies to all teens, not just to those with weight problems.

Three recommendations focus on behaviors to avoid.

In the first, parents and doctors shouldn't encourage dieting. The second is they should avoid "weight talk" such commenting on their own weight or their child's weight while the third says teens should never be teased about their weight.

Two recommendations focus on behaviors to promote: Families should eat regular meals together, and parents should help their children develop a healthy body image by encouraging them to eat a balanced diet and to exercise for fitness, not weight loss.

"Scientific evidence increasingly shows that for teenagers, dieting is bad news," said Dr. Golden.

Teens who diet in ninth grade are three times more likely than their peers to be overweight in 12th grade, for instance. And calorie-counting diets can deprive growing teenagers of the energy they need and lead to symptoms of anorexia nervosa, which may even become life-threatening.

"It's not unusual for us to see young people who have rapidly lost a lot of weight but are not healthy; they end up in the hospital attached to a heart monitor with unstable vital signs," said Dr. Golden.

Negative comments about weight can also be detrimental to a teen's health. Dr. Golden noted that mothers who talk about their own bodies and weights can inadvertently encourage their kids to have body dissatisfaction, which is seen in half of teen girls and a quarter of boys.

Family meals protect against weight problems. The mechanism isn't certain, but it might be partly due to the opportunity for teenagers to see their parents modeling healthy eating. Pediatricians can encourage families to have family meals as often as possible.

The new advice is important in part because obesity rates in adolescents haven't declined, although childhood obesity rates have begun to drop. 

Tagsweight, diets, American Academy of Pediatrics, Dr. Neville Golden