Article By Michelle Karten, MD at Nemours Alfred I. duPont Hospital for Children.

It can be a challenge to talk to your teen about reaching a healthy weight. It’s all too easy to imagine the ways in which the subject can backfire.

But it’s more important than ever to get this discussion started. Because even as more American teens are carrying extra pounds, fewer are trying to lose weight.

A recent study in JAMA Pediatrics found the percentage of teens aged 16-19 who are overweight or obese sharply increased in recent decades, to 34 percent. Meanwhile, the percentage of overweight teens trying to lose weight fell to 23 percent for boys and 54 percent for girls.

As teens see more people who are overweight, their ideas about what’s a healthy weight might be changing. Emotionally, it’s a positive when teens accept their body — but there are health risks to having extra weight.

Overweight teens are at higher risk for:

• diabetes
• high blood pressure
• mental health concerns, like anxiety and depression

So the best approach for parents is to focus on healthy behaviors rather than on shaming their teen about weight.

Before you talk to your son or daughter, know the basics, starting with: Is my teen overweight?

What’s a Healthy Weight for Teens?
Most parents of kids who are overweight or obese aren’t aware there’s a problem. According to the most recent Delaware Survey of Children’s Health, 80 percent of children who are overweight and 53 percent of children who are obese are considered to be “normal weight” by their parents.

Unlike for adults, who can use a single number to determine a healthy weight, kids and teens have to refer to a growth chart comparing them with others of their gender and age. For example, if your child is in the 85th percentile, it means 85 percent of kids of their gender and age have a lower body-mass index (BMI).

In other words, each child has a healthy weight for their given gender, age, and height:

• Kids in greater than or equal to the 85th percentile but less than the 95th percentile are considered overweight.
• Kids in greater than or equal to the 95th percentile are considered obese.

Calculating BMI

For an easy way to calculate your child’s BMI and percentile, use Nemours’ KidsHealth simple online calculator. It uses kids’ gender, birth date, weight and height to calculate their BMI percentile.

When you calculate a BMI, remember that it’s only an estimate of a person’s body fat. Having a high BMI doesn’t necessarily mean that a teen is overweight, in part because this estimate can’t tell the difference between muscle and fat. An athletic teen may have a higher BMI without being at an unhealthy weight.

It’s important to get an accurate height. So make sure your teen takes off his or her shoes and stands flat and straight against a wall.

If you or your teen is concerned about weight, talk to your child’s doctor. But before you have that conversation, think about how you’ll approach the subject.

Strike the Right Chord
We all know how easy it is to get sensitive and defensive when talking about our weight. So choose your words ahead of time.

Here are some do’s and don’ts about what to say (and leave unsaid):

Do’s

1. Do emphasize the rewards of a healthy weight. Kids of all ages are generally motivated best by praise and other positive reinforcement. Focus on healthy behaviors, not on weight.
2. Do set small, realistic goals. Rather than simply setting a target weight, pick small goals that will set your teen on the right path, such as eating more fruit and vegetables, limiting sugary drinks, and being more active.
3. Do model healthy behavior. By being active with your teen and involving him or her in planning and preparing healthy meals, you’re letting your actions do the talking.

Don’ts

1. Don’t tell your child they’re fat or obese. Though we use the word “obese” for its medical definition, it’s not one you’d want to use with your child.
2. Don’t focus on the number. A target weight can present a tempting goal. But an unhealthy focus on weight can switch the focus from fitness to dieting.
3. Don’t criticize your own body or take up fad diets. These mindsets can associate weight and food with guilt in your teen’s mind. Teens who are upset with their body image are at higher risk for eating disorders. Instead, teach your teen by example, and focus on making healthy decisions that help you feel better, not help you look better.

Focus on Habits
Find habits that are likely to work for your teen and the whole family, and ones you think you can keep up over time.

Here are some tips to get you started:

• Limit fast food. As they explore their independence, teens are likely to be tempted by high-calorie, convenient fast foods. A treat every now and then is OK, but the food habits your teen picks up now could last for years.
• Pay attention to your teen’s sleep habits. Sleep is linked with weight. Teens should get 8 to 10 hours of sleep a night. When they get less than that it can affect their energy, activity, and motivation levels. It can also increase their cortisol levels, a stress hormone that promotes weight gain. 
• Find active habits that work for your teen. Teens should get moving for an hour a day, but gym workouts aren’t for everybody. If your teen is a social butterfly, suggest activities with friends, like team sports. Chores inside and outside the house count too, whether they’re at your home or volunteering elsewhere.

Make the Healthy Choice the Easy Choice
As with most of us, the food teens eat and the things they do are often a reflection of what’s convenient. So:

• If you’re snacking on chips, your teen is more likely to reach for the bag.
• If healthy snacks are in the fridge, teens are less likely to go to the trouble of finding junk food elsewhere.
• If their parents enjoy being active, teens are more likely to pick up the habit.
• If you have less processed, sugar laden food at home, your teen is likely to make better food choices.

You Can Do It!
Starting a conversation about weight with your teen might not be easy. But it is important.

If you or your teen have questions about healthy nutrition and the benefits of exercise, the best person to ask is your doctor.