Learning Weight Loss Lessons for Teens: The Eat Smart Program

Weight loss for adolescents

Body image is a problem for many of us at some time in our lives, but for no group is it more of a problem than for overweight teenagers. Furthermore, obesity in childhood and adolescence is a strong predictor of being overweight in adulthood. Given the importance of this problem and all its associated health risks, it is striking that very little research has been done to determine the most appropriate treatment options for overweight teenagers.

The Eat Smart Study

The Eat Smart study, a review of a randomized controlled trial of a reduced carbohydrate versus a low fat diet for weight loss in obese adolescents that was published by BioMed Central in 2010, plans to address this oversight. It has specifically been designed to determine the most effective strategies for management of obesity in adolescents, as well as to compare the effects of a reduced carbohydrate diet versus a low fat diet. Over a 2 ½ year period, 100 adolescents will participate in the study, along with their families.

Participants will be assigned to one of two interventions: 1) a structured reduced carbohydrate diet or 2) a structured low fat diet. Each teenager will first go through a 6-week course in life skills training, in order to improve coping skills. A series of 24 dietetic appointments will follow, followed by a maintenance phase.

While the study has not yet been undertaken, both the design of the study and preliminary research leading to this project offer some interesting insights into possible directions for adolescent weight loss treatment.

Life Skills Training

Low self-esteem is a common characteristic of overweight teens. The Eat Smart study addresses this issue head-on by teaching coping skills, helping with goal setting, and reducing anxiety. Before teens even begin the diet, they will have new tools to use in waging their battles against obesity. Family members are also involved in the training, and this fact points to the importance of involving the entire family in the weight-loss process.

In addition to providing additional moral support, family members can learn ways to avoid sabotaging the dieter’s efforts.

Potential lessons learned:
• Improving a teen’s ability to cope with life also improves the ability to cope with a diet.
• Family involvement can provide much needed support to a struggling teenage dieter.

Structured Diet Plans

The Eat Smart study uses a “tailored energy prescription” for each diet plan. Each diet plan will be based on a 20% energy (calorie) reduction compared to the individual’s estimated energy requirements. In other words, the teen must eat 20% less than he or she is burning. The study also offers the use of a plate portion system.

Whatever the particular method, researchers found that teens will select a structured or semi-structured diet plan over an unstructured one when given the choice.

Potential lessons learned:
• Structured plans generally fare better over time.
• Allowing adolescents choices will increase cooperation.

Reduced Carbohydrates versus Low Fat

In preliminary research, teens were also offered the choice of a reduced carbohydrate date versus a low-fat one. Factoring in levels of structure as well, it was found that 10% chose an unstructured low fat diet, 42% chose a structured low fat plan, and 48% chose a semi-structured reduced carbohydrate plan. The typical teenage diet has found to consist of 37% fat, 17% protein, and 45% carbohydrates.

Previous studies point to the benefits of a reduced carbohydrate diet in decreasing body fat and improving insulin sensitivity (e.g., Adam-Perrot et al., 2006). The Eat Smart researchers theorize that a structured reduced carbohydrate approach to dieting may provide a regiment that many families will find easier to maintain as well as more effective than a conventional low fat approach.

Potential lessons learned:
• Reducing consumption in the most over-consumed food categories makes sense. What do you or your teen over-eat?
• Low carbohydrate diets may be more effective, with associated health benefits.

The final results of this 2 ½ year study will be awaited with great interest. In the meantime, the Eat Smart plan provides healthy food for thought to families and teens.


Truby et. al, BMC Public Health 2010,
10: 464

Weight Loss For Teens