Background: Adolescents with obesity may engage in dieting attempts prior to participating in supervised weight management programs, but little is known about these practices. This study aimed to understand prior engagement with a dietitian and previous dieting practices of adolescents presenting for obesity treatment.
Methods: 141 adolescents - median (range) age of 14.8 (12.9-17.9) years, mean (SD) BMI 35.39 (4.17) kg/m2 - with obesity and ≥1 related complication presenting for an intensive dietary intervention were asked whether they had previously seen a dietitian (yes/no) and if they had tried any other diets. Fishers exact test was used to examine the type of diet trialed based on the number of dieting attempts (one diet or two/three diets).
Results: 68 of 141 (48.2%) adolescents had previously seen a dietitian and 106 (75.2%) had tried at least one diet. Most adolescents had tried one type of diet (n=74, 52.5%), with 29 (20.6%) having tried two or three different diets. Most reported following a healthy eating pattern (n=76, 53.9%), low carbohydrate diet (n=11, 7.8%), specific eating plan e.g. low sugar, vegetarian (n=11, 7.8%), hypocaloric diet (n=9, 6.4%) or a very low energy diet (n=9, 6.4%). There were 46 (32.6%) adolescents who had tried at least one diet and had not seen a dietitian. Adolescents who had tried two or three diets were more likely to have used hypocaloric diets, low carbohydrate, intermittent fasting, ketogenic diet or following a specific diet plan (p<0.05). The was no difference in use of healthy eating or very low energy diets.
Conclusion: Many adolescents presenting to obesity treatment will have tried one or more diets with or without the support of a dietitian. Clinicians providing nutrition education and prescribing diet interventions should be aware of this and the potential influence on adolescent perceptions of healthy and unhealthy dieting practices.