Stress, frustration and other difficult emotions can affect how we eat. For teenagers, who are still learning to navigate their feelings and growing independence, those connections may be especially important. Now, new research suggests that helping teens manage emotions surrounding food could make weight-management treatment more effective over time.
In a clinical trial involving 166 teenagers and their parents, researchers found that adding emotional coping skills to a family-based weight-management program helped teens maintain more of their initial weight loss. They also reported less emotional eating than those who received standard treatment alone.
The findings, published in JAMA Network Open, suggest that addressing the emotional side of eating may help young people maintain progress after regular treatment and coaching end.
Researchers at the University of California San Diego and the University of Minnesota enrolled teens ages 13 to 16 who had overweight or obesity. Each participated with a parent in a six-month program that included nutrition education, physical activity guidance, goal-setting and family support.
Half of the families received additional guidance on recognizing and responding to difficult emotions. Teenagers practiced identifying feelings connected to eating, while parents learned ways to acknowledge and support their children's emotions.
Both groups made similar progress during treatment. But once the program ended, their results began to differ.
A year later, teens who received the additional emotional support had regained less weight than those in the standard program. Researchers estimated that 22% in the enhanced group maintained a meaningful reduction in their weight relative to age and growth, compared with 4% in the standard group.
The enhanced group also reported less emotional eating, suggesting that the additional support may have helped teens respond differently when emotions influenced their food choices.
Interestingly, researchers didn't find a significant difference in the groups' overall ability to manage emotions. In other words, the teens may have changed how they handled feelings around food without necessarily becoming better at managing emotions in every part of their lives.
It's also unclear whether the benefits came mainly from the coping skills teenagers learned, the emotional support parents provided or a combination of both.
The study has limitations. It involved a relatively small group of families seeking professional weight-management treatment, and only 111 teens had weight measurements available at the final follow-up. Much of the program also took place online during the COVID-19 pandemic.
Importantly, this was a professionally supervised program, not a test of whether parents should encourage teenagers to lose weight on their own. The results also don't mean emotional eating is always a problem or that the same approach would benefit every teen.
“Weight loss is only part of the story,” said Kerri Boutelle, a professor at UC San Diego and the study's lead author.
For the families in this trial, addressing the feelings connected to eating appeared to make a difference long after the structured program ended. The findings suggest that helping teenagers navigate those emotions may be one way to make weight-management treatment more sustainable.
The study was supported by the National Institutes of Health, including funding through UC San Diego's Clinical and Translational Science Award.