Teens' dieting choices, healthy or dangerous, usually start at home, according to Tammy Hutchisen, a registered dietician in Frederick who does nutritional counseling for bariatric surgery and has experience with pediatric nutrition.
Hutchisen said parents need to set a good example in the kitchen and beyond.
"I think the biggest thing a parent could do is be a role model in terms of food choices and portion control," she said. A good foundation can avoid overeating or under eating in a child's future.
Hutchisen said parents should help adolescents choose more nutritionally dense foods, such as fresh produce and whole grains, over calorie-dense alternatives, such as fast food and other prepared meals and snacks.
She noted that parents are the primary food purchasers of the house, and essentially the gatekeepers in setting the family up with healthy alternatives to junk food.
"They're not going to really buy into something if you're not doing it, too," she said.
Don Caparotti, a personal trainer based at In-Fitness in Urbana, said it's more effective for a whole family to be involved in healthy life choices rather than one person go on boxed health foods for a month.
He said parents sometimes try to show support by purchasing a gym membership for a teen, but that can be misinterpreted. Instead, he recommends a parent saying, "Hey, I was thinking of joining the gym. Want to do it together?"
Hutchisen said as a licensed dietitian-nutritionist, when working with a teen the focus is healthy eating and portion control.
"It's not a diet, per se," she said, adding that diets are more for adults, who require less calories than growing teens. "It is calorie control and making healthier food choices."
Caparotti said the way things are worded is important. "If you start bringing diet' in to teenagers, that's where you could run into some issues," he said.
Hutchisen said diets for teens are not advocated in her industry, and when dealing with teens in athletics, it can be more complicated.
She said there is an energy balance equation of "calories in and calories out" that needs to be considered with highly active teens.
"There's a fine line with that," she said. "If you are not eating enough calories for the amount of calories you're burning, the body goes into a conservation mode."
Brunswick High School wrestling coach Trey Coates said he stresses that to his teenage athletes. "I tell the kids it's the gas that makes the car go," he said.
Hutchisen said when teens start going too far in restricting their diets, it brings on a host of problems.
"They run the risk of nutrient deficiency, they run the risk of injury because they're not fueling properly … even not losing the weight they want to," she said.
She said some teen girls will cut out dairy because they think it's calorie dense, but the move can be damaging because their bone growth needs the calcium diary provides.
Hutchisen said there are some warning signs of a teen being obsessed with diet and food: "definitely real controlled behaviors like meal skipping, exercising a lot to counterbalance calories and even restricting certain food groups," she said.
Caparotti said warning signs of unhealthy habits can be lowered energy levels or a lot of conversation about weight and food.
Caparotti, who has taught classes on parenting athletic children, said sometimes it's the parent demanding a restricted lifestyle for the teen.
"Some parents push their kids too hard," he said. "It's a team effort. You listen to them rather than tell them what they need."
Coates said that teen athletes seem to be much more monitored than when he was an athlete in high school.
"Currently we have a chart that tells us how they're allowed to lose weight, so kids are losing weight in a healthier manner now," he said.
Tuscarora High School wrestling coach T.J. Salb said guidelines restrict dangerous methods that use dehydration for rapid weight loss. High school wrestlers, who commonly watch weight closely, now must be certified by a doctor and pass a hydration test.
"They generally won't let people drop below a certain body fat level," Coates said.