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Putter KC, Jackson B, Thornton AL, Willis CE, Goh KMB, Beauchamp MR, Benjanuvatra N, Dimmock JA, Budden T. Perceptions of a family-based lifestyle intervention for children with overweight and obesity: a qualitative study on sustainability, self-regulation, and program optimization. BMC Public Health 2022; 22:1534. [PMID: 35953799 PMCID: PMC9373481 DOI: 10.1186/s12889-022-13956-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 07/12/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Family-based lifestyle interventions (FBLIs) are an important method for treating childhood weight problems. Despite being recognized as an effective intervention method, the optimal structure of these interventions for children's overweight and obesity has yet to be determined. Our aim was to better understand participants' (a) implementation of behaviour strategies and long-term outcomes, (b) perceptions regarding the optimal structure of FBLIs, and (c) insights into psychological concepts that may explain the success of these programs. METHODS Purposive sampling was used to recruit participants. We conducted focus groups as well as one-to-one interviews with parents (n = 53) and children (n = 50; aged 7-13, M = 9.4 yr, SD = 3.1) three months following their involvement in a 10-week, multi-component, FBLI involving education and activities relating to healthy nutrition, physical activity, and behavior modification. Using an interpretivist approach, a qualitative study design was employed to examine participant experiences. RESULTS We identified three higher-order categories: (a) participants' program experiences and perceptions (b) lifestyle changes post-program, and (c) recommendations for optimizing family-based programs. Themes identified within these categories included (a) support and structure & content, (b) diet and physical activity, and (c) in-program recommendations and post-program recommendations. CONCLUSIONS We identified several challenges that can impair lasting behavior change (e.g., physical activity participation) following involvement in a FBLI. On optimizing these programs, participants emphasized fun, interactive content, interpersonal support, appropriate educational content, and behavior change techniques. Concepts rooted in motivational theory could help address calls for greater theoretical and mechanistic insight in FBLIs. Findings may support research advancement and assist health professionals to more consistently realize the potential of these interventions.
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Affiliation(s)
- Kaila C Putter
- Department of Psychology, College of Healthcare Sciences, James Cook University, Townsville, Australia
| | - Ben Jackson
- School of Human Sciences (Exercise and Sport Science), The University of Western, Perth, Australia.,Telethon Kids Institute, Perth, WA, Australia
| | - Ashleigh L Thornton
- Division of Paediatrics, Faculty of Health and Medical Sciences, The University of Western, Perth, Australia.,Kids Rehab WA, Perth Children's Hospital, Nedlands, Australia
| | - Claire E Willis
- Sports & Exercise Science, La Trobe University, Melbourne, Australia
| | - Kong Min Bryce Goh
- School of Human Sciences (Exercise and Sport Science), The University of Western, Perth, Australia
| | - Mark R Beauchamp
- School of Kinesiology, The University of British Columbia, Vancouver, Canada
| | - Nat Benjanuvatra
- School of Human Sciences (Exercise and Sport Science), The University of Western, Perth, Australia
| | - James A Dimmock
- Department of Psychology, College of Healthcare Sciences, James Cook University, Townsville, Australia.,Telethon Kids Institute, Perth, WA, Australia
| | - Timothy Budden
- School of Human Sciences (Exercise and Sport Science), The University of Western, Perth, Australia. .,Telethon Kids Institute, Perth, WA, Australia.
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Perceived Social Support for Exercise and Weight Loss in Adolescents Undergoing Sleeve Gastrectomy. Obes Surg 2018; 28:421-426. [PMID: 28770423 DOI: 10.1007/s11695-017-2853-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVES Bariatric surgery is an effective treatment for youth with severe obesity. However, outcomes are variable and there remains sparse understanding of predictors of weight loss following surgery. The current study examines the role of adolescent-reported pre-operative social support around exercise, binge eating, and exercise to predict excess body mass index (EBMI) loss from 3 to 12 months post-surgery. METHOD Participants were 101 adolescents ages 12-21 (M age = 16.6, SD = 1.8). Pre-operative body mass index (BMI) ranged from 35 to 87 (M = 50.3, SD = 8.6). Structural equation modeling (SEM) was used to evaluate a model of the association of adolescent report of perceived social support for exercise with less binge eating (items from the Eating Disorder Diagnostic Scale) and more self-reported exercise (items from the Youth Risk Behavior Surveillance System). The model was used to predict EBMI loss at 3, 6, 9, and 12 months post-surgery. RESULTS Social support significantly predicted exercise and demonstrated a trend for predicting binge eating, such that more social support was associated with more exercise and a trend for less binge eating. Binge eating was associated with less EBMI loss. However, there was no association of exercise with EBMI loss. CONCLUSIONS Pre-operative binge eating should be a target for identification and treatment prior to sleeve gastrectomy in adolescents. Although not directly or indirectly associated with EBMI loss, perceived social support around exercise was associated with increased exercise, which may make it a consideration for a target for intervention as well.
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Grammatikopoulou MG, Chourdakis M, Gkiouras K, Roumeli P, Poulimeneas D, Apostolidou E, Chountalas I, Tirodimos I, Filippou O, Papadakou-Lagogianni S, Dardavessis T. Edmonton obesity staging system among pediatric patients: a validation and obesogenic risk factor analysis. J Endocrinol Invest 2018; 41:947-957. [PMID: 29313283 DOI: 10.1007/s40618-017-0821-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2017] [Accepted: 12/24/2017] [Indexed: 02/08/2023]
Abstract
PURPOSE The Edmonton Obesity Staging System for Pediatrics (EOSS-P) is a useful tool, delineating different obesity severity tiers associated with distinct treatment barriers. The aim of the study was to apply the EOSS-P on a Greek pediatric cohort and assess risk factors associated with each stage, compared to normal weight controls. METHODS A total of 361 children (2-14 years old), outpatients of an Athenian hospital, participated in this case-control study by forming two groups: the obese (n = 203) and the normoweight controls (n = 158). Anthropometry, blood pressure, blood and biochemical markers, comorbidities and obesogenic lifestyle parameters were recorded and the EOSS-P was applied. Validation of EOSS-P stages was conducted by juxtaposing them with IOTF-defined weight status. Obesogenic risk factors' analysis was conducted by constructing gender-and-age-adjusted (GA) and multivariate logistic models. RESULTS The majority of obese children were stratified at stage 1 (46.0%), 17.0% were on stage 0, and 37.0% on stage 2. The validation analysis revealed that EOSS-P stages greater than 0 were associated with diastolic blood pressure and levels of glucose, cholesterol, LDL and ALT. Reduced obesity odds were observed among children playing outdoors and increased odds for every screen time hour, both in the GA and in the multivariate analyses (all P < 0.05). Although participation in sports > 2 times/week was associated with reduced obesity odds in the GA analysis (OR = 0.57, 95% CI = 0.33-0.98, P linear = 0.047), it lost its significance in the multivariate analysis (P linear = 0.145). Analogous results were recorded in the analyses of the abovementioned physical activity risk factors for the EOSS-P stages. Linear relationships were observed for fast-food consumption and IOTF-defined obesity and higher than 0 EOSS-P stages. Parental obesity status was associated with all EOSS-P stages and IOTF-defined obesity status. CONCLUSIONS Few outpatients were healthy obese (stage 0), while the majority exhibited several comorbidities. Since each obesity tier entails different impacts to disease management, the study herein highlights modifiable factors facilitating descend to lower stages, and provides insight for designing tailored approaches tackling the high national pediatric obesity rates.
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Affiliation(s)
- M G Grammatikopoulou
- Laboratory of Hygiene, Department of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
- Department of Nutrition and Dietetics, Alexander Technological Educational Institute, Thessaloniki, Greece
| | - M Chourdakis
- Laboratory of Hygiene, Department of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.
| | - K Gkiouras
- Laboratory of Clinical Pharmacology, Department of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - P Roumeli
- Department of Nutrition and Dietetics, Alexander Technological Educational Institute, Thessaloniki, Greece
- Department of Pediatrics, Asklipio General Hospital, Voula, Athens, Greece
| | - D Poulimeneas
- Department of Nutrition and Dietetics, Alexander Technological Educational Institute, Thessaloniki, Greece
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - E Apostolidou
- Laboratory of Clinical Pharmacology, Department of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - I Chountalas
- Department of Nutrition and Dietetics, Alexander Technological Educational Institute, Thessaloniki, Greece
| | - I Tirodimos
- Laboratory of Hygiene, Department of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - O Filippou
- Department of Pediatrics, Asklipio General Hospital, Voula, Athens, Greece
| | | | - T Dardavessis
- Laboratory of Hygiene, Department of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Greenleaf C, Petrie T, Martin S. Exploring weight-related teasing and depression among overweight and obese adolescents. EUROPEAN REVIEW OF APPLIED PSYCHOLOGY-REVUE EUROPEENNE DE PSYCHOLOGIE APPLIQUEE 2017. [DOI: 10.1016/j.erap.2017.01.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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5
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Xu F, Marchand S, Corcoran C, DiBiasio H, Clough R, Dyer CS, Nobles J, White J, Greaney ML, Greene GW. A Community-Based Nutrition and Physical Activity Intervention for Children Who Are Overweight or Obese and Their Caregivers. J Obes 2017; 2017:2746595. [PMID: 29312784 PMCID: PMC5651117 DOI: 10.1155/2017/2746595] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 09/12/2017] [Accepted: 09/17/2017] [Indexed: 01/06/2023] Open
Abstract
There is a need for efficacious interventions to reduce the prevalence of childhood obesity, and a limited body of research suggests that collaborative community-based programs designed for children and their caregivers may be effective in reducing obesity rates. This paper reports the results of a community-based obesity intervention, South County Food, Fitness and Fun (SCFFF), designed for preadolescent children who are overweight or obese and their caregivers. SCFFF was developed in response to community concerns. Families were referred to the program by their physician and participated in the program at no cost. The 16-week intervention includes weekly group nutrition and physical activity sessions. Analyses determined that 65 out of the 97 children who completed SCFFF provided 2-year follow-up data and had reduced BMI z-scores over 2 years following the intervention. These participants decreased their energy, fat, carbohydrate, saturated fat, and sodium intake and increased core body strength and endurance from baseline to the end of the intervention. SCFFF was effective in reducing relative weight and improving diet and core muscle strength and endurance in children who are overweight or obese.
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Affiliation(s)
- Furong Xu
- Department of Kinesiology, University of Rhode Island, Independence Square II, Kingston, RI 02881, USA
| | | | - Celeste Corcoran
- Coastal Medical Narragansett Bay Pediatrics, 65 Village Square Drive, South Kingstown, RI 02879, USA
| | - Heather DiBiasio
- Wakefield Pediatrics, LLC, 46 Holley Street, Wakefield, RI 02879, USA
| | - Rachel Clough
- Busy Bodies Studio, 12 High Street, South Kingstown, RI 02879, USA
| | - Christopher S. Dyer
- Department of Kinesiology, University of Rhode Island, Independence Square II, Kingston, RI 02881, USA
| | - Jennifer Nobles
- Department of Nutrition and Food Sciences, University of Rhode Island, Fogarty Hall, Kingston, RI 02881, USA
| | - Jade White
- Department of Nutrition and Food Sciences, University of Rhode Island, Fogarty Hall, Kingston, RI 02881, USA
| | - Mary L. Greaney
- Department of Kinesiology, University of Rhode Island, Independence Square II, Kingston, RI 02881, USA
| | - Geoffrey W. Greene
- Department of Nutrition and Food Sciences, University of Rhode Island, Fogarty Hall, Kingston, RI 02881, USA
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6
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Borrello M, Pietrabissa G, Ceccarini M, Manzoni GM, Castelnuovo G. Motivational Interviewing in Childhood Obesity Treatment. Front Psychol 2015; 6:1732. [PMID: 26617555 PMCID: PMC4641908 DOI: 10.3389/fpsyg.2015.01732] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Accepted: 10/27/2015] [Indexed: 12/22/2022] Open
Abstract
Obesity is one of today's most diffused and severe public health problems worldwide. It affects both adults and children with critical physical, social, and psychological consequences. The aim of this review is to appraise the studies that investigated the effects of motivational interviewing techniques in treating overweight and obese children. The electronic databases PubMed and PsychINFO were searched for articles meeting inclusion criteria. The review included studies based on the application of motivational interviewing (MI) components and having the objective of changing body mass index (BMI) in overweight or obese children from age 2 to age 11. Six articles have been selected and included in this review. Three studies reported that MI had a statistically significant positive effect on BMI and on secondary obesity-related behavior outcomes. MI can be applicable in the treatment of overweight and obese children, but its efficacy cannot be proved given the lack of studies carried out on this specific sample.
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Affiliation(s)
- Maria Borrello
- Department of Psychology, University of Bergamo Bergamo, Italy
| | - Giada Pietrabissa
- Psychology Research Laboratory, IRCCS Istituto Auxologico Italiano, Ospedale San Giuseppe Piancavallo, Italy ; Department of Psychology, Catholic University of Milan Milan, Italy
| | - Martina Ceccarini
- Department of Psychology, University of Bergamo Bergamo, Italy ; Psychology Research Laboratory, IRCCS Istituto Auxologico Italiano, Ospedale San Giuseppe Piancavallo, Italy
| | - Gian M Manzoni
- Psychology Research Laboratory, IRCCS Istituto Auxologico Italiano, Ospedale San Giuseppe Piancavallo, Italy ; Faculty of Psychology, eCampus University Novedrate, Italy
| | - Gianluca Castelnuovo
- Psychology Research Laboratory, IRCCS Istituto Auxologico Italiano, Ospedale San Giuseppe Piancavallo, Italy ; Department of Psychology, Catholic University of Milan Milan, Italy
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8
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Stein D, Weinberger-Litman SL, Latzer Y. Psychosocial perspectives and the issue of prevention in childhood obesity. Front Public Health 2014; 2:104. [PMID: 25133140 PMCID: PMC4116804 DOI: 10.3389/fpubh.2014.00104] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Accepted: 07/15/2014] [Indexed: 11/13/2022] Open
Abstract
A dramatic increase in childhood overweight/obesity has been recognized globally over the past 50 years. This observed increase may reflect genetic, as well as psychological, environmental, and socio-cultural influences. In the first part of this review, we present an updated summary of the psychosocial factors associated with this change and discuss possible ways in which they operate. Among these factors, lower socio economic status (in both industrialized and non-industrialized countries), being female, belonging to a minority group, and being exposed to adverse life events may all be associated with a greater risk of childhood overweight/obesity. These influences may be mediated via a variety of mechanisms, in particular above-average food intake of low nutritional quality and reduction in physical activity. Other important psychosocial mediators include the influence of the family and peer environment, and exposure to the media. In the second part of the review, we discuss the potential of psychosocial prevention programs to intervene in the processes involved in the rise of childhood overweight/obesity. Two points are emphasized. First, prevention programs should be multidisciplinary, combining the knowledge of experts from different professions, and taking into consideration the important role of the family environment and relevant influential social organizations, particularly school. Second, effective change is unlikely to occur without large-scale programs carried out on a public policy level.
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Affiliation(s)
- Daniel Stein
- Pediatric Psychosomatic Department, Edmond and Lily Safra Children's Hospital, Chaim Sheba Medical Center , Tel Hashomer , Israel ; Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv , Israel
| | | | - Yael Latzer
- Faculty of Social Welfare and Health Sciences, Haifa University , Haifa , Israel ; Eating Disorders Clinic, Psychiatric Division, Rambam Medical Center , Haifa , Israel
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Mogul A, Irby MB, Skelton JA. A systematic review of pediatric obesity and family communication through the lens of addiction literature. Child Obes 2014; 10:197-206. [PMID: 24809221 PMCID: PMC4038995 DOI: 10.1089/chi.2013.0157] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Both treatment of addiction and treatment of pediatric obesity often integrate the family unit. Thus, addiction therapies may provide a model to guide treatment of pediatric obesity, particularly issues of family communication, weight, and weight-related behaviors. The aim of this systematic review is to assess what knowledge in the field of addiction treatment can be translated to pediatric weight management, particularly in relation to family-based approaches and communication. METHODS A systematic review of family communication and food addiction in obese children was conducted using MEDLINE and other databases, including all English-language studies published after 1990 meeting search criteria and related to family factors or family communication, and addiction treatment strategies used in obesity interventions. RESULTS Three reviews, two survey studies, and two observational studies were included. Most focused on family communication; less-healthy communication patterns and parental restriction were related to maladaptive eating behaviors in children and attrition from weight management programs. A few studies suggested family communication interventions to improve unhealthy eating patterns in children, using therapies common in family treatment of addiction (e.g., motivational interviewing and cognitive behavioral therapy). No studies presented concrete suggestions to aid family communication around issues of food and weight management. Potential contributions of addiction therapies are discussed. CONCLUSIONS Though the addictive properties of food have not been fully delineated and obesity is not classified as a disease of addiction, the field of addiction offers many approaches that may prove useful in the treatment of obesity.
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Affiliation(s)
- Ashley Mogul
- Wake Forest School of Medicine, Winston-Salem, NC
| | - Megan B. Irby
- Department of Pediatrics, Wake Forest School of Medicine, Winston-Salem, NC.,Brenner FIT (Families In Training) Program, Brenner Children's Hospital, Winston-Salem, NC
| | - Joseph A. Skelton
- Department of Pediatrics, Wake Forest School of Medicine, Winston-Salem, NC.,Brenner FIT (Families In Training) Program, Brenner Children's Hospital, Winston-Salem, NC.,Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC
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10
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Abstract
Family-based interventions have been effective in managing childhood obesity, and pediatric nurse practitioners (PNPs) are positioned to provide obesity interventions in both patient and family primary care settings. The purpose of this article is to guide the PNP in implementing family-based childhood obesity interventions, including identification, diagnostic evaluation, and management.
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Cote AT, Harris KC, Panagiotopoulos C, Sandor GGS, Devlin AM. Childhood obesity and cardiovascular dysfunction. J Am Coll Cardiol 2013; 62:1309-19. [PMID: 23954339 DOI: 10.1016/j.jacc.2013.07.042] [Citation(s) in RCA: 306] [Impact Index Per Article: 27.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2013] [Revised: 07/19/2013] [Accepted: 07/22/2013] [Indexed: 12/17/2022]
Abstract
Obesity-related cardiovascular disease in children is becoming more prevalent in conjunction with the rise in childhood obesity. Children with obesity are predisposed to an increased risk of cardiovascular morbidity and mortality in adulthood. Importantly, research in children with obesity over the last decade has demonstrated that children may exhibit early signs of cardiovascular dysfunction as a result of their excess adiposity, often independent of other obesity-related comorbidities such as dyslipidemia and insulin resistance. The clinical evidence is accumulating to suggest that the cardiovascular damage, once observed only in adults, is also occurring in obese children. The objective of this review is to provide a synopsis of the current research on cardiovascular abnormalities in children with obesity and highlight the importance and need for early detection and prevention programs to mitigate this potentially serious health problem.
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Affiliation(s)
- Anita T Cote
- Department of Pediatrics, University of British Columbia, Child and Family Research Institute, Vancouver, British Columbia, Canada
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12
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Sysko R, Zandberg LJ, Devlin MJ, Annunziato RA, Zitsman JL, Walsh BT. Mental Health Evaluations for Adolescents Prior to Bariatric Surgery: A Review of Existing Practices and a Specific Example of Assessment Procedures. Clin Obes 2013; 3:62-72. [PMID: 24073019 PMCID: PMC3781169 DOI: 10.1111/cob.12019] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Best practice guidelines for adolescents considering bariatric surgery recommend a pre-operative mental health evaluation. However, only general information about these assessments appears in the literature, which makes consistency of administration challenging. This review proposes a specific empirically-derived format for pre-surgical mental health evaluations and summarizes currently available data on the psychiatric functioning of adolescents seeking bariatric surgery. DESIGN Studies of mental health evaluations for adults preparing for bariatric surgery are reviewed, as is the limited literature relevant to adolescent evaluations. A specific and detailed example of an evaluation (clinical interview, self-report questionnaires, cognitive assessment) used for younger patients at a major metropolitan hospital center is presented, followed by data from an initial group of adolescents completing this evaluation. SUBJECTS 200 adolescents (n=139 female; age: 14-18 y, BMI: 35.4-83.3 kg/m2) presenting for bariatric surgery. RESULTS A notable subset of adolescents reported current Axis I conditions (31.5%) and current mental health treatment (29.5%), but reports of current illicit drug use (1.5%) and regular alcohol use (0.5%) were relatively rare. Procedures for using the completed evaluation and post-surgery monitoring of psychosocial issues are discussed. CONCLUSIONS Adolescents considering weight loss surgery should receive comprehensive pre-surgical mental health evaluations, but additional data are needed to develop specific recommendations the use of these evaluations in post-operative care.
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Affiliation(s)
- Robyn Sysko
- Columbia Center for Eating Disorders, Division of Clinical Therapeutics, New York State Psychiatric Institute and the Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, New York, NY
| | | | - Michael J. Devlin
- Columbia Center for Eating Disorders, Division of Clinical Therapeutics, New York State Psychiatric Institute and the Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, New York, NY
| | | | - Jeffrey L. Zitsman
- Center for Adolescent Bariatric Surgery, Department of Surgery, Division of Pediatric Surgery, Columbia University Medical Center, New York, NY
| | - B. Timothy Walsh
- Columbia Center for Eating Disorders, Division of Clinical Therapeutics, New York State Psychiatric Institute and the Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, New York, NY
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Abstract
Sports psychologists play an important role in enhancing performance among athletes. In conjunction with team physicians, they can also shed light on psychological disorders common in athletes, such as mood and eating disorders, and overtraining syndrome. Sports psychologists can also lend their expertise to assist with injury prevention and recovery and compliance issues. Sports psychology has a role in helping to reverse the growing obesity epidemic among school-aged children. These professionals, working with coaches, can increase children's levels of physical activity. Cognitive-behavioral techniques could lead to enhanced enjoyment, increased participation, improved school performance, and a reduction in obesity.
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Affiliation(s)
- Vincent Morelli
- Department of Family and Community Medicine, Meharry Medical College, Nashville, TN 37208, USA.
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14
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Cohen TR, Hazell TJ, Vanstone CA, Plourde H, Rodd CJ, Weiler HA. A family-centered lifestyle intervention to improve body composition and bone mass in overweight and obese children 6 through 8 years: a randomized controlled trial study protocol. BMC Public Health 2013; 13:383. [PMID: 23617621 PMCID: PMC3648398 DOI: 10.1186/1471-2458-13-383] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2013] [Accepted: 04/15/2013] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Childhood obesity gives rise to health complications including impaired musculoskeletal development that associates with increased risk of fractures. Prevention and treatment programs should focus on nutrition education, increasing physical activity (PA), reducing sedentary behaviours, and should monitor bone mass as a component of body composition. To ensure lifestyle changes are sustained in the home environment, programs need to be family-centered. To date, no study has reported on a family-centered lifestyle intervention for obese children that aims to not only ameliorate adiposity, but also support increases in bone and lean muscle mass. Furthermore, it is unknown if programs of such nature can also favorably change eating and activity behaviors. The aim of this study is to determine the effects of a 1 y family-centered lifestyle intervention, focused on both nutrient dense foods including increased intakes of milk and alternatives, plus total and weight-bearing PA, on body composition and bone mass in overweight or obese children. METHODS/DESIGN The study design is a randomized controlled trial for overweight or obese children (6-8 y). Participants are randomized to control, standard treatment (StTx) or modified treatment (ModTx). This study is family-centred and includes individualized counselling sessions on nutrition, PA and sedentary behaviors occurring 4 weeks after baseline for 5 months, then at the end of month 8. The control group receives counselling at the end of the study. All groups are measured at baseline and every 3 months for the primary outcome of changes in body mass index Z-scores. At each visit blood is drawn and children complete a researcher-administered behavior questionnaire and muscle function testing. Changes from baseline to 12 months in body fat (% and mass), waist circumference, lean body mass, bone (mineral content, mineral density, size and volumetric density), dietary intake, self-reported PA and sedentary behaviour are examined. DISCUSSION This family-centered theory-based study permits for biochemical and physiological assessments. This trial will assess the effectiveness of the intervention at changing lifestyle behaviours by decreasing adiposity while enhancing lean and bone mass. If successful, the intervention proposed offers new insights for the management or treatment of childhood obesity. TRIAL REGISTRATION ClinicalTrials.gov, NCT01290016.
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Affiliation(s)
| | | | | | | | | | - Hope A Weiler
- School of Dietetics and Human Nutrition, McGill University, Montreal, QC H9X 3V9, Canada.
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15
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Kreier F, Genco ŞM, Boreel M, Langkemper MP, Nugteren IC, Rijnveld V, Thissen V, Deden S, Keessen M. An individual, community-based treatment for obese children and their families: the solution-focused approach. Obes Facts 2013; 6:424-32. [PMID: 24107796 PMCID: PMC5644677 DOI: 10.1159/000355909] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2012] [Accepted: 06/19/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND This study evaluates an individual, community-based treatment for obese children and their families. In this program, a treatment team applied solution-focused techniques to develop a custom-made treatment plan in collaboration with the participants. The treatment plan consisted of community-based lifestyle activities. METHODS 559 obese children with an average BMI z-score of 2.76 ± 0.54 took part in the 12-month study, and 372 children with an average BMI z-score of 2.75 ± 0.52 took part in the 24-month study. At the start of the study, ethnicity and special school needs were recorded. Before, after 12 months, and after 24 months of the treatment, body weight and height were measured. The effect of the treatment on body weight was evaluated using BMI z-scores. RESULTS 291 children (52%) completed 12 months of treatment, whereas 22 children (4%) were dismissed earlier due to a good response. After 12 months, the children showed a significant decrease in BMI z-score by 0.16 (95% confidence interval (CI) 0.11-0.20; p < 0.005). After 24 months, 103 children (28%) were participating in the program, with a significant decrease in BMI z-score of 0.15 (95% CI 0.07-0.22; p < 0.005). 50 children (13%) were dismissed before the end of the second year due to significant weight loss (standard deviation z-score reduction -0.38; 95% CI 0.30-0.46; p < 0.005; with an average treatment duration of 12.9 ± 6.4 months). There was a negative correlation of age and reduction in BMI z-score: children younger than 6 years showed a decrease in BMI z-score of 0.45 (95% CI 0.26-0.65) and 0.31 (95% CI 0.11-0.53) after 12 and after 24 months, respectively. CONCLUSIONS Children showed a significant decrease in BMI z-score after the treatment. We found a negative correlation of age and weight loss. Special attention to patients with a high risk of drop-out might further improve these results. We advise a referral to obesity treatment as early as possible since a 'wait and see' policy might have adverse results in obese children.
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Affiliation(s)
- Felix Kreier
- *Dr. Felix Kreier, Department of Pediatrics, Onze Lieve Vrouwe Gasthuis, Oosterpark 9, Postbus 95500, 1090 HM Amsterdam (The Netherlands),
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Önnerfält J, Erlandsson LK, Orban K, Broberg M, Helgason C, Thorngren-Jerneck K. A family-based intervention targeting parents of preschool children with overweight and obesity: conceptual framework and study design of LOOPS- Lund overweight and obesity preschool study. BMC Public Health 2012; 12:879. [PMID: 23072247 PMCID: PMC3538526 DOI: 10.1186/1471-2458-12-879] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2012] [Accepted: 10/09/2012] [Indexed: 11/10/2022] Open
Abstract
Background As the rate of overweight among children is rising there is a need for evidence-based research that will clarify what the best interventional strategies to normalize weight development are. The overall aim of the Lund Overweight and Obesity Preschool Study (LOOPS) is to evaluate if a family-based intervention, targeting parents of preschool children with overweight and obesity, has a long-term positive effect on weight development of the children. The hypothesis is that preschool children with overweight and obesity, whose parents participate in a one-year intervention, both at completion of the one-year intervention and at long term follow up (2-, 3- and 5-years) will have reduced their BMI-for-age z-score. Methods/Design The study is a randomized controlled trial, including overweight (n=160) and obese (n=80) children 4-6-years-old. The intervention is targeting the parents, who get general information about nutrition and exercise recommendations through a website and are invited to participate in a group intervention with the purpose of supporting them to accomplish preferred lifestyle changes, both in the short and long term. To evaluate the effect of various supports, the parents are randomized to different interventions with the main focus of: 1) supporting the parents in limit setting by emphasizing the importance of positive interactions between parents and children and 2) influencing the patterns of daily activities to induce alterations of everyday life that will lead to healthier lifestyle. The primary outcome variable, child BMI-for-age z-score will be measured at referral, inclusion, after 6 months, at the end of intervention and at 2-, 3- and 5-years post intervention. Secondary outcome variables, measured at inclusion and at the end of intervention, are child activity pattern, eating habits and biochemical markers as well as parent BMI, exercise habits, perception of health, experience of parenthood and level of parental stress. Discussion The LOOPS project will provide valuable information on how to build effective interventions to influence an unhealthy weight development to prevent the negative long-term effects of childhood obesity. Trial registration ClinicalTrials.gov NCT00916318
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Affiliation(s)
- Jenny Önnerfält
- Department of Paediatrics, Clinical Sciences Lund, Lund University, Lund, Sweden.
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Deierlein AL, Siega-Riz AM, Herring AH, Adair LS, Daniels JL. Gestational weight gain and predicted changes in offspring anthropometrics between early infancy and 3 years. Pediatr Obes 2012; 7:134-42. [PMID: 22434753 PMCID: PMC3313077 DOI: 10.1111/j.2047-6310.2011.00025.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2011] [Revised: 11/02/2011] [Accepted: 11/22/2011] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To determine how gestational weight gain (GWG), categorized using the 2009 Institute of Medicine recommendations, relates to changes in offspring weight-for-age (WAZ), length-for-age (LAZ) and weight-for-length z-scores (WLZ) between early infancy and 3 years. METHODS Women with singleton infants were recruited from the third cohort of the Pregnancy, Infection, and Nutrition Study (2001-2005). Term infants with at least one weight or length measurement during the study period were included (n = 476). Multivariable linear mixed effects regression models estimated longitudinal changes in WAZ, LAZ and WLZ associated with GWG. RESULTS In early infancy, compared with infants of women with adequate weight gain, those of women with excessive weight gains had higher WAZ, LAZ and WLZ. Excessive GWG ≥ 200% of the recommended amount was associated with faster rates of change in WAZ and LAZ and noticeably higher predicted mean WAZ and WLZ that persisted across the study period. CONCLUSIONS GWG is associated with significant differences in offspring anthropometrics in early infancy that persisted to 3 years of age. More longitudinal studies that utilize maternal and paediatric body composition measures are necessary to understand the nature of this association.
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Affiliation(s)
- Andrea L. Deierlein
- Andrea Deierlein is now at Mount Sinai School of Medicine, Department of Preventive Medicine, NY, NY
| | | | - Amy H. Herring
- University of North Carolina Gillings School of Global Public Health
| | - Linda S. Adair
- University of North Carolina Gillings School of Global Public Health
| | - Julie L. Daniels
- University of North Carolina Gillings School of Global Public Health
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Dreyhaupt J, Koch B, Wirt T, Schreiber A, Brandstetter S, Kesztyüs D, Wartha O, Kobel S, Kettner S, Prokopchuk D, Hundsdörfer V, Klepsch M, Wiedom M, Sufeida S, Fischbach N, Muche R, Seufert T, Steinacker JM. Evaluation of a health promotion program in children: Study protocol and design of the cluster-randomized Baden-Württemberg primary school study [DRKS-ID: DRKS00000494]. BMC Public Health 2012; 12:157. [PMID: 22394693 PMCID: PMC3351371 DOI: 10.1186/1471-2458-12-157] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2012] [Accepted: 03/06/2012] [Indexed: 11/16/2022] Open
Abstract
Background Increasing prevalences of overweight and obesity in children are known problems in industrialized countries. Early prevention is important as overweight and obesity persist over time and are related with health problems later in adulthood. "Komm mit in das gesunde Boot - Grundschule" is a school-based program to promote a healthier lifestyle. Main goals of the intervention are to increase physical activity, decrease the consumption of sugar-sweetened beverages, and to decrease time spent sedentary by promoting active choices for healthy lifestyle. The program to date is distributed by 34 project delivery consultants in the state of Baden-Württemberg and is currently implemented in 427 primary schools. The efficacy of this large scale intervention is examined via the Baden-Württemberg Study. Methods/Design The Baden-Württemberg Study is a prospective, stratified, cluster-randomized, and longitudinal study with two groups (intervention group and control group). Measurements were taken at the beginning of the academic years 2010/2011 and 2011/2012. Efficacy of the intervention is being assessed using three main outcomes: changes in waist circumference, skinfold thickness and 6 minutes run. Stratified cluster-randomization (according to class grade level) was performed for primary schools; pupils, teachers/principals, and parents were investigated. An approximately balanced number of classes in intervention group and control group could be reached by stratified randomization and was maintained at follow-up. Discussion At present, "Komm mit in das Gesunde Boot - Grundschule" is the largest school-based health promotion program in Germany. Comparative objective main outcomes are used for the evaluation of efficacy. Simulations showed sufficient power with the existing sample size. Therefore, the results will show whether the promotion of a healthier lifestyle in primary school children is possible using a relatively low effort within a school-based program involving children, teachers and parents. The research team anticipates that not only efficacy will be proven in this study but also expects many other positive effects of the program. Trial registration German Clinical Trials Register (DRKS), DRKS-ID: DRKS00000494
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Affiliation(s)
- Jens Dreyhaupt
- Institute of Epidemiology and Medical Biometry, Ulm University, Schwabstr, 13, D-89075 Ulm, Germany.
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Brandstetter S, Klenk J, Berg S, Galm C, Fritz M, Peter R, Prokopchuk D, Steiner RP, Wartha O, Steinacker J, Wabitsch M. Overweight prevention implemented by primary school teachers: a randomised controlled trial. Obes Facts 2012; 5:1-11. [PMID: 22433612 DOI: 10.1159/000336255] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2011] [Accepted: 09/20/2011] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE To describe the effects of URMEL-ICE, a German school-based intervention for overweight prevention, on children's BMI and other measures of fat mass. METHODS A cluster-randomised controlled design was used. The intervention which focused on physical activity, TV time and soft drink consumption was integrated into a second-grade curriculum and was implemented by classroom teachers themselves. It comprised 29 teaching lessons, 2 short exercise blocks per day and 6 family homework lessons. BMI was assessed as primary outcome measure, waist circumference and skinfold thickness as secondary outcomes. Data of 945 children were analysed. RESULTS Multivariate analyses adjusted for baseline values showed no statistically significant effect of the intervention on BMI, but on waist circumference (-0.85; 95% confidence interval (95% CI) -1.59 to -0.12) and subscapular skinfold thickness (-0.64; 95% CI -1.25 to -0.02). After additional adjustment for individual time lag between baseline and follow-up, these effects were reduced to -0.60 (95% CI -1.25 to 0.05) and -0.61 (95% CI -1.26 to 0.04) and lost their statistical significance. CONCLUSION This study contributes to the field of randomised school-based studies on overweight prevention and shows that within a 1-year, integrated intervention no effect on BMI, but a tendency towards effects on fat mass can be achieved.
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Affiliation(s)
- Susanne Brandstetter
- Division of Sports and Rehabilitation, Department of Internal Medicine II-Cardiology, Ulm University Medical Centre, Eythstrasse 24, Ulm, Germany
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Abstract
To effectively intervene with the overweight and obese youth, it is imperative that primary care providers and behavioral interventionists work in concert to help families implement healthy behaviors across socioenvironmental domains. In this article, the authors review current office-based counseling practices and provide evidence-based recommendations for addressing weight status and strategies for encouraging behavior change with children and families, primarily by increasing social support. By providing such collaborative targeted efforts, consistent health messages and support are delivered across children's everyday contexts, thereby helping the youth to achieve successful implementation of eating and activity behaviors and sustainable weight loss outcomes.
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Affiliation(s)
- Denise E. Wilfley
- Department of Psychiatry, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8134, St. Louis, Missouri 63110, Phone: 314-286-2079, Fax: 314-286-2091
| | - Andrea E. Kass
- Department of Psychiatry, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8134, St. Louis, Missouri 63110, Phone: 314-286-2113, Fax: 314-286-2091
| | - Rachel P. Kolko
- Department of Psychiatry, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8134, St. Louis, Missouri 63110, Phone: 314-286-0253, Fax: 314-286-2091
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Aikenhead A, Knai C, Lobstein T. Effectiveness and cost-effectiveness of paediatric bariatric surgery: a systematic review. Clin Obes 2011; 1:12-25. [PMID: 25586971 DOI: 10.1111/j.1758-8111.2010.00003.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Strong evidence for successful and cost-effective obesity management strategies is still generally lacking, leading the medical profession to rely increasingly on surgical options to treat obesity in children and adolescents. We performed a systematic review to examine the effectiveness of surgical interventions to treat obese children and adolescents, and whether they are cost-effective. We searched PubMed, ISI Web of Science, Embase and the Cochrane Library to 6 September 2010, and hand-searched bibliographies. We included articles with English abstracts if they examined subjects ≤19 years of age, reported at least one postoperative weight loss measure and at least 1 year of postoperative follow-up. Thirty-seven relevant papers on bariatric surgery effectiveness in 831 children or adolescents were included, spanning 36 years. Thirteen studies examined gastric banding, with mean body mass index (BMI) reductions ranging from 8.5 to 43 kg m(-2) . Weight gain was reported in one case study. Eight papers examined Roux-en-Y gastric bypass, with mean BMI reductions ranging from 9 to 25 kg m(-2) . Fourteen publications studied other forms of bariatric surgery: sleeve gastrectomies, vertical banded gastroplasty, biliopancreatic diversion or a combination of procedures. Mean BMI reductions ranged from 9 to 24 kg m(-2) . Three surgery-related mortalities were reported, as was weight regain in several cases. The majority of studies reported resolution or improvement of comorbid conditions. A range of postoperative complications were identified across surgery types, including: ulcers, intestinal leakage, wound infection, anastomotic stricture, nutritional deficiencies, bowel obstruction, pulmonary embolism, disrupted staple lines, band slippage, psychological intolerance and repeated vomiting. Evidence on cost-effectiveness was limited to one Australian modelling project, which deemed laparoscopic adjustable gastric banding cost-effective for adolescents. Existing evidence - although based generally on underpowered, retrospective studies - suggests that bariatric surgery in older children results in significant weight loss and improvements in comorbidities and quality of life. However, postoperative complications, compliance and follow-up may be more problematic in adolescents than adults, and availability of long-term data on safety, effectiveness and cost-effectiveness remains largely unknown. Pending an improvement in the quality of available evidence, a cautious approach to child and adolescent bariatric surgery is warranted, and reversible techniques are advisable compared to approaches that permanently alter anatomy.
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Affiliation(s)
- A Aikenhead
- International Association for the Study of Obesity, London, UKLondon School of Hygiene and Tropical Medicine, London, UK
| | - C Knai
- International Association for the Study of Obesity, London, UKLondon School of Hygiene and Tropical Medicine, London, UK
| | - T Lobstein
- International Association for the Study of Obesity, London, UKLondon School of Hygiene and Tropical Medicine, London, UK
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Kelly KP, Kirschenbaum DS. Immersion treatment of childhood and adolescent obesity: the first review of a promising intervention. Obes Rev 2011; 12:37-49. [PMID: 20070541 DOI: 10.1111/j.1467-789x.2009.00710.x] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Obese children have attended weight loss camps and residential programmes for more than 40 years. This paper provides the first systematic review of the effects of those programmes. Twenty-two studies met inclusion criteria (targeted and assessed change in weight status, minimal stay of 10 days and nights). Similar components across programmes included controlled diet, activities, nutrition education, and therapy and/or education regarding behaviour change. Participants lost substantial amounts of weight in all 22 studies, as measured by reductions in per cent-overweight during intervention. Eleven programmes included long-term follow-up evaluations. Compared with results highlighted in a recent meta-analysis of out-patient treatments, these immersion programmes produced an average of 191% greater reductions in per cent-overweight at post-treatment and 130% greater reduction at follow-up. Furthermore, mean attrition rates were much lower when compared with standard out-patient treatment. Inclusion of a cognitive-behavioural therapy (CBT) component seemed especially promising; follow-up evaluations showed decreased per cent-overweight at follow-up by an average of 30% for CBT immersion programmes vs. 9% for programmes without CBT. Explanations for the potentially greater impact of immersion relative to out-patient treatments are presented, including possibly differential effects on self-efficacy for both children and their parents.
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Affiliation(s)
- K P Kelly
- Wellspring, CRC Health Group, Cupertino, CA, USA.
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Morinder G, Biguet G, Mattsson E, Marcus C, Larsson UE. Adolescents' perceptions of obesity treatment--an interview study. Disabil Rehabil 2010; 33:999-1009. [PMID: 20874445 DOI: 10.3109/09638288.2010.520800] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To describe adolescents' perceptions of obesity treatment in order to provide valuable information for design and development of treatment. METHOD A nominated sample of 18 obese adolescents (12 girls, 14-16 years, body mass index (BMI) 25-47.4 kg·m(-2)), recruited from a paediatric obesity clinic, participated in semi-structured interviews. These were analysed using a phenomenographic research approach. Purposeful sampling reflected variations in age, gender, degree of obesity, weight loss achievement, ethnicity, time of registration and socioeconomic status. RESULTS The adolescents expressed numerous physical, psychological and social disabilities as a consequence of their obesity. Qualitatively different ways of perceiving and responding to obesity treatment were identified and could be described in six categories of descriptions and a two-dimensional construct for interpreting these categories; (a) personal empowerment, (b) despair and disappointment, (c) safety and relief, (d) ambivalence and uncertainty, (e) acceptance and realisation and (f) shame and guilt. The distinguishing structures to be found between the categories were as follows: focus on the individual and focus on body weight. CONCLUSIONS Treatment strategies must consider the large impact obesity has on adolescents' lives. It is necessary to engage the obese adolescent personally in the treatment process and to focus on the adolescents' personal needs, goals and motive for weight reduction.
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Affiliation(s)
- Gunilla Morinder
- Karolinska Institutet, Department for Clinical Science, Intervention and Technology, Division of Pediatrics, Karolinska University Hospital, National Childhood Obesity Centre, Huddinge, SE 141 86 Stockholm, Sweden.
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Ciangura C, Basdevant A. Bariatric surgery in young massively obese diabetic patients. DIABETES & METABOLISM 2010; 35:532-6. [PMID: 20152740 DOI: 10.1016/s1262-3636(09)73462-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Obesity is the most important lifestyle-related risk factor for type 2 diabetes (T2DM). The prevalence of T2DM in adolescents is increasing in parallel with the increasing incidence of major obesity. In adult obese subjects, the greatest degree of T2DM prevention, improvement or recovery has been reported in patients who have undergone bariatric surgery. However, few studies are available on the benefits and risks of bariatric surgery in adolescents with T2DM. The indications for obesity surgery in this population are unusual, and should only be considered in academic settings after comprehensive interdisciplinary evaluation.
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Affiliation(s)
- C Ciangura
- Pôle d'Endocrinologie, Faculté de Médecine Pierre & Marie Curie -Paris 6 University-CNRH-IDF, AP-HP, Pitié-Salpêtrière, Paris, France
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Affiliation(s)
- Leonard H Epstein
- Department of Pediatrics, University at Buffalo School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, New York, USA.
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Lubans DR, Sheaman C, Callister R. Exercise adherence and intervention effects of two school-based resistance training programs for adolescents. Prev Med 2010; 50:56-62. [PMID: 20006641 DOI: 10.1016/j.ypmed.2009.12.003] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2009] [Revised: 11/22/2009] [Accepted: 12/02/2009] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the efficacy and feasibility of two school-based RT programs to improve muscular fitness and body composition in adolescents. METHODS The study was conducted in Australia from July 2008 to June 2009. Participants [n=108, mean age (SD)=15.0 (0.7) years] were randomized to free weights (n=37) or elastic tubing (n=41) RT groups and a control group was recruited (n=30). Participants in the RT groups completed 2 sets of 10-12 repetitions on 10 exercises for 8 weeks. Waist circumference, body composition (bioelectrical impedance analysis) and muscular strength (bench press and leg press) were assessed at baseline and posttest. RESULTS Boys (p<0.001) and girls (p<0.01) in both RT groups improved their body composition over the study period. Boys in both RT groups significantly improved both upper and lower body strength and their improvements were significantly greater than changes observed in the control group. Girls in the free weights groups achieved larger improvements in lower body strength compared to the control group (p<0.05). CONCLUSIONS Free weights and elastic tubing RT are feasible and effective strategies for improving aspects of health-related fitness in adolescents.
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Affiliation(s)
- David R Lubans
- School of Education, The University of Newcastle, Callaghan Campus, NSW 2308, Australia.
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