1
|
Manasse SM, Moussaoui JR, Lampe EW, Brown KL, Zhang F, Janicke DM, McCrea L, Cardel MI, Butryn ML. Evaluating an acceptance-based lifestyle modification program to address cardiovascular disease risk among adolescent girls with overweight and obesity: Protocol for a randomized controlled trial. Contemp Clin Trials 2024; 144:107634. [PMID: 39019153 DOI: 10.1016/j.cct.2024.107634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 07/03/2024] [Accepted: 07/13/2024] [Indexed: 07/19/2024]
Abstract
BACKGROUND Behavioral weight loss interventions achieve only limited weight loss in adolescent samples and weight regain is common. This limited intervention success may be attributed, in part, to adolescents' lack of self-regulation skills essential for lifestyle modification and use of a one-size fits-all approach to produce weight loss in boys and girls. Interventions which teach self-regulation skills, such as Acceptance-Based Therapy (ABT), and are tailored to meet gender-specific concerns, are critical to help adolescents adapt to pervasive biological and environmental influences toward weight gain. OBJECTIVE This trial tests the effect of an ABT intervention on cardiometabolic health, health-related behaviors, and psychological factors among adolescent girls with overweight or obesity (OW/OB). METHODS Girls 14-19 years (N = 148; ≥ 40% racial/ethnic minorities) with OW/OB (BMI: ≥ 85th percentile) will be enrolled in the study. Participants will be randomized to one of two 6-month interventions, consisting of either 18 sessions of ABT or 9 sessions of a health education control, an augmented version of standard care for adolescent OW/OB, both led by bachelor's level interventionists. RESULTS Recruitment is taking place in Philadelphia, USA, from January 2024 to January 2028. Cardiometabolic health markers (adiposity; blood pressure; blood lipids), health-related behaviors (dietary intake; physical activity; sleep), and psychological factors (quality of life; depression; disordered eating; psychological flexibility) will be measured at baseline, mid-treatment, post-treatment, 6-month follow-up, and 12-month follow-up. CONCLUSIONS This study will provide valuable information on a novel intervention tailored to the needs of adolescent girls with OW/OB to address self-regulation and cardiometabolic health.
Collapse
Affiliation(s)
- Stephanie M Manasse
- Center for Weight, Eating, and Lifestyle Science (WELL Center), Drexel University, Philadelphia, PA, United States; Department of Psychological and Brain Sciences, Drexel University, Philadelphia, PA, United States.
| | - Jannah R Moussaoui
- Center for Weight, Eating, and Lifestyle Science (WELL Center), Drexel University, Philadelphia, PA, United States
| | - Elizabeth W Lampe
- Center for Weight, Eating, and Lifestyle Science (WELL Center), Drexel University, Philadelphia, PA, United States; Department of Psychological and Brain Sciences, Drexel University, Philadelphia, PA, United States
| | - Kristal L Brown
- Department of Creative Arts Therapies, Drexel University, Philadelphia, PA, United States
| | - Fengqing Zhang
- Department of Psychological and Brain Sciences, Drexel University, Philadelphia, PA, United States
| | - David M Janicke
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States
| | - Leon McCrea
- Department of Family, Community, and Preventive Medicine, Drexel University College of Medicine, United States
| | - Michelle I Cardel
- WW International, Inc., New York, NY, United States; Department of Health Outcomes and Biomedical Informatics, University of Florida College of medicine, Gainesville, FL, United States
| | - Meghan L Butryn
- Center for Weight, Eating, and Lifestyle Science (WELL Center), Drexel University, Philadelphia, PA, United States; Department of Psychological and Brain Sciences, Drexel University, Philadelphia, PA, United States
| |
Collapse
|
2
|
Al-Daghri NM, Amer OE, Khattak MNK, Hussain SD, Alkhaldi G, Alfawaz HA, Elsaid MA, Sabico S. Attendance-Based Adherence and Outcomes of Obesity Management Program in Arab Adolescents. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1449. [PMID: 37761410 PMCID: PMC10529466 DOI: 10.3390/children10091449] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 08/21/2023] [Accepted: 08/24/2023] [Indexed: 09/29/2023]
Abstract
Pediatric obesity has become a global pandemic in the last century, contributing to short and long-term medical conditions that heighten the risk of morbidity and mortality in children. The 12-month school-based obesity management educational program aims to assess the effect of adherence to the lifestyle educational program and target outcomes, obesity, and hypertension. A total of 363 (nonadherent, N = 179; adherent, N = 184) Saudi school adolescents aged 12-18 were recruited from 60 schools in Riyadh City, Saudi Arabia. Anthropometrics, lipid profile, and blood glucose were measured at baseline and post-intervention. The level of adherence was based on the number of attended educational sessions, and participants were grouped accordingly into two groups: adherent group (attended ≥ 3 sessions) and nonadherent group (attended 1-2 sessions) out of a total of five sessions. Results demonstrated that significantly more participants in the adherent group achieved the primary program goal of reducing obesity indices [body weight, body mass index (BMI), and BMI z-score] than the nonadherent group. Additionally, among adherent obese participants, BMI z-score significantly decreased after the 12-month intervention (post-intervention: 1.5 ± 0.7 vs. baseline: 1.7 ± 0.6, p < 0.05), while the trend in BMI z-score modestly increased in the nonadherent obese participants post-intervention (post-intervention: 1.8 ± 0.7 vs. baseline: 1.7 ± 0.6, p > 0.05). Moreover, there was a substantial reduction in hypertension prevalence only in the adherent group (p = 0.003) and among adherent obese participants in particular (p = 0.03). Furthermore, adherence to session attendance was higher in girls than boys, which led to better outcomes among girls than boys. For the secondary outcomes, lipid profile indices increased in both groups, while no changes were observed in the glycemic profile. In conclusion, greater adherence to educational sessions achieved modest but favorable weight changes and improved blood pressure among obese adolescents. Future intervention studies should take into consideration the need to improve attendance to enhance adherence to the program among adolescents at risk.
Collapse
Affiliation(s)
- Nasser M. Al-Daghri
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia; (O.E.A.); (M.N.K.K.); (S.D.H.); (M.A.E.); (S.S.)
| | - Osama E. Amer
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia; (O.E.A.); (M.N.K.K.); (S.D.H.); (M.A.E.); (S.S.)
| | - Malak N. K. Khattak
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia; (O.E.A.); (M.N.K.K.); (S.D.H.); (M.A.E.); (S.S.)
| | - Syed D. Hussain
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia; (O.E.A.); (M.N.K.K.); (S.D.H.); (M.A.E.); (S.S.)
| | - Ghadah Alkhaldi
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11451, Saudi Arabia;
| | - Hanan A. Alfawaz
- Department of Food Science and Nutrition, College of Food Science and Agriculture, King Saud University, Riyadh 11451, Saudi Arabia;
| | - Mohamed A. Elsaid
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia; (O.E.A.); (M.N.K.K.); (S.D.H.); (M.A.E.); (S.S.)
| | - Shaun Sabico
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia; (O.E.A.); (M.N.K.K.); (S.D.H.); (M.A.E.); (S.S.)
| |
Collapse
|
3
|
Hampl SE, Hassink SG, Skinner AC, Armstrong SC, Barlow SE, Bolling CF, Avila Edwards KC, Eneli I, Hamre R, Joseph MM, Lunsford D, Mendonca E, Michalsky MP, Mirza N, Ochoa ER, Sharifi M, Staiano AE, Weedn AE, Flinn SK, Lindros J, Okechukwu K. Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents With Obesity. Pediatrics 2023; 151:e2022060640. [PMID: 36622115 DOI: 10.1542/peds.2022-060640] [Citation(s) in RCA: 277] [Impact Index Per Article: 277.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/16/2022] [Indexed: 01/10/2023] Open
|
4
|
Skinner AC, Staiano AE, Armstrong SC, Barkin SL, Hassink SG, Moore JE, Savage JS, Vilme H, Weedn AE, Liebhart J, Lindros J, Reilly EM. Appraisal of Clinical Care Practices for Child Obesity Treatment. Part I: Interventions. Pediatrics 2023; 151:190447. [PMID: 36622110 DOI: 10.1542/peds.2022-060642] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/16/2022] [Indexed: 01/10/2023] Open
Abstract
The objective of this technical report is to provide clinicians with evidence-based, actionable information upon which to make assessment and treatment decisions for children and adolescents with obesity. In addition, this report will provide an evidence base to inform clinical practice guidelines for the management and treatment of overweight and obesity in children and adolescents. To this end, the goal of this report was to identify all relevant studies to answer 2 overarching key questions: (KQ1) "What are clinically based, effective treatments for obesity?" and (KQ2) "What is the risk of comorbidities among children with obesity?" See Appendix 1 for the conceptual framework and a priori key questions.
Collapse
Affiliation(s)
- Asheley C Skinner
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina
| | - Amanda E Staiano
- Louisiana State University Pennington Biomedical Research Center, Baton Rouge, Louisiana
| | - Sarah C Armstrong
- Departments of Pediatrics and Population Health Sciences, Duke Clinical Research Institute, Duke University, Durham, North Carolina
| | - Shari L Barkin
- Children's Hospital of Richmond at Virginia Commonwealth University, Richmond, Virginia
| | - Sandra G Hassink
- Medical Director, American Academy of Pediatrics, Institute for Healthy Childhood Weight, Wilmington, Delaware
| | - Jennifer E Moore
- Institute for Medicaid Innovation, University of Michigan Medical School, Ann Arbor, Michigan
| | - Jennifer S Savage
- Center for Childhood Obesity Research, Pennsylvania State University, Department of Nutritional Sciences, Pennsylvania State University, University Park, Pennsylvania
| | - Helene Vilme
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina
| | - Ashley E Weedn
- Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | | | | | | |
Collapse
|
5
|
Hassapidou M, Duncanson K, Shrewsbury V, Ells L, Mulrooney H, Androutsos O, Vlassopoulos A, Rito A, Farpourt N, Brown T, Douglas P, Ramos Sallas X, Woodward E, Collins C. EASO and EFAD Position Statement on Medical Nutrition Therapy for the Management of Overweight and Obesity in Children and Adolescents. Obes Facts 2022; 16:29-52. [PMID: 36349767 PMCID: PMC9890183 DOI: 10.1159/000527540] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 09/21/2022] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION This position statement on medical nutrition therapy in the management of overweight or obesity in children and adolescents was prepared by an expert committee convened by the European Association for the Study of Obesity (EASO) and developed in collaboration with the European Federation of the Associations of Dietitians (EFAD). METHODS It is based on the best evidence available from systematic reviews of randomized controlled trials on child and adolescent overweight and obesity treatment and other relevant peer-reviewed literature. RESULTS Multicomponent behavioural interventions are generally considered to be the gold standard treatment for children and adolescents living with obesity. The evidence presented in this position statement confirms that dietary interventions can effectively improve adiposity-related outcomes. Dietary strategies should focus on the reduction of total energy intake through promotion of food-based guidelines that target modification of usual eating patterns and behaviours. These should target increasing intakes of nutrient-rich foods with a lower energy density, specifically vegetables and fruits, and a reduction in intakes of energy-dense nutrient-poor foods and beverages. In addition, higher intensity, longer duration treatments, delivered by interventionists with specialized dietetic-related skills and co-designed with families, are associated with greater treatment effects. DISCUSSION Such interventions should be resourced adequately so that they can be implemented in a range of settings and in different formats, including digital or online delivery, to enhance accessibility.
Collapse
Affiliation(s)
- Maria Hassapidou
- Department of Nutritional Sciences & Dietetics, International Hellenic University, Thessaloniki, Greece
- ESDN Obesity, European Federation of the Associations of Dieticians, Naarden, The Netherlands
| | - Kerith Duncanson
- School of Medicine and Public Health, The University of Newcastle Australia, Callaghan, New South Wales, Australia
| | - Vanessa Shrewsbury
- School of Health Sciences, College of Health, Medicine and Wellbeing, The University of Newcastle Australia, Callaghan, New South Wales, Australia
| | - Louisa Ells
- Obesity Institute, School of Health, Leeds Beckett University, Leeds, UK
| | - Hilda Mulrooney
- ESDN Obesity, European Federation of the Associations of Dieticians, Naarden, The Netherlands
- Department of Life Sciences, Pharmacy and Chemistry, SEC Faculty, Kingston University London, Kingston upon Thames, UK
| | - Odysseas Androutsos
- ESDN Obesity, European Federation of the Associations of Dieticians, Naarden, The Netherlands
- Department of Nutrition-Dietetics, University of Thessaly, Trikala, Greece
| | - Antonis Vlassopoulos
- ESDN Obesity, European Federation of the Associations of Dieticians, Naarden, The Netherlands
- Department of Food Science & Human Nutrition, Agricultural University of Athens, Athens, Greece
| | - Ana Rito
- National Institute of Health Ricardo Jorge I.P., Lisbon, Portugal
| | - Nathalie Farpourt
- Obesity Prevention and Care Program Contrepoids, Service of Endocrinology, Diabetology and Therapeutic Education, Department of Medicine, University Hospitals of Geneva and University of Geneva, Geneva, Switzerland
| | - Tamara Brown
- Applied Obesity Research Centre in the School of Health, Leeds Beckett University, Leeds, UK
| | - Pauline Douglas
- Nutrition Innovation Center for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, UK
| | | | - Euan Woodward
- European Association for the Study of Obesity, Teddington, UK
| | - Clare Collins
- School of Health Sciences, College of Health, Medicine and Wellbeing, The University of Newcastle Australia, Callaghan, New South Wales, Australia
| |
Collapse
|
6
|
Diamond G, Kodish T, Ewing ESK, Hunt QA, Russon JM. Family processes: Risk, protective and treatment factors for youth at risk for suicide. AGGRESSION AND VIOLENT BEHAVIOR 2022; 64:101586. [PMID: 35662798 PMCID: PMC9159634 DOI: 10.1016/j.avb.2021.101586] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Family factors have continually been identified as potential risk and protective factors for youth at risk for suicide. This paper reviews family processes that not only are associated with suicide risk, but also might be malleable enough to target in treatment. We also review family intervention components have been incorporated into most youth suicide treatments. Unfortunately research on if these family processes moderator, mediator or change as a result of treatment is limited. Recommendations for future research are offered.
Collapse
|
7
|
Faith MS, Cochran WC, Diewald L, Hoffer K, Moore R, Berkowitz RI, Hauer CA, Stettler-Davis N, Tripicchio G, Rukstalis MR. Group lifestyle modification vs. lifestyle newsletters for early childhood obesity: Pilot study in rural primary care. ACTA ACUST UNITED AC 2021. [DOI: 10.1016/j.jbct.2021.01.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
|
8
|
Bean MK, Caccavale LJ, Adams EL, Burnette CB, LaRose JG, Raynor HA, Wickham EP, Mazzeo SE. Parent Involvement in Adolescent Obesity Treatment: A Systematic Review. Pediatrics 2020; 146:peds.2019-3315. [PMID: 32839242 PMCID: PMC7461263 DOI: 10.1542/peds.2019-3315] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/22/2020] [Indexed: 02/06/2023] Open
Abstract
CONTEXT Family-based lifestyle interventions are recommended for adolescent obesity treatment, yet the optimal role of parents in treatment is unclear. OBJECTIVE To examine systematically the evidence from prospective randomized controlled and/or clinical trials (RCTs) to identify how parents have been involved in adolescent obesity treatment and to identify the optimal type of parental involvement to improve adolescent weight outcomes. DATA SOURCES Data sources included PubMed, PsychINFO, and Medline (inception to July 2019). STUDY SELECTION RCTs evaluating adolescent (12-18 years of age) obesity treatment interventions that included parents were reviewed. Studies had to include a weight-related primary outcome (BMI and BMI z score). DATA EXTRACTION Eligible studies were identified and reviewed, following the Preferred Reporting for Systematic Review and Meta-Analyses guidelines. Study quality and risk of bias were evaluated by using the Cochrane Collaboration risk of bias tool. RESULTS This search identified 32 studies, of which 23 were unique RCTs. Only 5 trials experimentally manipulated the role of parents. There was diversity in the treatment target (parent, adolescent, or both) and format (group sessions, separate sessions, or mixed) of the behavioral weight loss interventions. Many studies lacked detail and/or assessments of parent-related behavioral strategies. In ∼40% of unique trials, no parent-related outcomes were reported, whereas parent weight was reported in 26% and associations between parent and adolescent weight change were examined in 17%. LIMITATIONS Only RCTs published in English in peer-reviewed journals were eligible for inclusion. CONCLUSIONS Further research, with detailed reporting, is needed to inform clinical guidelines related to optimizing the role of parents in adolescent obesity treatment.
Collapse
Affiliation(s)
- Melanie K. Bean
- Department of Pediatrics, Children’s Hospital
of Richmond at Virginia Commonwealth University, Richmond, Virginia
| | - Laura J. Caccavale
- Department of Pediatrics, Children’s Hospital
of Richmond at Virginia Commonwealth University, Richmond, Virginia
| | - Elizabeth L. Adams
- Department of Pediatrics, Children’s Hospital
of Richmond at Virginia Commonwealth University, Richmond, Virginia
| | | | | | - Hollie A. Raynor
- Department of Nutrition, The University of Tennessee,
Knoxville, Knoxville, Tennessee
| | - Edmond P. Wickham
- Department of Pediatrics, Children’s Hospital
of Richmond at Virginia Commonwealth University, Richmond, Virginia;,Internal Medicine, School of Medicine, Virginia
Commonwealth University, Richmond, Virginia; and
| | - Suzanne E. Mazzeo
- Department of Pediatrics, Children’s Hospital
of Richmond at Virginia Commonwealth University, Richmond, Virginia;,Department of Psychology, College of Humanities and
Sciences and
| |
Collapse
|
9
|
McGavock J, Chauhan BF, Rabbani R, Dias S, Klaprat N, Boissoneault S, Lys J, Wierzbowski AK, Sakib MN, Zarychanski R, Abou-Setta AM. Layperson-Led vs Professional-Led Behavioral Interventions for Weight Loss in Pediatric Obesity: A Systematic Review and Meta-analysis. JAMA Netw Open 2020; 3:e2010364. [PMID: 32658289 PMCID: PMC7358915 DOI: 10.1001/jamanetworkopen.2020.10364] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
IMPORTANCE The appropriate approach for weight loss among children and adolescents with overweight and obesity remains unclear. OBJECTIVE To evaluate the difference in the treatment outcomes associated with behavioral weight loss interventions led by laypersons and professionals in comparison with unsupervised control arms among children and adolescents with overweight and obesity. DATA SOURCES For this systematic review and meta-analysis, the Medical Literature Analysis and Retrieval System Online (MEDLINE), Embase, the Cochrane Library, and Cumulative Index of Nursing and Allied Health Literature (CINAHL) databases were searched from January 1, 1996, to June 1, 2019. STUDY SELECTION Included in this study were randomized clinical trials (RCTs) of behavioral interventions lasting at least 12 weeks for children and adolescents (aged 5-18 years) with overweight and obesity. Exclusion criteria included non-RCT studies, interventions lasting less than 12 weeks, adult enrollment, participants with other medical diagnoses, pharmacological treatment use, and articles not written in English. Two of 6 reviewers independently screened all citations. Of 25 586 citations, after duplicate removal, 78 RCTs (5780 participants) met eligibility criteria. DATA EXTRACTION AND SYNTHESIS A bayesian framework and Markov chain Monte Carlo simulation methods were used to combine direct and indirect associations. Random-effects and fixed-effect network meta-analysis models were used with the preferred model chosen by comparing the deviance information criteria. This study was registered with the International Prospective Register of Systematic Reviews (PROSPERO) and followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline. MAIN OUTCOMES AND MEASURES The immediate and sustained changes in weight and body mass index (BMI) standardized mean difference (SMD) were primary outcomes planned before data collection began, whereas waist circumference and percent body fat were secondary outcomes. The hypothesis being tested was formulated before the data collection. RESULTS Of 25 586 citations retrieved, we included 78 RCTs (5780 participants), with a follow-up of 12 to 104 weeks. Compared with the control condition, random-effects models revealed that professional-led weight loss interventions were associated with reductions in weight (mean difference [MD], -1.60 kg [95% CI, -2.30 to -0.99 kg]; 68 trials; P < .001) and BMI (SMD, -0.30 [95% CI, -0.39 to -0.20]; 59 trials; P < .001) that were not sustained long term (weight MD, -1.02 kg [95% CI, -2.20 to 0.34 kg]; 21 trials; P = .06; BMI SMD, -0.12 [95% CI, -0.46 to 0.21]; 20 trials; P < .001). There was no association between layperson-led interventions and weight loss in the short-term (MD, -1.40 kg [95% CI, -3.00 to 0.26 kg]; 5 trials; P = .05) or long-term (MD, -0.98 kg [95% CI, -3.60 to 1.80 kg]; 1 trial; P = .23) compared with standard care. No difference was found in head-to-head trials (professional vs layperson MD, -0.25 kg [95% CI -1.90 to 1.30 kg]; 5 trials; P = .38). CONCLUSIONS AND RELEVANCE This systematic review and meta-analysis found that professional-led weight loss interventions were associated with short-term but not sustained weight reduction among children and adolescents with overweight or obesity, and the evidence for layperson-led approaches was insufficient to draw firm conclusions.
Collapse
Affiliation(s)
- Jonathan McGavock
- Children's Hospital Research Institute of Manitoba, Winnipeg, Canada
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Canada
- Diabetes Research Envisioned and Accomplished in Manitoba, Children’s Hospital Research Institute of Manitoba, Winnipeg, Canada
| | - Bhupendrasinh F. Chauhan
- George & Fay Yee Centre for Healthcare Innovation, Winnipeg, Manitoba, Canada
- I. H. Asper Clinical Research Institute, St. Boniface Hospital Research Centre, Winnipeg, Manitoba, Canada
| | - Rasheda Rabbani
- George & Fay Yee Centre for Healthcare Innovation, Winnipeg, Manitoba, Canada
| | - Sofia Dias
- Centre for Reviews and Dissemination, University of York, York, United Kingdom
| | - Nika Klaprat
- Children's Hospital Research Institute of Manitoba, Winnipeg, Canada
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Canada
- Diabetes Research Envisioned and Accomplished in Manitoba, Children’s Hospital Research Institute of Manitoba, Winnipeg, Canada
| | - Sara Boissoneault
- Children's Hospital Research Institute of Manitoba, Winnipeg, Canada
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Canada
- Diabetes Research Envisioned and Accomplished in Manitoba, Children’s Hospital Research Institute of Manitoba, Winnipeg, Canada
| | - Justin Lys
- George & Fay Yee Centre for Healthcare Innovation, Winnipeg, Manitoba, Canada
| | | | - Mohammad Nazmus Sakib
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Ryan Zarychanski
- George & Fay Yee Centre for Healthcare Innovation, Winnipeg, Manitoba, Canada
- Centre for Reviews and Dissemination, University of York, York, United Kingdom
- Department of Haematology and Medical Oncology, CancerCare Manitoba, Winnipeg, Canada
- Department of Internal Medicine, University of Manitoba, Winnipeg, Canada
| | - Ahmed M. Abou-Setta
- George & Fay Yee Centre for Healthcare Innovation, Winnipeg, Manitoba, Canada
| |
Collapse
|
10
|
Tronieri JS, Wadden TA, Leonard SM, Berkowitz RI. A pilot study of acceptance-based behavioural weight loss for adolescents with obesity. Behav Cogn Psychother 2019; 47:686-696. [PMID: 30992093 PMCID: PMC6785377 DOI: 10.1017/s1352465819000262] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Acceptance and commitment therapy (ACT) is a psychological treatment that has been found to increase weight loss in adults when combined with lifestyle modification, compared with the latter treatment alone. However, an ACT-based treatment for weight loss has never been tested in adolescents. METHODS The present pilot study assessed the feasibility and acceptability of a 16-week, group ACT-based lifestyle modification treatment for adolescents and their parents/guardians. The co-primary outcomes were: (1) mean acceptability scores from up to 8 biweekly ratings; and (2) the percentage reduction in body mass index (BMI) from baseline to week 16. The effect size for changes in cardiometabolic and psychosocial outcomes from baseline to week 16 also was examined. RESULTS Seven families enrolled and six completed treatment (14.3% attrition). The mean acceptability score was 8.8 for adolescents and 9.0 for parents (on a 1-10 scale), indicating high acceptability. The six adolescents who completed treatment experienced a 1.3% reduction in BMI (SD = 2.3, d = 0.54). They reported a medium increase in cognitive restraint, a small reduction in hunger, and a small increase in physical activity. They experienced small improvements in most quality of life domains and a large reduction in depression. CONCLUSIONS These preliminary findings indicate that ACT plus lifestyle modification was a highly acceptable treatment that improved weight, cognitive restraint, hunger, physical activity, and psychosocial outcomes in adolescents with obesity.
Collapse
Affiliation(s)
- Jena Shaw Tronieri
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine
| | - Thomas A. Wadden
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine
| | - Sharon M. Leonard
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine
| | - Robert I. Berkowitz
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, The Children’s Hospital of Philadelphia
| |
Collapse
|
11
|
Bergmann K, Mestre Z, Strong D, Eichen DM, Rhee K, Crow S, Wilfley D, Boutelle KN. Comparison of Two Models of Family-Based Treatment for Childhood Obesity: A Pilot Study. Child Obes 2019; 15:116-122. [PMID: 30720354 PMCID: PMC6386083 DOI: 10.1089/chi.2018.0250] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Family-based weight loss treatment (FBT) for childhood obesity, the current "gold standard," is typically provided in weekly groups for 6 months. Although this program is considered effective, it poses limitations to treatment engagement, due to time commitment and lack of widespread availability. A guided self-help version of FBT (gshFBT; eleven 20-minute sessions and one 1-hour over 5 months) was developed to circumvent such limitations. The current study examined the comparative efficacy of a 5-month FBT and gshFBT program. METHODS Participants included 50 parent-child dyads enrolled in FBT between 2011 and 2013 and 50 parent-child dyads enrolled in gshFBT between 2009 and 2010. Data were collected at baseline, posttreatment, and 6-month follow-up. Noninferiority analyses were conducted to assess comparative efficacy of changes in parent and child weight status, child nutrition, child physical activity, and drop-out. RESULTS Results indicated that gshFBT was noninferior to FBT in changes in child BMI z-score, overweight parent BMI, child nutritional intake, child vigorous physical activity, and drop-out. Results did not support noninferiority for changes in moderate to vigorous physical activity. CONCLUSIONS gshFBT is less intensive, more flexible, and may be similarly effective to FBT and could reach a greater proportion of the pediatric overweight population. Further research, including a randomized clinical trial, is needed to confirm these results.
Collapse
Affiliation(s)
- Kristie Bergmann
- California School of Professional Psychology, Alliant International University, San Diego, CA.,Department of Pediatrics, University of California, San Diego, La Jolla, CA
| | - Zoe Mestre
- SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, La Jolla, CA.,Department of Psychiatry, University of California, San Diego, La Jolla, CA.,Address correspondence to: Zoe Mestre, MS, Department of Psychiatry, University of California, San Diego, 9500 Gilman Drive, MC 0984, La Jolla, CA 92093
| | - David Strong
- Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, CA
| | - Dawn M. Eichen
- Department of Pediatrics, University of California, San Diego, La Jolla, CA
| | - Kyung Rhee
- Department of Pediatrics, University of California, San Diego, La Jolla, CA
| | - Scott Crow
- Department of Psychiatry, University of Minnesota, Saint Paul, MN
| | - Denise Wilfley
- Department of Psychology, Washington University in St. Louis, St. Louis, MO
| | - Kerri N. Boutelle
- Department of Pediatrics, University of California, San Diego, La Jolla, CA.,Department of Psychiatry, University of California, San Diego, La Jolla, CA.,Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, CA
| |
Collapse
|
12
|
Abstract
PURPOSE OF REVIEW This narrative review synthesized recent research related to obesity in adolescents with psychiatric disorders, with a focus on epidemiology, mechanisms, and weight management approaches. The paper reviews literature on depressive and anxiety disorders, bipolar disorder, and schizophrenia spectrum and other psychotic disorders. RECENT FINDINGS Depression has a bidirectional relationship with obesity. Bipolar disorder and schizophrenia spectrum disorders, and their treatments, increase the risk of developing obesity. Mechanisms underlying this weight gain include lifestyle and environmental factors and psychiatric medications, though emerging evidence has also suggested the role of genetic and neuroendocrine processes. Evidence about the most effective treatments for obesity in adolescents with psychiatric disorders remains limited. Adolescents with psychiatric disorders are at high risk for obesity. Close monitoring for increases in weight and cardiometabolic risk factors with use of antipsychotic and mood-stabilizing medications is recommended. Clinical trials are needed that test the efficacy of weight management strategies for this population.
Collapse
Affiliation(s)
- Ariana M. Chao
- University of Pennsylvania School of Nursing, Department of Biobehavioral Health Sciences;,Perelman School of Medicine at the University of Pennsylvania, Department of Psychiatry
| | - Thomas A. Wadden
- Perelman School of Medicine at the University of Pennsylvania, Department of Psychiatry
| | - Robert I. Berkowitz
- Perelman School of Medicine at the University of Pennsylvania, Department of Psychiatry;,Children’s Hospital of Philadelphia, Department of Child and Adolescent Psychiatry and Behavioral Sciences
| |
Collapse
|
13
|
Moores CJ, Bell LK, Miller J, Damarell RA, Matwiejczyk L, Miller MD. A systematic review of community-based interventions for the treatment of adolescents with overweight and obesity. Obes Rev 2018; 19:698-715. [PMID: 29345042 DOI: 10.1111/obr.12660] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 11/09/2017] [Accepted: 11/29/2017] [Indexed: 12/20/2022]
Abstract
Adolescent obesity is a risk factor for obesity and other chronic disease in adulthood. Evidence for the effectiveness of community-based obesity treatment programs for adolescents is required to inform policy and clinical decisions. This systematic review aims to evaluate recent effective and scalable community-based weight management programs for adolescents (13-17 years) who are overweight or obese. Eight databases (Medline, Embase, PsycINFO, CINAHL, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Informit, and Scopus) were searched for studies published between January 2011-2 March 2017 which are scalable in a community setting and reported primary outcome measures relating to weight. Following deduplication, 10,074 records were screened by title/abstract with 31 publications describing 21 programs included in this review. Programs were heterogeneous in nature (including length, number and frequency of sessions, parent-involvement and technology involvement). Reduction in adolescent BMIz ranged from 2 to 9% post-program and from 2 to 11% after varied lengths of follow-up. Study quality varied (n = 5 weak; n = 8 moderate; n = 8 high), and findings are limited by the risk of selection and retention bias in the included studies. Factors including the effectiveness and acceptability to the target population must be considered when selecting such community programs.
Collapse
Affiliation(s)
- C J Moores
- Nutrition and Dietetics, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - L K Bell
- Nutrition and Dietetics, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - J Miller
- Nutrition and Dietetics, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - R A Damarell
- Gus Fraenkel Medical Library, Flinders University, Adelaide, South Australia, Australia
| | - L Matwiejczyk
- Nutrition and Dietetics, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - M D Miller
- Nutrition and Dietetics, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| |
Collapse
|
14
|
Sarwer DB, Dilks RJ, Spitzer JC, Berkowitz RI, Wadden TA, Moore RH, Chittams JL, Brandt ML, Chen MK, Courcoulas AP, Harmon CM, Helmrath MA, Michalsky MP, Xanthakos SA, Zeller MH, Jenkins TM, Inge TH. Changes in Dietary Intake and Eating Behavior in Adolescents After Bariatric Surgery: an Ancillary Study to the Teen-LABS Consortium. Obes Surg 2018. [PMID: 28625002 DOI: 10.1007/s11695-017-2764-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND A growing number of studies suggest that bariatric surgery is safe and effective for adolescents with severe obesity. However, surprisingly little is known about changes in dietary intake and eating behavior of adolescents who undergo bariatric surgery. OBJECTIVE Investigate changes in dietary intake and eating behavior of adolescents with obesity who underwent bariatric surgery (n = 119) or lifestyle modification (LM) (n = 169). SETTING University-based health systems METHODS: A prospective investigation of 288 participants (219 female and 69 male) prior to bariatric surgery or LM and again 6, 12, and 24 months (surgery patients only) after treatment. Measures included changes in weight, macronutrient intake, eating behavior, and relevant demographic and physiological variables. RESULTS Adolescents who underwent bariatric surgery experienced significantly greater weight loss than those who received LM. The two groups differed in self-reported intake of a number of macronutrients at 6 and 12 months from baseline, but not total caloric intake. Patients treated with surgery, compared to those treated with LM, also reported significantly greater reductions in a number of disordered eating symptoms. After bariatric surgery, greater weight loss from postoperative month 6 to 12 was associated with self-reported weight consciousness, craving for sweets, and consumption of zinc. CONCLUSIONS Adolescents who underwent bariatric surgery, compared to those who received LM, reported significantly greater reductions in weight after 1 year. They also reported greater reductions in disordered eating symptoms. These findings provide new information on changes in dietary intake and eating behavior among adolescents who undergo bariatric surgery.
Collapse
Affiliation(s)
- David B Sarwer
- Department of Psychiatry, Center for Weight and Eating Disorders, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA. .,Center for Obesity Research and Education, College of Public Health, Temple University, 3223 N. Broad Street, Suite 175, Philadelphia, PA, 19428, USA.
| | - Rebecca J Dilks
- Department of Psychiatry, Center for Weight and Eating Disorders, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Jacqueline C Spitzer
- Department of Psychiatry, Center for Weight and Eating Disorders, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.,Center for Obesity Research and Education, College of Public Health, Temple University, 3223 N. Broad Street, Suite 175, Philadelphia, PA, 19428, USA
| | - Robert I Berkowitz
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.,Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Thomas A Wadden
- Department of Psychiatry, Center for Weight and Eating Disorders, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Renee H Moore
- Department of Psychiatry, Center for Weight and Eating Disorders, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.,Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Jesse L Chittams
- University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | - Mary L Brandt
- Division of Pediatric Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA
| | - Mike K Chen
- Division of Pediatric Surgery, Children's Hospital of Alabama, University of Alabama, Birmingham, AL, USA
| | - Anita P Courcoulas
- Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | | | - Michael A Helmrath
- Division of Pediatric Surgery, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Marc P Michalsky
- Department of Pediatric Surgery, The Ohio State University College of Medicine and Nationwide Children's Hospital, Columbus, OH, USA
| | - Stavra A Xanthakos
- Division of Gastroenterology, Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Meg H Zeller
- Division of Behavioral Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Todd M Jenkins
- Division of Pediatric Surgery, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Thomas H Inge
- Division of Pediatric Surgery, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| |
Collapse
|
15
|
Prout Parks E, Moore RH, Li Z, Bishop-Gilyard CT, Garrett AR, Hill DL, Bruton YP, Sarwer DB. Assessing the Feasibility of a Social Media to Promote Weight Management Engagement in Adolescents with Severe Obesity: Pilot Study. JMIR Res Protoc 2018; 7:e52. [PMID: 29555623 PMCID: PMC5881040 DOI: 10.2196/resprot.8229] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Revised: 09/28/2017] [Accepted: 12/07/2017] [Indexed: 11/13/2022] Open
Abstract
Background Severe obesity in adolescents has deleterious physical and psychological complications necessitating frequent multi-disciplinary clinic visits. Greater treatment engagement has been equated with weight-loss. However, traditional medical weight-loss programs for adolescents have high attrition rates. Social media is widely used by adolescents and may enhance medical weight management engagement and success. Objective The first objective was to examine the acceptability and feasibility of using a private social media group as an adjunct to medical weight management in youth ages 14 to 20 years with severe obesity [body mass index (BMI) ≥ 35 kg/m2]. The second objective was to pilot test the use of social media to improve treatment engagement and decrease attrition rates. Methods In this single arm, 12 week pre-post study, participants attended individual clinic visits and participated in a moderated private social media group that received nutrition, exercise, and behavior change social media communications or “posts” 3 to 4 times/week. Youth commented and/or liked posts from the moderator and each other. Social media engagement was measured with the number of likes and comments on social media. Clinic attrition was compared, measuring clinic visit attendance 12 weeks prior, during, and after the intervention with mixed linear regression models. Correlations of social media engagement with changes from baseline for BMI, BMI-z score, and psychosocial measures were fit. Results All 13 enrolled youth completed the study and reported that the group was enjoyable, helpful, reinforced their weight management program, and would recommend using social media to support other youth. The pilot trial was acceptable and feasible. Youth mean weekly engagement (likes + comments) in social media was greater than once a day (8.6 ±3.6). Compared to 12 weeks prior to the intervention, there was no significant decrease in clinic visit attendance at the end of the intervention (M=.231, P=.69) or 12 weeks at the conclusion of the intervention (M=.589, P=.28). Increased social media comments correlated with weight change (r=–.633, P=.04). Conclusions This pilot trial demonstrated that the use of social media as an adjunct to medical weight management was feasible and acceptable to adolescents with severe obesity. Based upon these preliminary findings, social media may be an effective way to mitigate attrition from obesity treatment programs, and improve health outcomes in this high-risk population.
Collapse
Affiliation(s)
- Elizabeth Prout Parks
- Division of Gastreoenterology, Hepatology and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, PA, United States.,Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Reneé H Moore
- Department of Biostatistics and Bioinformatics, Emory University, Atlanta, GA, United States.,Biostatistics Collaboration Core, Emory University, Atlanta, GA, United States
| | - Ziyi Li
- Department of Biostatistics and Bioinformatics, Emory University, Atlanta, GA, United States
| | | | - Andrew R Garrett
- Division of Gastreoenterology, Hepatology and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, PA, United States.,College of Science and Technology, Temple University, Philadelphia, PA, United States
| | - Douglas L Hill
- Pediatrics Advanced Care Team, The Children's Hospital of Philadelphia, Philadelphia, PA, United States
| | - Yasmeen P Bruton
- Division of Gastreoenterology, Hepatology and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, PA, United States
| | - David B Sarwer
- College of Public Health, Temple University, Philadelphia, PA, United States
| |
Collapse
|
16
|
Berkowitz RI, Marcus MD, Anderson BJ, Delahanty L, Grover N, Kriska A, Laffel L, Syme A, Venditti E, Van Buren DJ, Wilfley DE, Yasuda P, Hirst K. Adherence to a lifestyle program for youth with type 2 diabetes and its association with treatment outcome in the TODAY clinical trial. Pediatr Diabetes 2018; 19:191-198. [PMID: 28664624 PMCID: PMC5748014 DOI: 10.1111/pedi.12555] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Revised: 05/12/2017] [Accepted: 06/06/2017] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVE To assess the association of proxies of behavioral adherence to the Treatment Options for type 2 Diabetes in Adolescents and Youth (TODAY) lifestyle program with changes in glycemic control and obesity in a multi-ethnic sample of youth with type 2 diabetes. METHODS The TODAY clinical trial included an intensive lifestyle intervention to promote weight reduction. Adherence was assessed with measures of attendance at intervention sessions and rates of self-monitoring of diet and physical activity by participants and their caregivers. The relation between participant characteristics and consistency of proxies of adherence were examined across 3 phases of intervention. RESULTS A total of 234 TODAY youth were randomized to the lifestyle program. Overall rate of session attendance was approximately 60% of planned sessions. Participants with an adequate dose of session attendance (≥75% attended) did not differ from those who attended <75% of sessions in glycemic control, but did have significantly greater reductions in percent overweight compared with those who attended fewer than 75% of sessions. Rates of self-monitoring were low and additional analysis was not possible. CONCLUSIONS Rates of session attendance were moderate in a lifestyle program for youth with type 2 diabetes, but levels of self-monitoring, considered a key lifestyle change behavior, were low. Glycemic control was not significantly associated with session attendance but reductions in percent overweight were. Given the salience of program attendance and self-monitoring to lifestyle weight management established in other populations, future research is needed to understand, develop, and promote strategies and interventions targeting weight loss to achieve improved glycemic control in youth diagnosed with type 2 diabetes.
Collapse
Affiliation(s)
- Robert I Berkowitz
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia and Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Marsha D Marcus
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | | | - Linda Delahanty
- Department of Medicine, Massachusetts General Hospital Diabetes Center and Harvard Medical School, Boston, Massachusetts
| | - Nisha Grover
- George Washington University Biostatistics Center, Rockville, Maryland
| | - Andrea Kriska
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Lori Laffel
- Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts
| | - Amy Syme
- Pediatric Endocrinology, Yale University, New Haven, Connecticut
| | - Elizabeth Venditti
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Dorothy J Van Buren
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Denise E Wilfley
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Patrice Yasuda
- Department of Pediatrics, Children's Hospital Los Angeles, University of Southern California, Keck School of Medicine, Los Angeles, California
| | - Kathryn Hirst
- George Washington University Biostatistics Center, Rockville, Maryland
| |
Collapse
|
17
|
Management of Childhood Obesity and Overweight in Primary Care Visits: Gaps Between Recommended Care and Typical Practice. Curr Nutr Rep 2017. [DOI: 10.1007/s13668-017-0221-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
|
18
|
Chung SJ, Ersig AL, McCarthy AM. The Influence of Peers on Diet and Exercise Among Adolescents: A Systematic Review. J Pediatr Nurs 2017; 36:44-56. [PMID: 28888511 DOI: 10.1016/j.pedn.2017.04.010] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Revised: 04/24/2017] [Accepted: 04/24/2017] [Indexed: 11/28/2022]
Abstract
Adolescents' diet and exercise are modifiable factors contributing to high rates of adolescent obesity. Diverse contextual factors, including family, social environment, and peers, affect adolescents' diet and exercise behaviors. Because peer influence increases during adolescence, peers' contributions to adolescents' diet and exercise behaviors should be examined as potential targets for intervention to reduce the prevalence of adolescent obesity. The purpose of this systematic review is to identify research examining the contribution of peers to diet and exercise of adolescents. The electronic databases PubMed, CINAHL, Web of Science, and SCOPUS were searched. A total of 24 unique articles were included: seven examined diet only, fourteen studied exercise only, and three explored diet and exercise. This review provided evidence that diet and exercise of adolescents were significantly associated with those of their peers. However, these associations differed depending on gender, the type of diet and exercise, and closeness of friends. Findings from this review suggest that peers could be possible targets for interventions to promote healthier diet and exercise among adolescents; however, more studies are needed to identify specific peer influences and develop tailored interventions.
Collapse
Affiliation(s)
| | | | - Ann Marie McCarthy
- The University of Iowa, College of Nursing, Iowa City, IA United States.
| |
Collapse
|
19
|
Boff RDM, Liboni RPA, Batista IPDA, de Souza LH, Oliveira MDS. Weight loss interventions for overweight and obese adolescents: a systematic review. Eat Weight Disord 2017; 22:211-229. [PMID: 27542161 DOI: 10.1007/s40519-016-0309-1] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Accepted: 07/26/2016] [Indexed: 01/06/2023] Open
Abstract
PURPOSE To determine what factors contribute to the efficacy of non-drug treatments designed to promote weight loss in overweight and obese adolescents. METHODS Data sources Medline/PubMed; Psychinfo; EMBASE; Web of Science (ISI); and Cochrane Central Register of Controlled Trials. Study selection Randomized clinical trials of treatments for obesity and overweight in adolescents aged 10-19 years with a minimum duration of 2 months. Data extraction 115 of the 12,948 publications retrieved met eligibility criteria and 26 were included in the final sample. Period of extraction January 2004 to November 2014. RESULTS The Delphi list was used to evaluate the methodological quality of the studies (M = 5.58, SD = 1.027). There was considerable variability between the interventions, but they were all multifactorial, with components such as nutritional education, physical activity, family support and psychological therapy. The number of contacts with subjects during the course of the intervention was a predictor of treatment efficacy when the groups were compared. Limitations This systematic review was limited to trials reported in English and by the lack of methodological rigor and shortcomings in reporting in the studies reviewed. CONCLUSIONS Multidisciplinary interventions including family support and guided behavior modification appear to be effective methods of reducing BMI in overweight and obese adolescents.
Collapse
Affiliation(s)
- Raquel de Melo Boff
- PUCRS, Pontifícia Universidade Católica do Rio Grande do Sul, Av. Ipiranga, 6681, Prédio 11, 9° Andar, Sala 927-Partenon, Porto Alegre, RS, 90619-900, Brazil.
| | - Ronald Patrick Araujo Liboni
- PUCRS, Pontifícia Universidade Católica do Rio Grande do Sul, Av. Ipiranga, 6681, Prédio 11, 9° Andar, Sala 927-Partenon, Porto Alegre, RS, 90619-900, Brazil
| | - Igor Pacheco de Azevedo Batista
- PUCRS, Pontifícia Universidade Católica do Rio Grande do Sul, Av. Ipiranga, 6681, Prédio 11, 9° Andar, Sala 927-Partenon, Porto Alegre, RS, 90619-900, Brazil
| | | | - Margareth da Silva Oliveira
- PUCRS, Pontifícia Universidade Católica do Rio Grande do Sul, Av. Ipiranga, 6681, Prédio 11, 9° Andar, Sala 927-Partenon, Porto Alegre, RS, 90619-900, Brazil
| |
Collapse
|
20
|
Berkowitz RI, Daniels S. Now is the time to improve access and healthcare systems for childhood obesity treatment. Obesity (Silver Spring) 2017; 25:13-14. [PMID: 27925457 DOI: 10.1002/oby.21740] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Accepted: 11/21/2016] [Indexed: 11/11/2022]
Affiliation(s)
- Robert I Berkowitz
- Department of Psychiatry, Perelman School of Medicine at The University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Stephen Daniels
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado, USA
| |
Collapse
|
21
|
Thomason DL, Lukkahatai N, Kawi J, Connelly K, Inouye J. A Systematic Review of Adolescent Self-Management and Weight Loss. J Pediatr Health Care 2016; 30:569-582. [PMID: 26818905 DOI: 10.1016/j.pedhc.2015.11.016] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Revised: 11/13/2015] [Accepted: 11/30/2015] [Indexed: 11/26/2022]
Abstract
INTRODUCTION The aim of this review is to evaluate self-management interventions among overweight and obese adolescents to direct future research and practice. METHODS Studies published between 2008 and 2014 were identified by electronic database searches. The Jadad Scoring of Quality Reports of Randomized Clinical Trials was used to evaluate the quality of the studies with subsequent reviews. RESULTS Out of 69 studies, 10 randomized controlled trials were reviewed after all inclusion and exclusion criteria were met. Quality scores ranged from 7 to 11 out of 13 (M = 9.2, SD = 1.13). For the majority of studies, self-management strategies for weight loss were found to be significant for a mix of behavioral, psychological, anthropometric, and metabolic outcomes. DISCUSSION Findings indicated that interventions were most successful when incorporating family members. Self-management interventions that include a combination of appropriate diet, physical activity, and behavioral strategies with a family component are recommended.
Collapse
|
22
|
Lenders CM, Manders AJ, Perdomo JE, Ireland KA, Barlow SE. Addressing Pediatric Obesity in Ambulatory Care: Where Are We and Where Are We Going? Curr Obes Rep 2016; 5:214-40. [PMID: 27048522 PMCID: PMC5497516 DOI: 10.1007/s13679-016-0210-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Since the "2007 summary report of child and adolescent overweight and obesity treatment" published by Barlow, many obesity intervention studies have been conducted in pediatric ambulatory care. Although several meta-analyses have been published in the interim, many studies were excluded because of the focus and criteria of these meta-analyses. Therefore, the primary goal of this article was to identify randomized case-control trials conducted in the primary care setting and to report on treatment approaches, challenges, and successes. We have developed four themes for our discussion and provide a brief summary of our findings. Finally, we identified major gaps and potential solutions and describe several urgent key action items.
Collapse
Affiliation(s)
- Carine M Lenders
- Nutrition and Fitness for Life Program, Department of Pediatrics, Boston Medical Center, Boston University School of Medicine, Vose Hall-3, 88, East Newton Street, Boston, MA, 02118, USA.
| | - Aaron J Manders
- Nutrition and Fitness for Life Program, Department of Pediatrics, Boston Medical Center, Boston University School of Medicine, Vose Hall-3, 88, East Newton Street, Boston, MA, 02118, USA
| | - Joanna E Perdomo
- Boston Combined Residency Program, Boston University School of Medicine and Harvard Medical School, Dowling 3-870 Harrison Avenue, Boston, MA, 02118, USA
| | - Kathy A Ireland
- Nutrition and Fitness for Life Program, Department of Pediatrics, Boston Medical Center, Boston University School of Medicine, Vose Hall-3, 88, East Newton Street, Boston, MA, 02118, USA
| | - Sarah E Barlow
- Division of Pediatric Gastroenterology, Nutrition, and Hepatology, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, 6701 Fannin St. Suite 1010, Houston, TX, 77030, USA
| |
Collapse
|
23
|
Hayes JF, Altman M, Coppock JH, Wilfley DE, Goldschmidt AB. Recent Updates on the Efficacy of Group Based Treatments for Pediatric Obesity. CURRENT CARDIOVASCULAR RISK REPORTS 2015; 9:16. [PMID: 25866596 DOI: 10.1007/s12170-015-0443-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND There is limited research on optimal treatment formats for childhood obesity. Group-based interventions are popular, but it is unclear whether outcomes can be obtained without an additional individual component. AIM To examine statistically and clinically significant outcomes of recent group-based and mixed-format (group + Individual) pediatric obesity interventions. METHODS Effect sizes and magnitudes of weight change were calculated for studies published between January 2013 and September 2014. RESULTS Approximately half of the group-based studies reviewed produced significant results compared to control, and effect sizes were small. Mixed-format studies were less likely to include a control group, but those that did evidenced medium to large effects. Magnitudes of weight change post-intervention were generally greater in mixed-format studies than group-only studies. CONCLUSIONS Recent studies in pediatric obesity interventions suggest including an individual component in a group-based intervention produces optimal outcomes. Future research should directly compare group-only and mixed formats to confirm this observation.
Collapse
Affiliation(s)
- Jacqueline F Hayes
- Washington University in St. Louis 660 S. Euclid Street Campus Box 8134 St. Louis, MO 63110
| | - Myra Altman
- Washington University in St. Louis 660 S. Euclid Street Campus Box 8134 St. Louis, MO 63110
| | - Jackson H Coppock
- Washington University in St. Louis 660 S. Euclid Street Campus Box 8134 St. Louis, MO 63110
| | - Denise E Wilfley
- Washington University in St. Louis 660 S. Euclid Street Campus Box 8134 St. Louis, MO 63110
| | | |
Collapse
|
24
|
Black MM, Hager ER. Commentary: Pediatric obesity: systems science strategies for prevention. J Pediatr Psychol 2014; 38:1044-50. [PMID: 24013965 DOI: 10.1093/jpepsy/jst071] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Pediatric obesity is a major public health problem that undermines the physical and mental health of children and increases their risk for adult obesity and other chronic illnesses. Although health care providers, including pediatric psychologists, have implemented prevention programs, effects have been minimal, with no solid evidence of sustainable programs. METHODS A systems science framework that incorporates the multiple interacting factors that influence pediatric obesity may be useful in guiding prevention. RESULTS The National Prevention Strategy provides recommendations that can be incorporated into systems science designs, including (1) Healthy and Safe Environments, (2) Clinical and Community Preventive Services, (3) Empowering People, and (4) Elimination of Health Disparities. In addition, our recommendation is that future obesity prevention programs target early in life (pre-pregnancy through toddlerhood) and use multilevel multidisciplinary designs. CONCLUSIONS The benefits of preventing pediatric obesity extend from the health and well-being of individual children to the economic security of the nation.
Collapse
|
25
|
Fiese BH. Context matters in pediatric obesity: commentary on innovative treatment and prevention programs for pediatric overweight and obesity. J Pediatr Psychol 2014; 38:1037-43. [PMID: 24014068 DOI: 10.1093/jpepsy/jst069] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
This commentary reviews the 9 articles in the Special Issue on Innovative Treatment and Prevention Programs for Pediatric Overweight and Obesity. Taking a socio-ecological perspective, contextual factors such as characteristics of the child, family, community, and culture are offered as ways to improve treatment and prevention programs. Using a more tailored approach that takes into account individual differences in family communication patterns and problem solving is warranted. Pediatric psychologists are urged to consider the role of prevention and targeted efforts during early childhood to reduce the prevalence of childhood obesity.
Collapse
|
26
|
Jelalian E, Rancourt D, Sato AF. Innovative interventions in pediatric obesity: commentary and future directions. J Pediatr Psychol 2014; 38:1030-6. [PMID: 24039241 DOI: 10.1093/jpepsy/jst072] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
|
27
|
Steele RG, Janicke DM. Changing times call for changing methods: introduction to the special issue on innovative treatments and prevention programs for pediatric obesity. J Pediatr Psychol 2013; 38:927-31. [PMID: 24006274 DOI: 10.1093/jpepsy/jst066] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Ric G Steele
- PhD, Clinical Child Psychology Program, University of Kansas, 2010 Dole Human Development Center, 1000 Sunnyside Avenue, Lawrence, KS 66045-7555, USA.
| | | |
Collapse
|