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Nygaard HS, Øen KG. Public health nurses' experiences following up children with overweight and obesity according to national guidelines. A qualitative study. Int J Qual Stud Health Well-being 2024; 19:2306658. [PMID: 38262000 PMCID: PMC10810652 DOI: 10.1080/17482631.2024.2306658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 01/14/2024] [Indexed: 01/25/2024] Open
Abstract
PURPOSE This study aimed to develop knowledge of how the follow-up regarding overweight and obesity among children in primary school is experienced by the PHN and how the guidelines may be used to improve health services in this follow-up. METHODS We analysed semi-structured interviews of 9 PHNs using qualitative content analysis. RESULTS Two themes emerged: Following up with children with overweight and obesity is an important but challenging duty; The PHNs call for clearer guidelines. Following five sub-themes: PHNs strive to adhere to the guidelines, show compassion in the follow-up, have difficulty handling parents' feelings and reactions, feel alone with the responsibility, and have suggestions for clearer guidelines. CONCLUSIONS PHNs call for enough resources to communicate the results of the child's weight in a sufficient form. PHNs and families should establish common goals. The PHN should avoid one-way communication but meet the parents' concerns and needs. This requires the PHN to focus on building a secure relation to the child and the families, as described by Peplau. Guidelines must include instructions and tools on how to communicate and meet the family's concerns. Political action and increased funding could strengthen the follow-up and thereby prevent more obesity among children, which can be a predictor of poorer health outcomes later in life.
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Affiliation(s)
- Hanna Skjelbred Nygaard
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Kirsten Gudbjørg Øen
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
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Gordon K, Matthews A, Zeller MH, Lin J. Practical guidelines for eating disorder risk mitigation in patients undergoing obesity treatment for the pediatric provider. Curr Opin Pediatr 2024; 36:367-374. [PMID: 38655793 DOI: 10.1097/mop.0000000000001356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
PURPOSE OF REVIEW Pediatric obesity is a growing concern globally. Patients with a history of overweight/obesity often experience stigmatization, especially in the healthcare setting, and are at increased risk of developing psychological comorbidities including eating disorders. This review appraises the most recent studies evaluating eating disorder risk in youth undergoing treatment for obesity, identifies gaps in the literature, and offers practical guidelines to pediatric providers regarding the management of this population. RECENT FINDINGS Recent studies suggest that structured weight management programs may decrease the risk of and/or improve symptoms of certain eating disorders such as binge eating disorder and bulimia nervosa. There is a paucity of research on some components of obesity management such as obesity pharmacotherapeutics and eating disorder risk. SUMMARY Children and adolescents with obesity are a psychologically vulnerable population with increased risk for the development of eating disorders. Further study is needed to evaluate general risk in the setting of specialized and primary care obesity interventions and develop appropriate screening and mitigation tools. Some evidence-based strategies can aid pediatric providers in both weight management and eating disorder prevention and risk assessment.
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Affiliation(s)
- Katelyn Gordon
- Division of Adolescent Medicine, Cincinnati Children's Hospital Medical Center
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Abigail Matthews
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota
| | - Meg H Zeller
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
- Department of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Jessica Lin
- Division of Adolescent Medicine, Cincinnati Children's Hospital Medical Center
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
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Voils CI, Shaw RJ, Gavin KL, Hetzel SJ, Lewis MA, Pabich S, Johnson HM, Elwert F, Mao L, Gray KE, Yuroff A, Garza K, Yancy WS, Porter LS. Outcomes from Partner2Lose: a randomized controlled trial to evaluate 24-month weight loss in a partner-assisted intervention. BMC Public Health 2024; 24:1948. [PMID: 39033273 PMCID: PMC11265014 DOI: 10.1186/s12889-024-19464-z] [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: 02/29/2024] [Accepted: 07/12/2024] [Indexed: 07/23/2024] Open
Abstract
BACKGROUND Partner support is associated with better weight loss outcomes in observational studies, but randomized trials show mixed results for including partners. Unclear is whether teaching communication skills to couples will improve weight loss in a person attempting weight loss (index participant). PURPOSE To compare the efficacy of a partner-assisted intervention versus participant-only weight management program on 24-month weight loss. METHODS This community-based study took place in Madison, WI. Index participants were eligible if they met obesity guideline criteria to receive weight loss counseling, were aged 18-74 years, lived with a partner, and had no medical contraindications to weight loss; partners were aged 18-74 years and not underweight. Couples were randomized 1:1 to a partner-assisted or participant-only intervention. Index participants in both arms received an evidence-based weight management program. In the partner-assisted arm, partners attended half of the intervention sessions, and couples were trained in communication skills. The primary outcome was index participant weight at 24 months, assessed by masked personnel; secondary outcomes were 24-month self-reported caloric intake and average daily steps assessed by an activity tracker. General linear mixed models were used to compare group differences in these outcomes following intent-to-treat principles. RESULTS Among couples assigned to partner-assisted (n = 115) or participant-only intervention (n = 116), most index participants identified as female (67%) and non-Hispanic White (87%). Average baseline age was 47.27 years (SD 11.51 years) and weight was 106.55 kg (SD 19.41 kg). The estimated mean 24-month weight loss was similar in the partner-assisted (2.66 kg) and participant-only arms (2.89 kg) (estimated mean difference, 0.23 kg [95% CI, -1.58, 2.04 kg], p=0.80). There were no differences in 24-month average daily caloric intake (estimated mean difference 50 cal [95% CI: -233, 132 cal], p=0.59) or steps (estimated mean difference 806 steps [95% CI: -1675, 64 steps], p=0.07). The percentage of participants reporting an adverse event with at least possible attribution to the intervention did not differ by arm (partner-assisted: 9%, participant-only, 3%, p = 0.11). CONCLUSIONS Partner-assisted and individual weight management interventions led to similar outcomes in index participants. TRIAL REGISTRATION Clinicaltrials.gov NCT03801174, January 11, 2019.
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Affiliation(s)
- Corrine I Voils
- Department of Surgery, University of Wisconsin-Madison School of Medicine & Public Health, 600 Highland Ave, K6/100 CSC, Madison, WI, 53792-1690, USA.
- William S Middleton Memorial Veterans Hospital, 2500 Overlook Terrace (151), Madison, WI, 53705, USA.
| | - Ryan J Shaw
- Duke University School of Nursing, 307 Trent Dr, Durham, NC27710, , DUMC 3322, USA
| | - Kara L Gavin
- Medical College of Wisconsin Center for Advancing Population Sciences, 8701 Watertown Plank Rd, Milwaukee, WI, 53226, USA
| | - Scott J Hetzel
- Department of Biostatistics and Medical Informatics, University of Wisconsin - Madison, School of Medicine and Public Health, 207G WARF 610 Walnut St., Madison, WI, 53726, USA
| | - Megan A Lewis
- RTI International, 3040 East Cornwallis Rd., Research Triangle Park, P.O. Box 12194, NC, 27709-2194, USA
| | - Samantha Pabich
- School of Medicine and Public Health, Department of Medicine, University of Wisconsin - Madison, 451 1685 Highland Ave, Madison, WI, 4144, USA
| | - Heather M Johnson
- Baptist Health South Florida/Charles E. Schmidt College of Medicine, Florida Atlantic University, 690 Meadows Road, Boca Raton, FL, 33486, USA
| | - Felix Elwert
- Department of Sociology, Department of Biostatistics and Medical Informatics, Department of Population Health Sciences, University of Wisconsin-Madison, 1800 Observatory Dr, Madison, WI, 53706, USA
| | - Lu Mao
- Department of Biostatistics and Medical Informatics, University of Wisconsin School of Medicine and Public Health, 207A WARF 610 Walnut St., Madison, WI, 53726, USA
| | - Kristen E Gray
- VA Puget Sound Health Care System, Health Services Research & Development, 1660 S. Columbian Way, Seattle, WA98108, S-152, USA
- Department of Health Systems and Population Health, University of Washington, 3980 15 Ave NE, Box 351621, Seattle, WA, 98195, USA
| | - Alice Yuroff
- University of Wisconsin-Madison School of Medicine & Public Health, Wisconsin Research and Education Network, 610 Whitney Way Suite 200, Madison, WI, 53705, USA
| | - Katya Garza
- Department of Surgery, University of Wisconsin-Madison School of Medicine & Public Health, 600 Highland Ave, K6/100 CSC, Madison, WI, 53792-1690, USA
| | - William S Yancy
- Department of Medicine, Duke University School of Medicine, 501 Douglas Street, Durham, NC, 27705, USA
| | - Laura S Porter
- Department of Psychiatry & Behavioral Sciences, Duke School of Medicine, Durham, NC, 27710, USA
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Smith KE, Goldschmidt AB. Treatment of Binge-Eating Disorder Across the Lifespan: An Updated Review of the Literature and Considerations for Future Research. Curr Obes Rep 2024; 13:195-202. [PMID: 38363468 PMCID: PMC11150297 DOI: 10.1007/s13679-024-00553-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/08/2024] [Indexed: 02/17/2024]
Abstract
PURPOSE OF REVIEW The present review describes the recent literature on treatment for binge-eating disorder (BED) in adults and youth, with a particular focus on research gaps, emerging treatments, and future research directions. RECENT FINDINGS Evidence supports the efficacy of several treatment modalities in adults, including self-help treatment, clinician-led psychotherapy, and pharmacotherapy; the largest effect sizes have been found for psychotherapies, most of which were cognitive-behavioral in orientation. Adapted psychotherapies for youth also show promise but lack a robust body of evidence. Predictors, moderators, and mediators of treatment outcome remain poorly understood; individuals with BED continue to experience significant barriers to treatment; and research is needed to address suboptimal treatment response. Recent work has highlighted the potential of adaptive interventions and investigation of novel mechanisms to address these gaps. Research on BED treatment continues to grow, though critical questions must be answered to improve treatment efficacy across the lifespan.
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Affiliation(s)
- Kathryn E Smith
- Department of Psychiatry and Behavioral Sciences, University of Southern California, 2250 Alcazar St #2200, Los Angeles, CA, 90033, USA.
| | - Andrea B Goldschmidt
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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Lister NB, Baur LA, Paxton SJ, Garnett SP, Ahern AL, Wilfley DE, Maguire S, Sainsbury A, Steinbeck K, Braet C, Hill AJ, Nicholls D, Jones RA, Dammery G, Grunseit A, Cooper K, Kyle TK, Heeren FA, Hunter KE, McMaster CM, Johnson BJ, Seidler AL, Jebeile H. Eating Disorders In weight-related Therapy (EDIT) Collaboration: rationale and study design. Nutr Res Rev 2024; 37:32-42. [PMID: 36788665 PMCID: PMC7615933 DOI: 10.1017/s0954422423000045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
The cornerstone of obesity treatment is behavioural weight management, resulting in significant improvements in cardio-metabolic and psychosocial health. However, there is ongoing concern that dietary interventions used for weight management may precipitate the development of eating disorders. Systematic reviews demonstrate that, while for most participants medically supervised obesity treatment improves risk scores related to eating disorders, a subset of people who undergo obesity treatment may have poor outcomes for eating disorders. This review summarises the background and rationale for the formation of the Eating Disorders In weight-related Therapy (EDIT) Collaboration. The EDIT Collaboration will explore the complex risk factor interactions that precede changes to eating disorder risk following weight management. In this review, we also outline the programme of work and design of studies for the EDIT Collaboration, including expected knowledge gains. The EDIT studies explore risk factors and the interactions between them using individual-level data from international weight management trials. Combining all available data on eating disorder risk from weight management trials will allow sufficient sample size to interrogate our hypothesis: that individuals undertaking weight management interventions will vary in their eating disorder risk profile, on the basis of personal characteristics and intervention strategies available to them. The collaboration includes the integration of health consumers in project development and translation. An important knowledge gain from this project is a comprehensive understanding of the impact of weight management interventions on eating disorder risk.
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Affiliation(s)
- Natalie B Lister
- Children's Hospital Westmead Clinical School, The University of Sydney, Westmead, New South Wales2145, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, New South Wales2145, Australia
| | - Louise A Baur
- Children's Hospital Westmead Clinical School, The University of Sydney, Westmead, New South Wales2145, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, New South Wales2145, Australia
| | - Susan J Paxton
- School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Sarah P Garnett
- Children's Hospital Westmead Clinical School, The University of Sydney, Westmead, New South Wales2145, Australia
- Kids Research, Sydney Children's Hospital Network, Westmead, New South Wales2145, Australia
| | - Amy L Ahern
- MRC Epidemiology Unit, University of Cambridge, Cambridge, CB2 0QQ, UK
| | - Denise E Wilfley
- School of Medicine, Washington University in St. Louis, St. Louis, USA
| | - Sarah Maguire
- InsideOut Institute for Eating Disorders, Boden Collaboration for Obesity, Nutrition and Eating Disorders, Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Amanda Sainsbury
- School of Human Sciences, The University of Western Australia, Crawley, Western Australia, Australia
| | - Katharine Steinbeck
- Children's Hospital Westmead Clinical School, The University of Sydney, Westmead, New South Wales2145, Australia
- The Academic Department of Adolescent Medicine, The Children's Hospital at Westmead, Westmead, New South Wales2145, Australia
| | - Caroline Braet
- Department of Developmental, Personality and Social Psychology, Ghent University, Henri Dunantlaan 2, 9000 Ghent, Belgium
| | - Andrew J Hill
- Leeds Institute of Health Sciences, University of Leeds, UK
| | - Dasha Nicholls
- Division of Psychiatry, Imperial College London, 2nd Floor, Commonwealth Building, Du Cane Road, London, W12 0NN, UK
| | - Rebecca A Jones
- MRC Epidemiology Unit, University of Cambridge, Cambridge, CB2 0QQ, UK
| | - Genevieve Dammery
- InsideOut Institute for Eating Disorders, Boden Collaboration for Obesity, Nutrition and Eating Disorders, Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Alicia Grunseit
- The Children's Hospital at Westmead, Nutrition and Dietetics, Weight Management Services, Westmead, New South Wales, NSW 2145, Australia
| | | | | | - Faith A Heeren
- Department of Health Outcomes and Biomedical Informatics, University of Florida College of Medicine, Gainesville, Florida, USA
| | - Kylie E Hunter
- National Health and Medical Research Council Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Caitlin M McMaster
- Children's Hospital Westmead Clinical School, The University of Sydney, Westmead, New South Wales2145, Australia
| | - Brittany J Johnson
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia5042, Australia
| | - Anna Lene Seidler
- National Health and Medical Research Council Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Hiba Jebeile
- Children's Hospital Westmead Clinical School, The University of Sydney, Westmead, New South Wales2145, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, New South Wales2145, Australia
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Brewerton TD, Dennis K, Wiss DA. Dismantling the myth of "all foods fit" in eating disorder treatment. J Eat Disord 2024; 12:60. [PMID: 38760858 PMCID: PMC11102136 DOI: 10.1186/s40337-024-01017-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Accepted: 05/09/2024] [Indexed: 05/19/2024] Open
Abstract
We call for a reevaluation of the long-standing dogmatic nutritional principle that "all foods fit" for all cases of eating disorders (EDs) and its corollary, "there are no bad foods" (for anyone ever) during ED treatment. Based on accumulated scientific research, we challenge these ideologies as outdated, confusing, and potentially harmful to many patients. We review the evidence that indicates the folly of these assumptions and show there are a variety of exceptions to these rules, including (1) food allergies, sensitivities, and intolerances, (2) religious and spiritual preferences or doctrines, and (3) the ubiquitous emergence and widespread availability of ultra-processed foods leading to the potential development of addiction-like eating and a higher prevalence of various medical and psychiatric comorbidities, as well as higher mortality. This evidence supports a nutritional psychiatry approach that should be integrated into (rather than dissociated from) ED treatment research and practice.
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Affiliation(s)
- Timothy D Brewerton
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA.
| | - Kim Dennis
- SunCloud Health, Chicago, IL, USA
- Department of Psychiatry, University of Illinois Chicago College of Medicine, Chicago, IL, USA
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Jakobsen DD, Järvholm K, Brader L, Bruun JM. Long-term changes in eating-related problems and quality of life in children with overweight and obesity attending a 10-week lifestyle camp. Obes Res Clin Pract 2024; 18:209-215. [PMID: 38705820 DOI: 10.1016/j.orcp.2024.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 04/09/2024] [Accepted: 04/23/2024] [Indexed: 05/07/2024]
Abstract
BACKGROUND Eating-related problems (e.g., binge eating (BE)) and impaired quality of life (QoL) is more prevalent in children with overweight and obesity. This study aimed to investigate changes in self-reported overeating (OE), BE, and QoL in children with overweight or obesity attending multicomponent 10-week lifestyle camps with a 52-weeks follow-up. Additionally, the study sought to investigate whether self-reported OE/BE before camp was associated with changes in QoL. METHODS Children aged 7 to 14-years could attend camp if they had overweight/obesity, were lonely, unhappy, or had social or family-related problems. In this study only children with overweight and obesity were included (n:185). OE, BE, and QoL were measured using self-reported questionnaires. RESULTS In total, 38 % of the children reported regular BE at baseline. Regular OE, occasional BE, and occasional OE was reported by 14 %, 13 %, and 11 %, respectively, while 24 % reported no eating-related problems. The relative risk of experiencing eating-related problems decreased at 10-weeks compared to baseline. Additionally, the probability of regular OE (RR 0.12 (95 % CI 0.04;0.38) (X2 = 8.44, p = 0.004)) and regular BE (RR 0.01 (95 % CI 0.00;0.11) (X2 = 9.91, p = 0.002)) remained lower at 52-weeks relative to baseline. All QoL dimensions improved after camp, and the presence of self-reported OE and regular BE at baseline was significantly associated with lower QoL at baseline, 10 and 52-weeks. CONCLUSION Children self-reporting OE and BE may be a particular vulnerable group that needs more support from camp staff and healthcare professionals to improve QoL. CLINICAL TRIAL REGISTRATION clinicaltrials.gov with ID: NCT04522921.
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Affiliation(s)
- Dorthe Dalstrup Jakobsen
- Steno Diabetes Center Aarhus, Aarhus University Hospital, 8200 Aarhus N., Denmark; Department of Clinical Medicine, Aarhus University, 8200 Aarhus N., Denmark; Danish National Center for Obesity, 8200 Aarhus N., Denmark.
| | - Kajsa Järvholm
- Department of Psychology, Lund University, 223 62 Lund, Sweden
| | - Lea Brader
- Global Nutrition, Arla Foods amba, 8200 Aarhus N., Denmark
| | - Jens Meldgaard Bruun
- Steno Diabetes Center Aarhus, Aarhus University Hospital, 8200 Aarhus N., Denmark; Department of Clinical Medicine, Aarhus University, 8200 Aarhus N., Denmark; Danish National Center for Obesity, 8200 Aarhus N., Denmark
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Ezpeleta M, Cienfuegos S, Lin S, Pavlou V, Gabel K, Tussing-Humphreys L, Varady KA. Time-restricted eating: Watching the clock to treat obesity. Cell Metab 2024; 36:301-314. [PMID: 38176412 PMCID: PMC11221496 DOI: 10.1016/j.cmet.2023.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 10/04/2023] [Accepted: 12/04/2023] [Indexed: 01/06/2024]
Abstract
Time-restricted eating (TRE) has become a popular strategy to treat obesity. TRE involves confining the eating window to 4-10 h per day and fasting for the remaining hours (14-20 h fast). During the eating window, individuals are not required to monitor food intake. The sudden rise in popularity of TRE is most likely due to its simplicity and the fact that it does not require individuals to count calories to lose weight. This feature of TRE may appeal to certain individuals with obesity, and this could help produce lasting metabolic health improvements. The purpose of this review is to summarize current evidence from randomized clinical trials of TRE (without calorie counting) on body weight and metabolic risk factors. The efficacy of TRE in various populations groups, including those with obesity, type 2 diabetes (T2DM), and polycystic ovary syndrome (PCOS), is also examined.
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Affiliation(s)
- Mark Ezpeleta
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL, USA
| | - Sofia Cienfuegos
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL, USA
| | - Shuhao Lin
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL, USA
| | - Vasiliki Pavlou
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL, USA
| | - Kelsey Gabel
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL, USA; University of Illinois Cancer Center, University of Illinois at Chicago, Chicago, IL, USA
| | - Lisa Tussing-Humphreys
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL, USA; University of Illinois Cancer Center, University of Illinois at Chicago, Chicago, IL, USA
| | - Krista A Varady
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL, USA; University of Illinois Cancer Center, University of Illinois at Chicago, Chicago, IL, USA.
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Chatzidaki E, Chioti V, Mourtou L, Papavasileiou G, Kitani RA, Kalafatis E, Mitsis K, Athanasiou M, Zarkogianni K, Nikita K, Kanaka-Gantenbein C, Pervanidou P. Parenting Styles and Psychosocial Factors of Mother-Child Dyads Participating in the ENDORSE Digital Weight Management Program for Children and Adolescents during the COVID-19 Pandemic. CHILDREN (BASEL, SWITZERLAND) 2024; 11:107. [PMID: 38255420 PMCID: PMC10814028 DOI: 10.3390/children11010107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 01/08/2024] [Accepted: 01/11/2024] [Indexed: 01/24/2024]
Abstract
Childhood obesity is a complex disease with multiple biological and psychosocial risk factors. Recently, novel digital programs were developed with growing evidence for their effectiveness in pediatric weight management studies. The ENDORSE platform consists of mobile applications, wearables, and serious games for the remote management of childhood obesity. The pilot studies included 50 mothers and their children aged 6-14 years and resulted in a clinically significant BMI z-score reduction over 4 to 5 months. This secondary analysis of the ENDORSE study focuses on parenting styles and psychosocial factors. METHODOLOGY Semi-structured clinical interviews were conducted with all participating mothers pre-and post-intervention. The Parenting Styles and Dimensions Questionnaire (PSDQ) evaluated the mothers' parenting styles. The psychosocial functioning of the participating children was assessed with the parental version of the Strengths and Difficulties Questionnaire (SDQ). The relationship between parenting styles, psychosocial parameters, and weight outcomes was investigated using a linear regression analysis. RESULTS Weight-related stigma at school (56%), body image concerns (66%), and difficulties in family relationships (48%) were the main concerns documented during the initial psychological interviews. According to the SDQ, there was a significant decrease in children's conduct problems during the study's initial phase (pre-pilot group). A decrease in maternal demandingness (i.e., strict parenting style) was associated with a decrease in BMI z-score (beta coefficient = 0.314, p-value = 0.003). CONCLUSION Decreasing parental demandingness was associated with better weight outcomes, highlighting the importance of assessing parenting factors in pediatric weight management programs.
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Affiliation(s)
- Evi Chatzidaki
- First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, Aghia Sophia Children’s Hospital, 11527 Athens, Greece; (E.C.); (V.C.); (C.K.-G.)
| | - Vassiliki Chioti
- First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, Aghia Sophia Children’s Hospital, 11527 Athens, Greece; (E.C.); (V.C.); (C.K.-G.)
| | - Lidia Mourtou
- Postgraduate Course on “The Science of Stress and Health Promotion”, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (L.M.); (G.P.); (R.-A.K.)
| | - Georgia Papavasileiou
- Postgraduate Course on “The Science of Stress and Health Promotion”, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (L.M.); (G.P.); (R.-A.K.)
| | - Rosa-Anna Kitani
- Postgraduate Course on “The Science of Stress and Health Promotion”, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (L.M.); (G.P.); (R.-A.K.)
| | - Eleftherios Kalafatis
- School of Electrical and Computer Engineering, National Technical University of Athens, 15780 Athens, Greece; (E.K.); (K.M.); (M.A.); (K.Z.); (K.N.)
| | - Kostas Mitsis
- School of Electrical and Computer Engineering, National Technical University of Athens, 15780 Athens, Greece; (E.K.); (K.M.); (M.A.); (K.Z.); (K.N.)
| | - Maria Athanasiou
- School of Electrical and Computer Engineering, National Technical University of Athens, 15780 Athens, Greece; (E.K.); (K.M.); (M.A.); (K.Z.); (K.N.)
| | - Konstantia Zarkogianni
- School of Electrical and Computer Engineering, National Technical University of Athens, 15780 Athens, Greece; (E.K.); (K.M.); (M.A.); (K.Z.); (K.N.)
- Department of Advanced Computing Sciences, Faculty of Sciences and Engineering, Maastricht University, 6200 MD Maastricht, The Netherlands
| | - Konstantina Nikita
- School of Electrical and Computer Engineering, National Technical University of Athens, 15780 Athens, Greece; (E.K.); (K.M.); (M.A.); (K.Z.); (K.N.)
| | - Christina Kanaka-Gantenbein
- First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, Aghia Sophia Children’s Hospital, 11527 Athens, Greece; (E.C.); (V.C.); (C.K.-G.)
- Postgraduate Course on “The Science of Stress and Health Promotion”, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (L.M.); (G.P.); (R.-A.K.)
| | - Panagiota Pervanidou
- First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, Aghia Sophia Children’s Hospital, 11527 Athens, Greece; (E.C.); (V.C.); (C.K.-G.)
- Postgraduate Course on “The Science of Stress and Health Promotion”, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (L.M.); (G.P.); (R.-A.K.)
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10
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Newson L, Abayomi J. Reframing interventions for optimal child nutrition and childhood obesity: the importance of considering psychological factors. Proc Nutr Soc 2024:1-12. [PMID: 38205619 DOI: 10.1017/s0029665124000028] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2024]
Abstract
This review aims to emphasise the impact of poor nutrition on children's health and psychological well-being, urging those involved in childhood obesity or nutrition services to broaden their intervention approach. Poor nutrition and childhood obesity affect physical and psychological health. The stress of living with obesity further impacts quality of life, well-being and self-esteem. Children living with obesity may experience adverse childhood events and stress, and young people are able to recall the impact of psychosocial issues such as experiencing stigma and discrimination. Food is often a coping mechanism for managing negative emotions, perpetuating cycles of emotional coping and unhealthy eating behaviours. UK guidelines recommend family-based, multi-component weight management interventions for children living with obesity. Interventions mainly target health behaviours and utilise behaviour change techniques attempting to directly improve diet and physical activity as behavioural outcomes. Whilst these interventions may show some improvements in psychological well-being, there is limited consideration or understanding of the underlying mechanisms of action which indirectly influence engagement and the sustainability of the behaviour change. Lack of attention and inclusion of psychosocial variables in intervention implementation may help explain the variable effectiveness reported across childhood obesity interventions. In conclusion, enhancing the effectiveness of childhood obesity interventions requires a broader approach that fully incorporates psychosocial factors. Those responsible for commissioning, designing and implementing these interventions should adopt a holistic approach that addresses psychological and emotional needs while incorporating underlying mechanisms of action. This shift in focus could result in more sustainable and comprehensive treatment for childhood obesity.
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Affiliation(s)
- Lisa Newson
- School of Psychology, Research Centre for Brain and Behaviour, Faculty of Health, Liverpool John Moores University, Liverpool, UK
- Liverpool Centre for Cardiovascular Science, Liverpool, UK
| | - Julie Abayomi
- Faculty of Health, Social Care and Medicine, Edgehill University, Liverpool, UK
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11
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Weinstock M, Thornton LM, Raynor HA, Mazzeo SE, LaRose JG, Caccavale LJ, Tatum KL, Bean MK. Parent involvement approach and changes in eating pathology within an adolescent obesity intervention. Eat Behav 2023; 51:101807. [PMID: 37659210 PMCID: PMC10840818 DOI: 10.1016/j.eatbeh.2023.101807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 07/24/2023] [Accepted: 08/28/2023] [Indexed: 09/04/2023]
Abstract
BACKGROUND Although adolescents with obesity have heightened risk for eating pathology, the impact of differential parent involvement on eating pathology after obesity treatment is unknown. We examined differences in eating pathology in adolescents whose parents were randomized to distinct interventions within adolescent obesity treatment. METHODS Participants were 82 adolescent/parent dyads (adolescents: 63 % female; 55 % racial/ethnically marginalized) enrolled in TEENS+, a 4-month behavioral weight loss intervention. Parents were randomized to either a parent weight loss treatment (TEENS+PWL) or parent skills training (TEENS+PAC). Adolescents completed the Eating Disorder Examination-Questionnaire with Instructions (EDE-Q-I) and Child Depression Inventory (CDI) at baseline, 4 m, and 7 m. Group differences in eating pathology (global score; eating concern, weight concern, shape concern, restraint) and depression across time points were evaluated with linear mixed models. RESULTS No significant differences were observed between TEENS+PAC and TEENS+PWL in eating pathology or depression, nor were there group by time interactions. Time point differences were observed for all EDE-Q-I and CDI outcomes, except eating concerns; pairwise contrasts revealed a variety of change patterns. Weight and shape concerns decreased from 0 to 4 m; observed reductions were maintained at 7 m. Restraint was highest at 4 m and decreased at 7 m but did not return to baseline. EDE-Q-I global scores significantly declined over time. Depression decreased over time, but a significant difference was only observed between 0 and 7 m. CONCLUSIONS Neither parent intervention yields harm related to eating pathology in adolescents engaged in obesity treatment. Obesity treatment does not appear to have iatrogenic effects on eating pathology in adolescents.
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Affiliation(s)
- Madison Weinstock
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Laura M Thornton
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Hollie A Raynor
- Department of Nutrition, University of Tennessee, Knoxville, TN, USA
| | - Suzanne E Mazzeo
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA; Department of Pediatrics, School of Medicine, Children's Hospital of Richmond at Virginia Commonwealth University, Richmond, VA, USA
| | - Jessica Gokee LaRose
- Department of Health and Behavior Policy, School of Medicine, Virginia Commonwealth University, Richmond, USA
| | - Laura J Caccavale
- Department of Pediatrics, School of Medicine, Children's Hospital of Richmond at Virginia Commonwealth University, Richmond, VA, USA
| | - Kristina L Tatum
- Department of Pediatrics, School of Medicine, Children's Hospital of Richmond at Virginia Commonwealth University, Richmond, VA, USA
| | - Melanie K Bean
- Department of Pediatrics, School of Medicine, Children's Hospital of Richmond at Virginia Commonwealth University, Richmond, VA, USA.
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12
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Skelton JA, Vitolins M, Pratt KJ, DeWitt LH, Eagleton SG, Brown C. Rethinking family-based obesity treatment. Clin Obes 2023; 13:e12614. [PMID: 37532265 DOI: 10.1111/cob.12614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 06/08/2023] [Accepted: 07/17/2023] [Indexed: 08/04/2023]
Abstract
Emerging research in paediatric obesity has demonstrated that parental involvement in the weight management process can improve weight outcomes in children. Recent guidelines by the American Academy of Pediatrics note the importance of parent and family involvement in treatment. However, it is currently unknown if including the entire family in obesity treatment can supersede outcomes associated with participation of only one parent. Family Systems Theory (FST) provides the theoretical foundation for examining one's healthy behaviours as they exist within the context of their family, defined by family dynamics. This narrative review aims to reconsider prior definitions of paediatric family-based management using the FST framework to be inclusive of family and household diversity and in doing so, inform research not only within weight management but also other domains of clinical care requiring family support or change. Applying FST to paediatric weight management highlights the link between family dynamics and paediatric obesity, demonstrating the association of dysfunctional family dynamics with more severe obesity. While family-based weight management remains the gold standard for treatment of paediatric obesity, more investigation is needed in expanding family-based interventions to impact entire families and potentially improve outcomes more broadly for overall family health and wellbeing.
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Affiliation(s)
- Joseph A Skelton
- Department of Pediatrics, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
- Center for Prevention Science in Child and Family Health, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
- Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Mara Vitolins
- Center for Prevention Science in Child and Family Health, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
- Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Keeley J Pratt
- Department of Human Sciences, Human Development & Family Science Program, College of Education and Human Ecology, The Ohio State University, Columbus, Ohio, USA
- Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Leila Hamzi DeWitt
- Department of Pediatrics, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
- Center for Prevention Science in Child and Family Health, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Sally G Eagleton
- Center for Prevention Science in Child and Family Health, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
- Clinical and Translational Science Institute, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Callie Brown
- Department of Pediatrics, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
- Center for Prevention Science in Child and Family Health, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
- Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
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13
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Gerges S, Obeid S, Malaeb D, Sarray El Dine A, Hallit R, Soufia M, Fekih-Romdhane F, Hallit S. Validation of an Arabic version of the eating disorder inventory's body dissatisfaction subscale among adolescents, adults, and pregnant women. J Eat Disord 2023; 11:187. [PMID: 37858280 PMCID: PMC10588257 DOI: 10.1186/s40337-023-00911-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 10/12/2023] [Indexed: 10/21/2023] Open
Abstract
INTRODUCTION The 9-item Body Dissatisfaction Subscale (BDS) of the Eating Disorder Inventory is one of the most used tools for assessing thinness-oriented body dissatisfaction in research and clinical practice. However, no validated Arabic version of this scale exists to date. In this study, we sought to validate this instrument in three samples of native Arabic-speaking adolescents, adults, and pregnant women from Lebanon. METHODS A total of 826 adults, 555 adolescents, and 433 pregnant women were included. To examine the factor structure of the BDS, we performed an exploratory factor analysis (EFA), using a principal component analysis via the FACTOR software on the first split-half subsample among Lebanese adults. We used data from the second split-half in the adult sample to conduct a Confirmatory Factor Analysis (CFA) through the SPSS AMOS v.29 software. That verified model was tested via CFA on adolescents and pregnant women. RESULTS The EFA showed a bidimensional structure for the BDS, with all 9 items retained and divided into Factor 1 = Body Satisfaction (negatively-worded items) and Factor 2 = Body Dissatisfaction (positively-worded items). The CFA demonstrated invariable goodness-of-fit of the instrument in the three studied populations. McDonald's omega values were also adequate in the three samples, demonstrating its reliability. Moreover, the BDS showed invariance across sex among both adolescents and adults. Finally, higher BDS scores were correlated with more disordered eating, less body appreciation and less functionality appreciation, thus attesting to convergent validity of the scale. In addition, BDS scores correlated positively with depression and anxiety scores, indicating adequate patterns of divergent validity. CONCLUSION In light of our findings, we endorse the use of the BDS by healthcare professionals in Arabic-speaking countries, in order to assess thinness-oriented body dissatisfaction in an appropriate and timely manner and ease early referral to a specialist, thereby preventing the deleterious health-related risks associated with this condition.
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Affiliation(s)
- Sarah Gerges
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
| | - Sahar Obeid
- Department of Social and Education Sciences, School of Arts and Sciences, Lebanese American University, Byblos, Lebanon.
| | - Diana Malaeb
- College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates
| | - Abir Sarray El Dine
- Department of Biomedical Sciences, School of Arts and Sciences, Lebanese International University, Beirut, Lebanon
| | - Rabih Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
- Department of Infectious Disease, Bellevue Medical Center, Mansourieh, Lebanon
- Department of Infectious Disease, Notre Dame Des Secours, University Hospital Center, Byblos, Lebanon
| | - Michel Soufia
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
| | - Feten Fekih-Romdhane
- The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry "Ibn Omrane", Razi Hospital, 2010, Manouba, Tunisia
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon.
- Applied Science Research Center, Applied Science Private University, Amman, 11931, Jordan.
- Research Department, Psychiatric Hospital of the Cross, P.O. Box 60096, Jal Eddib, Lebanon.
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14
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Garcia-Beltran C, Malpique R, Andersen MS, Bas F, Bassols J, Darendeliler F, Díaz M, Dieris B, Fanelli F, Fröhlich-Reiterer E, Gambineri A, Glintborg D, López-Bermejo A, Mann C, Marin S, Obermayer-Pietsch B, Ødegård R, Ravn P, Reinehr T, Renzulli M, Salvador C, Singer V, Vanky E, Torres JV, Yildiz M, de Zegher F, Ibáñez L. SPIOMET4HEALTH-efficacy, tolerability and safety of lifestyle intervention plus a fixed dose combination of spironolactone, pioglitazone and metformin (SPIOMET) for adolescent girls and young women with polycystic ovary syndrome: study protocol for a multicentre, randomised, double-blind, placebo-controlled, four-arm, parallel-group, phase II clinical trial. Trials 2023; 24:589. [PMID: 37715279 PMCID: PMC10503102 DOI: 10.1186/s13063-023-07593-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 08/17/2023] [Indexed: 09/17/2023] Open
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is the most prevalent, chronic endocrine-metabolic disorder of adolescents and young women (AYAs), affecting 5-10% of AYAs worldwide. There is no approved pharmacological therapy for PCOS. Standard off-label treatment with oral contraceptives (OCs) reverts neither the underlying pathophysiology nor the associated co-morbidities. Pilot studies have generated new insights into the pathogenesis of PCOS, leading to the development of a new treatment consisting of a fixed, low-dose combination of two so-called insulin sensitisers [pioglitazone (PIO), metformin (MET)] and one mixed anti-androgen and anti-mineralocorticoid also acting as an activator of brown adipose tissue [spironolactone (SPI)], within a single tablet (SPIOMET). The present trial will evaluate the efficacy, tolerability and safety of SPIOMET, on top of lifestyle measures, for the treatment of PCOS in AYAs. METHODS In this multicentre, randomised, double-blind, placebo-controlled, four-arm, parallel-group, phase II clinical trial, AYAs with PCOS will be recruited from 7 clinical centres across Europe. Intention is to randomise a total of 364 eligible patients into four arms (1:1:1:1): Placebo, PIO, SPI + PIO (SPIO) and SPI + PIO + MET (SPIOMET). Active treatment over 12 months will consist of lifestyle guidance plus the ingestion of one tablet daily (at dinner time); post-treatment follow-up will span 6 months. Primary endpoint is on- and post-treatment ovulation rate. Secondary endpoints are clinical features (hirsutism, menstrual regularity); endocrine-metabolic variables (androgens, lipids, insulin, inflammatory markers); epigenetic markers; imaging data (carotid intima-media thickness, body composition, abdominal fat partitioning, hepatic fat); safety profile; adherence, tolerability and acceptability of the medication; and quality of life in the study participants. Superiority (in this order) of SPIOMET, SPIO and PIO will be tested over placebo, and if present, subsequently the superiority of SPIOMET versus PIO, and if still present, finally versus SPIO. DISCUSSION The present study will be the first to evaluate-in a randomised, double-blind, placebo-controlled way-the efficacy, tolerability and safety of SPIOMET treatment for early PCOS, on top of a lifestyle intervention. TRIAL REGISTRATION EudraCT 2021-003177-58. Registered on 22 December 2021. https://www.clinicaltrialsregister.eu/ctr-search/search?query=%092021-003177-58 .
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Affiliation(s)
- Cristina Garcia-Beltran
- Paediatric Endocrinology, Paediatric Research Institute Sant Joan de Déu, University of Barcelona, 08950, Esplugues, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), ISCIII, Madrid, 28029, Spain
| | - Rita Malpique
- Paediatric Endocrinology, Paediatric Research Institute Sant Joan de Déu, University of Barcelona, 08950, Esplugues, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), ISCIII, Madrid, 28029, Spain
| | - Marianne S Andersen
- Department of Gynaecology and Obstetrics and Department of Endocrinology, University of Southern Denmark, Odense University Hospital, Odense, Denmark
| | - Firdevs Bas
- Pediatric Endocrinology Unit, Istanbul University, Istanbul, Turkey
| | - Judit Bassols
- Maternal-Fetal Metabolic Research Group, Girona Institute for Biomedical Research (IDIBGI), Girona, Spain
| | | | - Marta Díaz
- Paediatric Endocrinology, Paediatric Research Institute Sant Joan de Déu, University of Barcelona, 08950, Esplugues, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), ISCIII, Madrid, 28029, Spain
| | - Barbara Dieris
- Department of Paediatric Endocrinology, Diabetes and Nutrition Medicine, Vestische Hospital for Children and Adolescents Datteln, University of Witten-Herdecke, Datteln, Germany
| | - Flaminia Fanelli
- Department of Medical and Surgical Science-DIMEC, Division of Endocrinology and Diabetes Prevention and Care, University of Bologna - S. Orsola-Hospital, Bologna, Italy
| | - Elke Fröhlich-Reiterer
- Division of General Paediatrics, Department of Paediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria
| | - Alessandra Gambineri
- Department of Medical and Surgical Science-DIMEC, Division of Endocrinology and Diabetes Prevention and Care, University of Bologna - S. Orsola-Hospital, Bologna, Italy
| | - Dorte Glintborg
- Department of Gynaecology and Obstetrics and Department of Endocrinology, University of Southern Denmark, Odense University Hospital, Odense, Denmark
| | - Abel López-Bermejo
- Paediatric Endocrinology Research Group, Girona Institute for Biomedical Research (IDIBGI), Paediatrics, Dr. Josep Trueta Hospital, Department of Medical Sciences, University of Girona, Girona, Spain
| | | | - Silvia Marin
- Paediatric Endocrinology, Paediatric Research Institute Sant Joan de Déu, University of Barcelona, 08950, Esplugues, Barcelona, Spain
| | - Barbara Obermayer-Pietsch
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Rønnaug Ødegård
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Centre for Obesity Research, St. Olavs Hospital, Trondheim University Hospital, Torgarden, Trondheim, Norway
| | - Pernille Ravn
- Department of Gynaecology and Obstetrics and Department of Endocrinology, University of Southern Denmark, Odense University Hospital, Odense, Denmark
| | - Thomas Reinehr
- Department of Paediatric Endocrinology, Diabetes and Nutrition Medicine, Vestische Hospital for Children and Adolescents Datteln, University of Witten-Herdecke, Datteln, Germany
| | - Matteo Renzulli
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy
| | - Cristina Salvador
- Paediatric Endocrinology, Paediatric Research Institute Sant Joan de Déu, University of Barcelona, 08950, Esplugues, Barcelona, Spain
| | - Viola Singer
- Department of Paediatric Endocrinology, Diabetes and Nutrition Medicine, Vestische Hospital for Children and Adolescents Datteln, University of Witten-Herdecke, Datteln, Germany
| | - Eszter Vanky
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Obstetrics and Gynaecology, St. Olavs Hospital, Trondheim University Hospital, 7006, Trondheim, Norway
| | | | - Melek Yildiz
- Pediatric Endocrinology Unit, Istanbul University, Istanbul, Turkey
| | - Francis de Zegher
- Leuven Research & Development, University of Leuven, 3000, Louvain, Belgium
| | - Lourdes Ibáñez
- Paediatric Endocrinology, Paediatric Research Institute Sant Joan de Déu, University of Barcelona, 08950, Esplugues, Barcelona, Spain.
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), ISCIII, Madrid, 28029, Spain.
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15
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Hayes JF, LaRose JG, Hutchinson K, Sutherland M, Wing RR. Health, health behaviors, and medical care utilization among college students with obesity. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023:1-7. [PMID: 37437179 PMCID: PMC10784414 DOI: 10.1080/07448481.2023.2225629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 04/27/2023] [Accepted: 06/01/2023] [Indexed: 07/14/2023]
Abstract
Objective: The study assessed perceived health, health behaviors and conditions, and medical care utilization among students of different weight categories. Participants: Participants were college students (n = 37,583) from 58 institutions who responded to a national survey of student health behaviors. Methods: Chi-squared and mixed model analyses were completed. Results: Compared to healthy weight students, those with obesity were less likely to report excellent health and meet dietary and physical activity recommendations, and more likely to have obesity-related chronic conditions and to have attended a medical appointment in the prior 12 months. Students with obesity (84%) and overweight (70%) were more likely to be attempting weight loss compared to students of healthy weight (35%). Conclusions: Students with obesity have poorer health and health behaviors relative to students of healthy weight; students with overweight were in between. Adapting and implementing evidence-based weight management programs within colleges/universities may be beneficial for student health.
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Affiliation(s)
- Jacqueline F. Hayes
- Alpert Medical School of Brown University and The Miriam Hospital, Providence, Rhode Island
| | - Jessica Gokee LaRose
- Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine Richmond, Richmond, Virginia
| | | | - Melissa Sutherland
- College of Nursing, University of Rhode Island, Providence, Rhode Island
| | - Rena R. Wing
- Alpert Medical School of Brown University and The Miriam Hospital, Providence, Rhode Island
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16
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Jebeile H, Lister NB, Libesman S, Hunter KE, McMaster CM, Johnson BJ, Baur LA, Paxton SJ, Garnett SP, Ahern AL, Wilfley DE, Maguire S, Sainsbury A, Steinbeck K, Askie L, Braet C, Hill AJ, Nicholls D, Jones RA, Dammery G, Grunseit AM, Cooper K, Kyle TK, Heeren FA, Quigley F, Barnes RD, Bean MK, Beaulieu K, Bonham M, Boutelle KN, Branco BHM, Calugi S, Cardel MI, Carpenter K, Cheng HL, Dalle Grave R, Danielsen YS, Demarzo M, Dordevic A, Eichen DM, Goldschmidt AB, Hilbert A, Houben K, Lofrano do Prado M, Martin CK, McTiernan A, Mensinger JL, Pacanowski C, do Prado WL, Ramalho SM, Raynor HA, Rieger E, Robinson E, Salvo V, Sherwood NE, Simpson SA, Skjakodegard HF, Smith E, Partridge S, Tanofsky-Kraff M, Taylor RW, Van Eyck A, Varady KA, Vidmar AP, Whitelock V, Yanovski J, Seidler AL. Eating disorders in weight-related therapy (EDIT): Protocol for a systematic review with individual participant data meta-analysis of eating disorder risk in behavioural weight management. PLoS One 2023; 18:e0282401. [PMID: 37428754 PMCID: PMC10332604 DOI: 10.1371/journal.pone.0282401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 02/07/2023] [Indexed: 07/12/2023] Open
Abstract
The Eating Disorders In weight-related Therapy (EDIT) Collaboration brings together data from randomised controlled trials of behavioural weight management interventions to identify individual participant risk factors and intervention strategies that contribute to eating disorder risk. We present a protocol for a systematic review and individual participant data (IPD) meta-analysis which aims to identify participants at risk of developing eating disorders, or related symptoms, during or after weight management interventions conducted in adolescents or adults with overweight or obesity. We systematically searched four databases up to March 2022 and clinical trials registries to May 2022 to identify randomised controlled trials of weight management interventions conducted in adolescents or adults with overweight or obesity that measured eating disorder risk at pre- and post-intervention or follow-up. Authors from eligible trials have been invited to share their deidentified IPD. Two IPD meta-analyses will be conducted. The first IPD meta-analysis aims to examine participant level factors associated with a change in eating disorder scores during and following a weight management intervention. To do this we will examine baseline variables that predict change in eating disorder risk within intervention arms. The second IPD meta-analysis aims to assess whether there are participant level factors that predict whether participation in an intervention is more or less likely than no intervention to lead to a change in eating disorder risk. To do this, we will examine if there are differences in predictors of eating disorder risk between intervention and no-treatment control arms. The primary outcome will be a standardised mean difference in global eating disorder score from baseline to immediately post-intervention and at 6- and 12- months follow-up. Identifying participant level risk factors predicting eating disorder risk will inform screening and monitoring protocols to allow early identification and intervention for those at risk.
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Affiliation(s)
- Hiba Jebeile
- The University of Sydney, Children’s Hospital Westmead Clinical School, Westmead, New South Wales, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Natalie B. Lister
- The University of Sydney, Children’s Hospital Westmead Clinical School, Westmead, New South Wales, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Sol Libesman
- National Health and Medical Research Council Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Kylie E. Hunter
- National Health and Medical Research Council Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Caitlin M. McMaster
- The University of Sydney, Children’s Hospital Westmead Clinical School, Westmead, New South Wales, Australia
| | - Brittany J. Johnson
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Louise A. Baur
- The University of Sydney, Children’s Hospital Westmead Clinical School, Westmead, New South Wales, Australia
- Weight Management Services, The Children’s Hospital at Westmead, Westmead, New South Wales, Australia
| | - Susan J. Paxton
- School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Sarah P. Garnett
- The University of Sydney, Children’s Hospital Westmead Clinical School, Westmead, New South Wales, Australia
- Kids Research, The Children’s Hospital at Westmead, Westmead, New South Wales, Australia
| | - Amy L. Ahern
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Denise E. Wilfley
- Washington University in St. Louis, St Louis, Missouri, United States of America
| | - Sarah Maguire
- InsideOut Institute for Eating Disorders, Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Amanda Sainsbury
- The University of Western Australia, School of Human Sciences, Crawley, Western Australia, Australia
| | - Katharine Steinbeck
- The University of Sydney, Children’s Hospital Westmead Clinical School, Westmead, New South Wales, Australia
- The Academic Department of Adolescent Medicine, The Children’s Hospital at Westmead, Westmead, New South Wales, Australia
| | - Lisa Askie
- National Health and Medical Research Council Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Caroline Braet
- Department of Developmental, Personality and Social Psychology, Ghent University, Henri Dunantlaan, Ghent, Belgium
| | - Andrew J. Hill
- Leeds Institute of Health Sciences, University of Leeds, Leeds, United Kingdom
| | - Dasha Nicholls
- Division of Psychiatry, Imperial College London, London, United Kingdom
- NIHR ACR Northwest London, London, United Kingdom
| | - Rebecca A. Jones
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Genevieve Dammery
- InsideOut Institute for Eating Disorders, Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Alicia M. Grunseit
- Weight Management Services, The Children’s Hospital at Westmead, Westmead, New South Wales, Australia
| | - Kelly Cooper
- Weight Issues Network, New South Wales, Australia
| | - Theodore K. Kyle
- ConscienHealth, Pittsburgh, Pennsylvania, United States of America
| | - Faith A. Heeren
- Department of Health Outcomes and Biomedical Informatics, University of Florida College of Medicine, Gainesville, Florida, United States of America
| | - Fiona Quigley
- Institute of Nursing and Health Research, Ulster University, Newtownabbey, Co. Antrim, Northern Ireland
| | - Rachel D. Barnes
- University of Minnesota Medical School, Minneapolis, Minnesota, United States of America
| | - Melanie K. Bean
- Department of Pediatrics, Children’s Hospital of Richmond at Virginia Commonwealth University, Richmond, Virginia, United States of America
| | - Kristine Beaulieu
- School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom
| | | | - Kerri N. Boutelle
- Department of Pediatrics, University of California, San Diego, San Diego, California, United States of America
| | | | - Simona Calugi
- Department of Eating and Weight Disorders, Villa Garda Hospital, Garda (VR), Italy
| | - Michelle I. Cardel
- Department of Health Outcomes and Biomedical Informatics, University of Florida College of Medicine, Gainesville, Florida, United States of America
- WW International, Inc., New York, NY, United States of America
| | - Kelly Carpenter
- Optum Center for Wellbeing Research, Seattle, Washington, United States of America
| | - Hoi Lun Cheng
- The Academic Department of Adolescent Medicine, The Children’s Hospital at Westmead, Westmead, New South Wales, Australia
| | - Riccardo Dalle Grave
- Department of Eating and Weight Disorders, Villa Garda Hospital, Garda (VR), Italy
| | | | - Marcelo Demarzo
- Mente Aberta, The Brazilian Center for Mindfulness and Health Promotion, Univesidade Federal de São Paulo, UNIFESP, Brazil
| | | | - Dawn M. Eichen
- Department of Pediatrics, University of California, San Diego, San Diego, California, United States of America
| | - Andrea B. Goldschmidt
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Philadelphia, United States of America
| | - Anja Hilbert
- Research Unit Behavioral Medicine, Integrated Research and Treatment Center Adiposity Diseases, Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
| | - Katrijn Houben
- Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Mara Lofrano do Prado
- Department of Psychology, California State University, San Bernardino, California, United States of America
- Department of Kinesiology, California State University, San Bernardino, California, United States of America
| | - Corby K. Martin
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, United States of America
| | - Anne McTiernan
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, Washington, United States of America
| | - Janell L. Mensinger
- Department of Clinical and School Psychology, Nova Southeastern University, Fort Lauderdale, Florida, United States of America
| | - Carly Pacanowski
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, Delaware, United States of America
| | - Wagner Luiz do Prado
- Department of Kinesiology, California State University, San Bernardino, California, United States of America
| | - Sofia M. Ramalho
- Psychology Research Centre, School of Psychology, University of Minho, Campus Gualtar, Braga, Portugal
| | - Hollie A. Raynor
- Department of Nutrition, University of Tennessee, Knoxville, Tennessee, United States of America
| | - Elizabeth Rieger
- Research School of Psychology, Australian National University, Canberra, Australia
| | - Eric Robinson
- Department of Psychology, University of Liverpool, Liverpool, United Kingdom
| | - Vera Salvo
- Mente Aberta, The Brazilian Center for Mindfulness and Health Promotion, Univesidade Federal de São Paulo, UNIFESP, Brazil
| | - Nancy E. Sherwood
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Sharon A. Simpson
- Medical Research Council/Chief Scientist Office Social and Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | | | - Evelyn Smith
- School of Psychology, Western Sydney University, Sydney, New South Wales, Australia
| | - Stephanie Partridge
- Engagement and Co-design Hub, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Marian Tanofsky-Kraff
- Departments of Medical and Clinical Psychology and Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, United States of America
| | | | - Annelies Van Eyck
- Laboratory of Experimental Medicine and Pediatrics, University of Antwerp, Antwerp, Belgium
- Member of the Infla-Med Centre of Excellence, University of Antwerp, Antwerp, Belgium
- Department of Pediatrics, Antwerp University Hospital, Edegem, Belgium
| | - Krista A. Varady
- University of Illinois Chicago, Department of Kinesiology and Nutrition, Chicago, Illinois, United States of America
| | - Alaina P. Vidmar
- Children’s Hospital Los Angeles and Keck School of Medicine of University of Southern California, Los Angeles, CA, United States of America
- Department of Pediatrics, Center for Endocrinology, Diabetes and Metabolism, Los Angeles, California, United States of America
| | | | - Jack Yanovski
- Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Division of Intramural Research, National Institutes of Health (NIH), Bethesda, Maryland, United States of America
| | - Anna L. Seidler
- National Health and Medical Research Council Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
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17
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Jebeile H, Libesman S, Melville H, Low‐wah T, Dammery G, Seidler AL, Jones RA, McMaster CM, Paxton SJ, Hill AJ, Ahern AL, Garnett SP, Braet C, Wilfley DE, Baur LA, Lister NB. Eating disorder risk during behavioral weight management in adults with overweight or obesity: A systematic review with meta-analysis. Obes Rev 2023; 24:e13561. [PMID: 36919475 PMCID: PMC10909435 DOI: 10.1111/obr.13561] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 01/12/2023] [Accepted: 02/27/2023] [Indexed: 03/16/2023]
Abstract
This systematic review examined change in eating disorder risk during weight management interventions. Four databases and clinical trials registries were searched in March and May 2022, respectively, to identify behavioral weight management intervention trials in adults with overweight/obesity measuring eating disorder symptoms at pre- and post-intervention or follow-up. Random effects meta-analyses were conducted examining within group change in risk. Of 12,023 screened, 49 were eligible (n = 6337, mean age range 22.1 to 59.9 years, mean (SD) 81(20.4)% female). Interventions ranged from 4 weeks to 18 months, with follow-up of 10 weeks to 36 months post-intervention. There was a within group reduction in global eating disorder scores (20 intervention arms; Hedges' g = -0.27; 95% CI -0.36, -0.17; I2 67.1%) and binge eating (49 intervention arms; -0.66; 95% CI -0.76, -0.56; I2 82.7%) post-intervention, both maintained at follow-up. Of 14 studies reporting prevalence or episodes of binge eating, all reported a reduction. Four studies reported eating disorder symptoms, not present at baseline, in a subset of participants (0%-6.5%). Overall, behavioral weight management interventions do not increase eating disorder symptoms for most adults; indeed, a modest reduction is seen post-intervention and follow-up. A small subset of participants may experience disordered eating; therefore, monitoring for the emergence of symptoms is important.
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Affiliation(s)
- Hiba Jebeile
- Children's Hospital Westmead Clinical SchoolThe University of SydneySydneyNew South WalesAustralia
| | - Sol Libesman
- NHMRC Clinical Trials CentreThe University of SydneySydneyNew South WalesAustralia
| | - Hannah Melville
- Children's Hospital Westmead Clinical SchoolThe University of SydneySydneyNew South WalesAustralia
| | - Timothy Low‐wah
- Children's Hospital Westmead Clinical SchoolThe University of SydneySydneyNew South WalesAustralia
| | - Genevieve Dammery
- InsideOut Institute for Eating DisordersThe University of SydneySydneyNew South WalesAustralia
| | - Anna L. Seidler
- NHMRC Clinical Trials CentreThe University of SydneySydneyNew South WalesAustralia
| | | | - Caitlin M. McMaster
- Children's Hospital Westmead Clinical SchoolThe University of SydneySydneyNew South WalesAustralia
| | - Susan J. Paxton
- School of Psychology and Public HealthLa Trobe UniversityMelbourneVictoriaAustralia
| | - Andrew J. Hill
- Leeds Institute of Health SciencesUniversity of LeedsLeedsUK
| | - Amy L. Ahern
- MRC Epidemiology UnitUniversity of CambridgeCambridgeCB2 0QQUK
| | - Sarah P. Garnett
- Children's Hospital Westmead Clinical SchoolThe University of SydneySydneyNew South WalesAustralia
- Kids ResearchThe Children's Hospital at WestmeadWestmeadNew South WalesAustralia
| | - Caroline Braet
- Department of Developmental, Personality and Social PsychologyGhent UniversityHenri Dunantlaan 2Ghent9000Belgium
| | - Denise E. Wilfley
- School of Medicine, Washington University in St. LouisMissouriSt. LouisUSA
| | - Louise A. Baur
- Children's Hospital Westmead Clinical SchoolThe University of SydneySydneyNew South WalesAustralia
| | - Natalie B. Lister
- Children's Hospital Westmead Clinical SchoolThe University of SydneySydneyNew South WalesAustralia
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18
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Lister NB, Baur LA, Felix JF, Hill AJ, Marcus C, Reinehr T, Summerbell C, Wabitsch M. Child and adolescent obesity. Nat Rev Dis Primers 2023; 9:24. [PMID: 37202378 DOI: 10.1038/s41572-023-00435-4] [Citation(s) in RCA: 59] [Impact Index Per Article: 59.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/12/2023] [Indexed: 05/20/2023]
Abstract
The prevalence of child and adolescent obesity has plateaued at high levels in most high-income countries and is increasing in many low-income and middle-income countries. Obesity arises when a mix of genetic and epigenetic factors, behavioural risk patterns and broader environmental and sociocultural influences affect the two body weight regulation systems: energy homeostasis, including leptin and gastrointestinal tract signals, operating predominantly at an unconscious level, and cognitive-emotional control that is regulated by higher brain centres, operating at a conscious level. Health-related quality of life is reduced in those with obesity. Comorbidities of obesity, including type 2 diabetes mellitus, fatty liver disease and depression, are more likely in adolescents and in those with severe obesity. Treatment incorporates a respectful, stigma-free and family-based approach involving multiple components, and addresses dietary, physical activity, sedentary and sleep behaviours. In adolescents in particular, adjunctive therapies can be valuable, such as more intensive dietary therapies, pharmacotherapy and bariatric surgery. Prevention of obesity requires a whole-system approach and joined-up policy initiatives across government departments. Development and implementation of interventions to prevent paediatric obesity in children should focus on interventions that are feasible, effective and likely to reduce gaps in health inequalities.
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Affiliation(s)
- Natalie B Lister
- Children's Hospital Westmead Clinical School, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
- Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Louise A Baur
- Children's Hospital Westmead Clinical School, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia.
- Weight Management Services, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.
| | - Janine F Felix
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
- Department of Paediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Andrew J Hill
- Institute of Health Sciences, School of Medicine, University of Leeds, Leeds, UK
| | - Claude Marcus
- Division of Paediatrics, Department of Clinical Science Intervention and Technology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Thomas Reinehr
- Vestische Hospital for Children and Adolescents Datteln, University of Witten/Herdecke, Datteln, Germany
| | - Carolyn Summerbell
- Department of Sport and Exercise Sciences, Durham University, Durham, UK
| | - Martin Wabitsch
- Division of Paediatric Endocrinology and Diabetes, Department of Paediatrics and Adolescent Medicine, Ulm University Medical Centre, Ulm, Germany
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19
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McMaster CM, Paxton SJ, Maguire S, Hill AJ, Braet C, Seidler AL, Nicholls D, Garnett SP, Ahern AL, Wilfley DE, Lister NB, Jebeile H. The need for future research into the assessment and monitoring of eating disorder risk in the context of obesity treatment. Int J Eat Disord 2023; 56:914-924. [PMID: 36694273 PMCID: PMC10946556 DOI: 10.1002/eat.23898] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 01/11/2023] [Accepted: 01/11/2023] [Indexed: 01/26/2023]
Abstract
In adolescents and adults, the co-occurrence of eating disorders and overweight or obesity is continuing to increase, and the prevalence of eating disorders is higher in people with higher weight compared to those with lower weight. People with an eating disorder with higher weight are more likely to present for weight loss than for eating disorder treatment. However, there are no clinical practice guidelines on how to screen, assess, and monitor eating disorder risk in the context of obesity treatment. In this article, we first summarize current challenges and knowledge gaps related to the identification and assessment of eating disorder risk and symptoms in people with higher weight seeking obesity treatment. Specifically, we discuss considerations relating to the validation of current self-report measures, dietary restraint, body dissatisfaction, binge eating, and how change in eating disorder risk can be measured in this setting. Second, we propose avenues for further research to guide the development and implementation of clinical and research protocols for the identification and assessment of eating disorders in people with higher weight in the context of obesity treatment. PUBLIC SIGNIFICANCE: The number of people with both eating disorders and higher weight is increasing. Currently, there is little guidance for clinicians and researchers about how to identify and monitor risk of eating disorders in people with higher weight. We present limitations of current research and suggest future avenues for research to enhance care for people living with higher weight with eating disorders.
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Affiliation(s)
- Caitlin M. McMaster
- The University of Sydney Children's Hospital Westmead Clinical SchoolWestmeadNew South WalesAustralia
| | - Susan J. Paxton
- School of Psychology and Public HealthLa Trobe UniversityMelbourneVictoriaAustralia
| | - Sarah Maguire
- InsideOut Institute for Eating Disorders, Boden Collaboration for Obesity, Nutrition and Eating DisordersCharles Perkins Centre, The University of SydneySydneyNew South WalesAustralia
| | - Andrew J. Hill
- Leeds Institute of Health SciencesUniversity of LeedsLeedsUK
| | - Caroline Braet
- Department of Developmental, Personality and Social PsychologyGhent UniversityGhentBelgium
| | - Anna L. Seidler
- National Health and Medical Research Council Clinical Trials CentreThe University of SydneySydneyNew South WalesAustralia
| | | | - Sarah P. Garnett
- The University of Sydney Children's Hospital Westmead Clinical SchoolWestmeadNew South WalesAustralia
- Kids ResearchSydney Children's Hospital NetworkWestmeadNew South WalesAustralia
| | - Amy L. Ahern
- MRC Epidemiology UnitUniversity of CambridgeCambridgeUK
| | | | - Natalie B. Lister
- The University of Sydney Children's Hospital Westmead Clinical SchoolWestmeadNew South WalesAustralia
| | - Hiba Jebeile
- The University of Sydney Children's Hospital Westmead Clinical SchoolWestmeadNew South WalesAustralia
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20
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Cardel MI, Newsome FA, Pearl RL, Ross KM, Dillard JR, Hayes JF, Wilfley D, Keel PK, Dhurandhar EJ, Balantekin KN. Authors' Response. J Acad Nutr Diet 2023; 123:400-403. [PMID: 36206862 DOI: 10.1016/j.jand.2022.09.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 09/29/2022] [Indexed: 11/06/2022]
Affiliation(s)
- Michelle I Cardel
- Adjunct Professor, Department of Health Outcomes and Biomedical Informatics, University of Florida College of Medicine, Gainesville, FL; Senior Director of Global Clinical Research & Nutrition, WW International Inc, City, State
| | - Faith A Newsome
- Graduate Research Assistant, Department of Health Outcomes and Biomedical Informatics, University of Florida College of Medicine, Gainesville, FL
| | - Rebecca L Pearl
- Assistant Professor, Department of Clinical and Health Psychology, University of Florida College of Public Health and Health Professions, Gainesville, FL
| | - Kathryn M Ross
- Associate Professor, Department of Clinical and Health Psychology, University of Florida College of Public Health and Health Professions, Gainesville, FL
| | - Julia R Dillard
- Medical Student, University of Toledo College of Medicine and Life Sciences, Toledo, OH
| | - Jacqueline F Hayes
- Assistant Professor, Weight Control and Diabetes Research Center at the Miriam Hospital, Department of Psychiatry and Human Behavior, Brown University, Providence, RI
| | - Denise Wilfley
- Professor of Psychological and Brain Sciences, Professor of Medicine, Pediatrics and Psychiatry, Washington University in St Louis College of Medicine, St Louis, MO
| | - Pamela K Keel
- Distinguished Research Professor, Department of Psychology, Florida State University, Tallahassee, FL
| | | | - Katherine N Balantekin
- Assistant Professor and Clinical Assistant Professor, Department of Exercise and Nutrition Sciences, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY
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21
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Jebeile H, McMaster CM, Johnson BJ, Garnett SP, Paxton SJ, Seidler AL, Jones RA, Hill AJ, Maguire S, Braet C, Dammery G, Wilfley DE, Baur LA, Lister NB. Identifying Factors Which Influence Eating Disorder Risk during Behavioral Weight Management: A Consensus Study. Nutrients 2023; 15:1085. [PMID: 36904085 PMCID: PMC10005214 DOI: 10.3390/nu15051085] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 02/16/2023] [Accepted: 02/16/2023] [Indexed: 02/24/2023] Open
Abstract
This study aimed to understand clinician, researcher and consumer views regarding factors which influence eating disorder (ED) risk during behavioral weight management, including individual risk factors, intervention strategies and delivery features. Eighty-seven participants were recruited internationally through professional and consumer organizations and social media and completed an online survey. Individual characteristics, intervention strategies (5-point scale) and delivery features (important/unimportant/unsure) were rated. Participants were mostly women (n = 81), aged 35-49 y, from Australia or United States, were clinicians and/or reported lived experience of overweight/obesity and/or ED. There was agreement (64% to 99%) that individual characteristics were relevant to ED risk, with history of ED, weight-based teasing/stigma and weight bias internalization having the highest agreement. Intervention strategies most frequently rated as likely to increase ED risk included those with a focus on weight, prescription (structured diets, exercise plans) and monitoring strategies, e.g., calorie counting. Strategies most frequently rated as likely to decrease ED risk included having a health focus, flexibility and inclusion of psychosocial support. Delivery features considered most important were who delivered the intervention (profession, qualifications) and support (frequency, duration). Findings will inform future research to quantitatively assess which of these factors predict eating disorder risk, to inform screening and monitoring protocols.
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Affiliation(s)
- Hiba Jebeile
- Children’s Hospital Westmead Clinical School, The University of Sydney, Sydney 2145, Australia
- Charles Perkins Centre, The University of Sydney, Sydney 2006, Australia
| | - Caitlin M. McMaster
- Children’s Hospital Westmead Clinical School, The University of Sydney, Sydney 2145, Australia
| | - Brittany J. Johnson
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide 5042, Australia
| | - Sarah P. Garnett
- Children’s Hospital Westmead Clinical School, The University of Sydney, Sydney 2145, Australia
- Institute of Endocrinology and Diabetes, The Children’s Hospital at Westmead, Sydney 2145, Australia
- Kids Research, The Children’s Hospital at Westmead, Sydney 2145, Australia
| | - Susan J. Paxton
- School of Psychology and Public Health, La Trobe University, Melbourne 3086, Australia
| | - Anna L. Seidler
- National Health and Medical Research Council Clinical Trials Centre, The University of Sydney, Sydney 2050, Australia
| | - Rebecca A. Jones
- MRC Epidemiology Unit, University of Cambridge, Cambridge CB2 0QQ, UK
| | - Andrew J. Hill
- Leeds Institute of Health Sciences, University of Leeds, Leeds LS2 9JT, UK
| | - Sarah Maguire
- InsideOut Institute for Eating Disorders, Charles Perkins Centre, The University of Sydney, Sydney 2006, Australia
| | - Caroline Braet
- Department of Developmental, Personality and Social Psychology, Ghent University, 9000 Ghent, Belgium
| | - Genevieve Dammery
- InsideOut Institute for Eating Disorders, Charles Perkins Centre, The University of Sydney, Sydney 2006, Australia
| | - Denise E. Wilfley
- School of Medicine, Washington University in St. Louis, St Louis, MO 63110, USA
| | - Louise A. Baur
- Children’s Hospital Westmead Clinical School, The University of Sydney, Sydney 2145, Australia
- Charles Perkins Centre, The University of Sydney, Sydney 2006, Australia
- Weight Management Services, The Children’s Hospital at Westmead, Sydney 2145, Australia
| | - Natalie B. Lister
- Children’s Hospital Westmead Clinical School, The University of Sydney, Sydney 2145, Australia
- Charles Perkins Centre, The University of Sydney, Sydney 2006, Australia
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22
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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. Executive Summary: Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents With Obesity. Pediatrics 2023; 151:190440. [PMID: 36622135 DOI: 10.1542/peds.2022-060641] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/16/2022] [Indexed: 01/10/2023] Open
Affiliation(s)
- Sarah E Hampl
- Children's Mercy Kansas City Center for Children's Healthy Lifestyles & Nutrition, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri
| | - Sandra G Hassink
- Medical Director, American Academy of Pediatrics, Institute for Healthy Childhood Weight, Wilmington, Delaware
| | - Asheley C Skinner
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina
| | - Sarah C Armstrong
- Departments of Pediatrics and Population Health Sciences, Duke Clinical Research Institute, Duke University, Durham, North Carolina
| | - Sarah E Barlow
- Department of Pediatrics, University of Texas Southwestern Medical Center, Children's Medical Center of Dallas, Dallas, Texas
| | - Christopher F Bolling
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Kimberly C Avila Edwards
- Children's Health Policy & Advocacy, Ascension; Department of Pediatrics, Dell Medical School at The University of Texas at Austin, Austin, Texas
| | - Ihuoma Eneli
- Department of Pediatrics, The Ohio State University, Center for Healthy Weight and Nutrition, Nationwide Children's Hospital, Columbus, Ohio
| | - Robin Hamre
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Madeline M Joseph
- Division of Pediatric Emergency Medicine, Department of Emergency Medicine, University of Florida College of Medicine-Jacksonville, University of Florida Health Sciences Center-Jacksonville, Jacksonville, Florida
| | | | - Eneida Mendonca
- Departments of Pediatrics and Biostatistics & Health Data Science, Indiana University School of Medicine, Indianapolis, Indiana
| | - Marc P Michalsky
- Department of Pediatric Surgery, The Ohio State University, College of Medicine, Nationwide Children's Hospital, Columbus, Ohio
| | - Nazrat Mirza
- Children's National Hospital, George Washington University, Washington, DC
| | - Eduardo R Ochoa
- Department of Pediatrics, University of Arkansas for Medical Sciences, Arkansas Children's Hospital, Little Rock, Arkansas
| | - Mona Sharifi
- Department of Pediatrics, Yale School of Medicine, New Haven, Connecticut
| | - Amanda E Staiano
- Louisiana State University Pennington Biomedical Research Center, Baton Rouge, Louisiana
| | - Ashley E Weedn
- Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
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23
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Nicholls D. Editorial Perspective: A perfect storm - how and why eating disorders in young people have thrived in lockdown and what is happening to address it. J Child Psychol Psychiatry 2023; 64:335-338. [PMID: 35902107 PMCID: PMC10087223 DOI: 10.1111/jcpp.13676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/02/2022] [Indexed: 01/17/2023]
Abstract
The number of children and young people referred to community eating disorders services escalated dramatically shortly after onset of the Covid-19 pandemic. Many presented with medical instability following restrictive eating and needed acute hospitalisation to correct malnutrition. In addition to the many risk factors for mental health problems that young people have been subjected to since onset of the pandemic, the question for eating disorders researchers, practitioners and policy makers is how, for so many, did it become about eating. In this editorial, some of the factors that may explain how eating, weight, shape and body image may have taken centre stage in young people's lives are explored. Finally, some clinical service adaptations and gaps, policy considerations, and research priorities are outlined.
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Affiliation(s)
- Dasha Nicholls
- Division of Psychiatry, Imperial College London, London, UK
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24
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Grammer AC, Best JR, Fowler LA, Stein RI, Conlon RPK, Balantekin KN, Welch RR, Perri MG, Epstein LH, Wilfley DE. Change in parent and child psychopathology following obesity treatment and maintenance: A secondary data analysis. Pediatr Obes 2023; 18:e12971. [PMID: 35971859 PMCID: PMC9772295 DOI: 10.1111/ijpo.12971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 07/11/2022] [Accepted: 08/01/2022] [Indexed: 01/09/2023]
Abstract
BACKGROUND General and eating disorder (ED) psychopathology are common among children and adults with overweight/obesity; few studies have examined their course of change throughout family-based behavioural obesity treatment (FBT) and maintenance. OBJECTIVES Examine: (1) the changes in the parent and child general and ED psychopathology during FBT and maintenance interventions; (2) the associations between change in psychopathology and change in weight among children or parents; (3) the associations between change in psychopathology within parent-child dyads. METHODS 172 parent-child dyads participated in 4-month FBT and were subsequently randomized to one of three 8-month maintenance interventions. General psychopathology (child anxiety/depressive symptoms, parent severity of global psychological distress), ED psychopathology (shape/weight concern), and percent overweight were assessed at baseline, post-FBT, and post-maintenance. Separate linear mixed-effects models evaluated change in general and ED psychopathology, including an interaction between maintenance condition and time. Partial correlations examined associations between change in psychopathology and percent overweight among children or parents, and associations between change in psychopathology within parent-child dyads. RESULTS Among children, significant reductions were observed from baseline to post-FBT in all forms of psychopathology and from post-FBT to post-maintenance in general psychopathology. Among parents, significant reductions were observed from baseline to post-FBT in all forms of psychopathology; reductions were maintained from post-FBT to post-maintenance. There was no significant interaction between maintenance condition and time. Correlations between change in most forms of parent or child psychopathology and percent overweight were observed. CONCLUSIONS Participation in FBT and maintenance was associated with improvements in general and ED psychopathology in both parents and children.
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Affiliation(s)
- Anne Claire Grammer
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
| | - John R. Best
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Lauren A. Fowler
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Richard I. Stein
- Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Rachel P. Kolko Conlon
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Katherine N. Balantekin
- Department of Exercise and Nutrition Sciences, School of Public Health and Health Professions, University at Buffalo, Buffalo, New York, USA
| | - R. Robinson Welch
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Michael G. Perri
- Department of Clinical & Health Psychology, University of Florida, Gainesville, Florida, USA
| | - Leonard H. Epstein
- Division of Behavioral Medicine, Department of Pediatrics, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, USA
| | - Denise E. Wilfley
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
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25
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Cuda SE, Kharofa R, Williams DR, O'Hara V, Conroy R, Karjoo S, Paisley J, Censani M, Browne NT. Metabolic, behavioral health, and disordered eating comorbidities associated with obesity in pediatric patients: An Obesity Medical Association (OMA) Clinical Practice Statement 2022. OBESITY PILLARS (ONLINE) 2022; 3:100031. [PMID: 37990723 PMCID: PMC10662000 DOI: 10.1016/j.obpill.2022.100031] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 08/01/2022] [Indexed: 11/23/2023]
Abstract
Background This Obesity Medicine Association (OMA) Clinical Practice Statement (CPS) details metabolic, behavioral health, and disordered eating comorbidities associated with obesity in children. This CPS will be followed by a companion CPS covering further comorbidities, including genetics and social consequences related to overweight and obesity. These CPSs are intended to provide clinicians with an overview of clinical practices applicable to children and adolescents with body mass indices greater than or equal to the 95th percentile for their ages, particularly those with adverse consequences resulting from increased body mass. The information in this CPS is based on scientific evidence, supported by the medical literature, and derived from the clinical experiences of members of the OMA. Methods The scientific information and clinical guidance in this CPS is based upon referenced evidence and derived from the clinical perspectives of the authors. Results This OMA statement details metabolic, behavioral health, and disordered eating comorbidities associated with obesity in children. It provides clinical information regarding identifying and treating metabolic, behavioral health, and disordered eating comorbidities associated with obesity in children over the 95th percentile of weight/height for age. Conclusions This OMA clinical practice statement details metabolic, behavioral health, and disordered eating comorbidities associated with obesity in children and provides an overview of current recommendations. These recommendations lay out a roadmap to the improvement of the health of children and adolescents with obesity, especially those with metabolic, physiological, and psychological complications.
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Affiliation(s)
- Suzanne E. Cuda
- Alamo City Healthy Kids and Families, 1919 Oakwell Farms Parkway, Ste 145, San Antonio, TX, 78218, USA
| | - Roohi Kharofa
- Center for Better Health & Nutrition, The Heart Institute, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229, USA
| | - Dominique R. Williams
- The Ohio State University College of Medicine Center for Healthy Weight and Nutrition, Nationwide Children's Hospital, 700 Children's Drive LA, Suite 5F, Columbus, OH, 43215, USA
| | - Valerie O'Hara
- WOW 4 Wellness Clinic/ PCHC, 6 Telcom Drive, Bangor, ME, 04401, USA
| | - Rushika Conroy
- Division of Pediatric Endocrinology, Baystate Children's Hospital Subspecialty Center, 50 Wason Avenue, Springfield, MA, 01107, USA
| | - Sara Karjoo
- Johns Hopkins All Children's Hospital, Pediatric Gastroenterology, 501 6th Ave S St. Petersburg, FL, 33701, USA
| | - Jennifer Paisley
- St Elizabeth Physician's Group Primary Care, 98 Elm Street, Lawrenceburg, IN, 47025-2048, USA
| | - Marisa Censani
- Division of Pediatric Endocrinology, Department of Pediatrics, New York Presbyterian Hospital, Weill Cornell Medicine, 525 East 68th Street, Box 103, New York, NY, 10021, USA
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Benefits of Exercise in Multidisciplinary Treatment of Binge Eating Disorder in Adolescents with Obesity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148300. [PMID: 35886152 PMCID: PMC9315465 DOI: 10.3390/ijerph19148300] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 07/04/2022] [Accepted: 07/06/2022] [Indexed: 11/17/2022]
Abstract
Obesity in childhood and adolescence represents a serious health problem worldwide. Similarly, eating disorders (EDs) are complex diseases that affect adolescents with an increasing prevalence and are an alarming health concern to both physical and mental health. Traditionally, obesity and EDs, particularly binge eating disorder (BED), have been considered separate conditions, but there is emerging evidence such as etiology, comorbidities, risk factors, psychosocial impairment, and prevention approaches, highlighting important overlaps among these conditions. In youth, the two conditions share risk factors and consequences at both the physical and psychological levels, requiring special care. Exercise, useful as strategy to prevent and treat overweight conditions, may have beneficial effects on BED symptoms, suggesting that it may be considered as one of the key factors in the treatment of individuals affected by obesity with BED. The purpose of this narrative review is to examine the bidirectional impact of obesity and BED in adolescents, in terms of risk factors, etiology and comorbid conditions. Specifically, we focused on the benefits of physical activity (PA) in the multidisciplinary treatment of subjects affected by obesity with BED. Even though additional research is needed to reach conclusions about the role of exercise in the treatment of obesity and comorbid BED, especially in adolescents, promising results have already suggested that closely monitored exercise is safe and, paired with cognitive behavioral therapy, may provide multiple benefits on both the physical and psychological levels. Tailored and integrated treatments for weight management and eating disorders are important to promptly and effectively treat obese subjects that have BED.
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Alberga AS, Edache IY, Sigal RJ, Ranson KM, Russell‐Mayhew S, Kenny GP, Doucette S, Prud’homme D, Hadjiyannakis S, Cameron J, Goldfield GS. Effects of the HEARTY exercise randomized controlled trial on eating behaviors in adolescents with obesity. Obes Sci Pract 2022; 9:158-171. [PMID: 37034563 PMCID: PMC10073823 DOI: 10.1002/osp4.620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 02/10/2022] [Accepted: 02/19/2022] [Indexed: 11/05/2022] Open
Abstract
Background There are well-recognized benefits of behavioral interventions that include exercise for children and adolescents with obesity. However, such behavioral weight management programs may precipitate unintended consequences. It is unclear if different exercise modalities impact eating behaviors differently in youth with obesity. Objectives The purpose of this study was to examine the effects of aerobic, resistance, and combined aerobic and resistance exercise training on eating attitudes and behaviors (uncontrolled eating, restrained eating, emotional eating, external eating and food craving) among adolescents with overweight and obesity. Methods N = 304 (70% female) adolescents with overweight and obesity participated in the 6-month Healthy Eating Aerobic and Resistance Training in Youth (HEARTY) randomized controlled trial. All participants were inactive post-pubertal adolescents (15.6 ± 1.4 years) with a mean BMI = 34.6 ± 4.5 kg/m2. The Food Craving Inventory (food cravings), Dutch Eating Behavior Questionnaire (restrained eating, emotional eating, external eating), and the Three-Factor Eating Questionnaire (uncontrolled eating) were used to assess eating attitudes and behaviors. Results All exercise groups showed within-group decreases in external eating and food cravings. Participants randomized to the Combined training group and were more adherent showed the greatest improvements in eating behaviors and cravings. Conclusions A 6-month exercise intervention produced improvements in disordered eating behaviors and food cravings, but effects may be gender and modality-specific. Findings highlight the need to tailor exercise intervention to participant characteristics for the promotion of healthier eating and weight management outcomes in youth with obesity. Clinical Trial Registration # and Date: ClinicalTrials.Gov NCT00195858, September 12, 2005.
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Affiliation(s)
- Angela S. Alberga
- Department of Health Kinesiology and Applied Physiology Concordia University 7141 Sherbrooke St WSP 165.31 Montreal QC CanadaH4B1R6
| | - Iyoma Y. Edache
- Department of Health Kinesiology and Applied Physiology Concordia University 7141 Sherbrooke St WSP 165.31 Montreal QC CanadaH4B1R6
| | - Ronald J. Sigal
- Departments of Medicine Cardiac Sciences and Community Health Sciences Faculties of Medicine and Kinesiology University of Calgary 1820 Richmond Road SWRoom 1898 Calgary AB CanadaT2T 5C7
- Clinical Epidemiology Program Ottawa Hospital Research Institute 725 Parkdale Avenue Ottawa Ontario CanadaON K1Y 4E9
- School of Human Kinetics Faculty of Health Sciences University of Ottawa 125 University Montpetit Hall Ottawa ON CanadaK1N 6N5
| | - Kristin M. Ranson
- Department of Psychology University of Calgary 2500 University Drive NW Calgary AB CanadaT2N 1N4
| | - Shelly Russell‐Mayhew
- Werklund School of Education University of Calgary 2750 University Drive NW Calgary AB CanadaT2N1N4
| | - Glen P. Kenny
- Clinical Epidemiology Program Ottawa Hospital Research Institute 725 Parkdale Avenue Ottawa Ontario CanadaON K1Y 4E9
- School of Human Kinetics Faculty of Health Sciences University of Ottawa 125 University Montpetit Hall Ottawa ON CanadaK1N 6N5
| | - Steve Doucette
- Department of Community Health and Epidemiology Dalhousie University 5790 University Ave. Room 207 Halifax NS CanadaB3H 1V7
| | - Denis Prud’homme
- Université de Moncton 18avenue Antonine‐MailletNouveau‐Brunswick MonctonE1A 3E9 Canada
| | - Stasia Hadjiyannakis
- Healthy Active Living & Obesity Research Group (HALO) Children’s Hospital of Eastern Ontario Research Institute 401 Smyth Rd Ottawa ON CanadaK1H 8L1
| | - Jameason Cameron
- Department of Pharmacy Children’s Hospital of Eastern Ontario 401 Smyth Rd Ottawa ON CanadaK1H 8L1
| | - Gary S. Goldfield
- Healthy Active Living & Obesity Research Group (HALO) Children’s Hospital of Eastern Ontario Research Institute 401 Smyth Rd Ottawa ON CanadaK1H 8L1
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Skjåkødegård HF, Conlon RPK, Hystad SW, Roelants M, Olsson SJG, Frisk B, Wilfley DE, Danielsen YS, Juliusson PB. Family-based treatment of children with severe obesity in a public healthcare setting: Results from a randomized controlled trial. Clin Obes 2022; 12:e12513. [PMID: 35218145 PMCID: PMC9286578 DOI: 10.1111/cob.12513] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 02/01/2022] [Accepted: 02/08/2022] [Indexed: 11/29/2022]
Abstract
To compare the effectiveness of family-based behavioural social facilitation treatment (FBSFT) versus treatment as usual (TAU) in children with severe obesity. Parallel-design, nonblinded, randomized controlled trial conducted at a Norwegian obesity outpatient clinic. Children aged 6-18 years referred to the clinic between 2014 and 2018 were invited to participate. Participants were randomly allocated using sequentially numbered, opaqued, sealed envelopes. FBSFT (n = 59) entailed 17 sessions of structured cognitive behavioural treatment, TAU (n = 55) entailed standard lifestyle counselling sessions every third month for 1 year. Primary outcomes included changes in body mass index standard deviation score (BMI SDS) and percentage above the International Obesity Task Force cut-off for overweight (%IOTF-25). Secondary outcomes included changes in sleep, physical activity, and eating behaviour. From pre- to posttreatment there was a statistically significant difference in change in both BMI SDS (0.19 units, 95% confidence interval [CI]: 0.10-0.28, p < .001) and %IOTF-25 (5.48%, 95%CI: 2.74-8.22, p < .001) between FBSFT and TAU groups. FBSFT participants achieved significant reductions in mean BMI SDS (0.16 units, (95%CI: -0.22 to -0.10, p < .001) and %IOTF-25 (6.53%, 95% CI: -8.45 to -4.60, p < .001), whereas in TAU nonsignificant changes were observed in BMI SDS (0.03 units, 95% CI: -0.03 to 0.09, p = .30) and %IOTF-25 (-1.04%, 95% CI: -2.99 to -0.90, p = .29). More FBSFT participants (31.5%) had clinically meaningful BMI SDS reductions of ≥0.25 from pre- to posttreatment than in TAU (13.0%, p = .021). Regarding secondary outcomes, only changes in sleep timing differed significantly between groups. FBSFT improved weight-related outcomes compared to TAU.
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Affiliation(s)
| | - Rachel P. K. Conlon
- Department of PsychiatryUniversity of Pittsburgh School of MedicinePittsburghPennsylvaniaUSA
| | - Sigurd W. Hystad
- Department of Psychosocial ScienceUniversity of BergenBergenNorway
| | - Mathieu Roelants
- Department of Public Health and Primary Care, KU LeuvenUniversity of LeuvenLeuvenBelgium
| | | | - Bente Frisk
- Department of Health and FunctioningWestern Norway University of Applied SciencesBergenNorway
- Department of PhysiotherapyHaukeland University HospitalBergenNorway
| | - Denise E. Wilfley
- Department of PsychiatryWashington University School of MedicineSt. LouisMissouriUSA
| | | | - Petur B. Juliusson
- Department of Clinical ScienceUniversity of BergenBergenNorway
- Children and Youth ClinicHaukeland University HospitalBergenNorway
- Department of Health Registry Research and DevelopmentNorwegian Institute of Public HealthBergenNorway
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Cardel MI, Newsome FA, Pearl RL, Ross KM, Dillard JR, Miller DR, Hayes JF, Wilfley D, Keel PK, Dhurandhar EJ, Balantekin KN. Patient-Centered Care for Obesity: How Health Care Providers Can Treat Obesity While Actively Addressing Weight Stigma and Eating Disorder Risk. J Acad Nutr Diet 2022; 122:1089-1098. [PMID: 35033698 PMCID: PMC10056599 DOI: 10.1016/j.jand.2022.01.004] [Citation(s) in RCA: 42] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 11/10/2021] [Accepted: 01/11/2022] [Indexed: 02/01/2023]
Affiliation(s)
- Michelle I Cardel
- Department of Health Outcomes and Biomedical Informatics, University of Florida College of Medicine, Gainesville, FL; WW International, Inc., New York, NY.
| | - Faith A Newsome
- Department of Health Outcomes and Biomedical Informatics, University of Florida College of Medicine, Gainesville, FL
| | - Rebecca L Pearl
- Department of Clinical and Health Psychology, University of Florida College of Public Health and Health Professions, Gainesville, FL
| | - Kathryn M Ross
- Department of Clinical and Health Psychology, University of Florida College of Public Health and Health Professions, Gainesville, FL
| | - Julia R Dillard
- University of Toledo, College of Medicine and Life Sciences, Toledo, OH
| | - Darci R Miller
- Department of Health Outcomes and Biomedical Informatics, University of Florida College of Medicine, Gainesville, FL
| | - Jacqueline F Hayes
- Weight Control and Diabetes Research Center at the Miriam Hospital and Department of Psychiatry and Human Behavior, Brown University, Providence, RI
| | - Denise Wilfley
- Washington University in St Louis, College of Medicine, St Louis, MO
| | - Pamela K Keel
- Department of Psychology, Florida State University, Tallahassee, FL
| | | | - Katherine N Balantekin
- Department of Exercise and Nutrition Sciences, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY
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Effect of an interactive mobile health support system and daily weight measurements for pediatric obesity treatment, a 1-year pragmatical clinical trial. Int J Obes (Lond) 2022; 46:1527-1533. [PMID: 35641569 PMCID: PMC9314258 DOI: 10.1038/s41366-022-01146-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 04/29/2022] [Accepted: 05/05/2022] [Indexed: 12/02/2022]
Abstract
Background Pediatric obesity lifestyle treatment is not always successful. Frequent clinical visits are of major importance to certify sufficient effect but are difficult due to the associated costs and the great demands on families. We hypothesized that an interactive digital support may reduce the need for frequent physical visits. The aim of the study was to assess 1-year weight outcome for patients using a digital support system compared with standard care. Methods An obesity lifestyle treatment with a digital support system was implemented in one clinic in Stockholm, Sweden. Measurements from a custom-made body scale without digits for daily home measurement of weights were transferred via Bluetooth to a mobile application, where BMI Z-score was calculated and presented graphically with an individualized weight loss target curve. An automatic transfer of data to the web-based clinic interface enables a close monitoring of treatment progress, and frequent written communication between the clinical staff and families via the application. One-year outcome was compared with a randomly retrieved, age and sex matched control group from the Swedish childhood obesity treatment register (BORIS), which received standard treatment at other clinics. Main outcome was change in BMI Z-score and missing data was imputed. Results 107 children were consecutively included to digi-physical treatment and 321 children to standard care. Age range 4.1–17.4 years (67% males). The attrition rate was 36% and 46% respectively, p = 0.08. After 1 year, the mean ± SD change in BMI Z-score in the treatment group was −0.30 ± 0.39 BMI Z-score units and in the standard care group −0.15 ± 0.28, p = 0.0002. The outcome was better for both sexes and all age groups in the digi-physical treated group. Conclusion A digital support system with a personalized weight-loss target curve and daily weight measurements shared by the family and the clinic is more effective than a standard care childhood obesity treatment. Clinicaltrial.gov ID NCT04323215
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Canfell OJ, Littlewood R, Wright ORL, Walker JL. "We'd be really motivated to do something about it": a qualitative study of parent and clinician attitudes towards predicting childhood obesity in practice. Health Promot J Austr 2022; 34:398-409. [PMID: 35504851 DOI: 10.1002/hpja.611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 01/25/2022] [Accepted: 04/27/2022] [Indexed: 11/06/2022] Open
Abstract
ISSUE ADDRESSED In Australia, one-in-four (24.9%) children live with overweight or obesity (OW/OB). Identifying infants at-risk of developing childhood OW/OB is a potential preventive pathway but its acceptability is yet to be investigated in Australia. This study aimed to (1) investigate acceptability of predicting childhood OW/OB with parents of infants (aged 0-2 years) and clinicians and (2) explore key language to address stigma and maximise the acceptability of predicting childhood OW/OB in practice. METHODS Cross-sectional and qualitative design, comprising individual semi-structured interviews. Participants were multidisciplinary paediatric clinicians (n=18) and parents (n=13) recruited across public hospitals and health services in Queensland, Australia. Data were analysed under the Framework Method using an inductive, thematic approach. RESULTS Five main themes were identified: (1) Optimism for prevention and childhood obesity prediction (2) Parent dedication to child's health (3) Adverse parent response to risk for childhood obesity (4) Language and phrasing for discussing weight and risk (5) Clinical delivery. Most participants were supportive of using a childhood OW/OB prediction tool in practice. Parents expressed dedication to their child's health that superseded potential feelings of judgment or blame. When discussing weight in a clinical setting, the use of sensitive (i.e. 'overweight', 'above average', 'growth' versus 'obesity') and positive, health-focused language was mostly supported. CONCLUSIONS Multidisciplinary paediatric clinicians and parents generally accept the concept of predicting childhood OW/OB in practice in Queensland, Australia. SO WHAT?: Clinicians, public health and health promotion professionals and policymakers can act now to implement sensitive communication strategies concerning weight and obesity risk.
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Affiliation(s)
- Oliver J Canfell
- School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, St Lucia, QLD, Australia.,Children's Health Queensland Hospital and Health Service, Department of Health, Queensland Government, South Brisbane, QLD, Australia.,Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Herston, QLD, Australia.,UQ Business School, Faculty of Business, Economics and Law, The University of Queensland, St Lucia, QLD, Australia.,Health and Wellbeing Queensland, Queensland Government, The State of Queensland, Milton QLD, Australia
| | - Robyn Littlewood
- School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, St Lucia, QLD, Australia.,Children's Health Queensland Hospital and Health Service, Department of Health, Queensland Government, South Brisbane, QLD, Australia.,Health and Wellbeing Queensland, Queensland Government, The State of Queensland, Milton QLD, Australia
| | - Olivia R L Wright
- School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, St Lucia, QLD, Australia
| | - Jacqueline L Walker
- School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, St Lucia, QLD, Australia.,Health and Wellbeing Queensland, Queensland Government, The State of Queensland, Milton QLD, Australia
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Johnson VR, Washington TB, Chhabria S, Wang EHC, Czepiel K, Reyes KJC, Stanford FC. Food as Medicine for Obesity Treatment and Management. Clin Ther 2022; 44:671-681. [PMID: 35618570 PMCID: PMC9908371 DOI: 10.1016/j.clinthera.2022.05.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 04/27/2022] [Accepted: 05/02/2022] [Indexed: 01/24/2023]
Abstract
PURPOSE Nutrition is an important lifestyle modification used in the treatment of obesity. The purpose of this review is to highlight different dietary interventions used to promote weight loss in both adults and children. METHODS A search using PubMed was performed for articles on topics related to nutrition and management and/or treatment of obesity in adults adolescents and children. The literature was reviewed and pertinent sources were used for this narrative review. DISCUSSION There are many effective nutrition interventions used to treat obesity, including altering macronutrient composition, implementing different dietary patterns, and changing meal timing. Although these interventions can induce weight loss in adults, management of obesity in children is more difficult given their varied nutrition needs in growth and development. The use of food as medicine in obesity treatment is individualized based on patient's age, food preference, and concurrent medical conditions. IMPLICATIONS Given the multifactorial etiology of obesity, treatment requires multidisciplinary care beyond nutrition intervention.
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Affiliation(s)
- Veronica R. Johnson
- Division of General Internal Medicine, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Tiffani Bell Washington
- Harvard T.H. Chan School of Public Health, Department of Health Policy and Management, Boston, MA, USA
| | | | | | - Kathryn Czepiel
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Stanford University, Palo Alto, CA, USA
| | - Karen J. Campoverde Reyes
- Liver Center, Division of Gastroenterology and Hepatology, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - Fatima Cody Stanford
- Department of Medicine-Neuroendocrine Unit, Pediatric Endocrinology, MGH Weight Center, Nutrition Obesity Research Center at Harvard, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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Jebeile H, Kelly AS, O'Malley G, Baur LA. Obesity in children and adolescents: epidemiology, causes, assessment, and management. Lancet Diabetes Endocrinol 2022; 10:351-365. [PMID: 35248172 PMCID: PMC9831747 DOI: 10.1016/s2213-8587(22)00047-x] [Citation(s) in RCA: 225] [Impact Index Per Article: 112.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 01/27/2022] [Accepted: 02/02/2022] [Indexed: 01/14/2023]
Abstract
This Review describes current knowledge on the epidemiology and causes of child and adolescent obesity, considerations for assessment, and current management approaches. Before the COVID-19 pandemic, obesity prevalence in children and adolescents had plateaued in many high-income countries despite levels of severe obesity having increased. However, in low-income and middle-income countries, obesity prevalence had risen. During the pandemic, weight gain among children and adolescents has increased in several jurisdictions. Obesity is associated with cardiometabolic and psychosocial comorbidity as well as premature adult mortality. The development and perpetuation of obesity is largely explained by a bio-socioecological framework, whereby biological predisposition, socioeconomic, and environmental factors interact together to promote deposition and proliferation of adipose tissue. First-line treatment approaches include family-based behavioural obesity interventions addressing diet, physical activity, sedentary behaviours, and sleep quality, underpinned by behaviour change strategies. Evidence for intensive dietary approaches, pharmacotherapy, and metabolic and bariatric surgery as supplemental therapies are emerging; however, access to these therapies is scarce in most jurisdictions. Research is still needed to inform the personalisation of treatment approaches of obesity in children and adolescents and their translation to clinical practice.
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Affiliation(s)
- Hiba Jebeile
- Sydney Medical School, The University of Sydney, Sydney, NSW, Australia; Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Aaron S Kelly
- Department of Pediatrics and Center for Pediatric Obesity Medicine, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Grace O'Malley
- School of Physiotherapy, RCSI University of Medicine and Health Sciences, Dublin, Ireland; Child and Adolescent Obesity Service, Children's Health Ireland at Temple Street, Dublin, Ireland
| | - Louise A Baur
- Sydney Medical School, The University of Sydney, Sydney, NSW, Australia; Weight Management Services, The Children's Hospital at Westmead, Westmead, NSW, Australia.
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Varady KA, Cienfuegos S, Ezpeleta M, Gabel K. Clinical application of intermittent fasting for weight loss: progress and future directions. Nat Rev Endocrinol 2022; 18:309-321. [PMID: 35194176 DOI: 10.1038/s41574-022-00638-x] [Citation(s) in RCA: 92] [Impact Index Per Article: 46.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/24/2022] [Indexed: 12/15/2022]
Abstract
Intermittent fasting diets have become very popular in the past few years, as they can produce clinically significant weight loss. These diets can be defined, in the simplest of terms, as periods of fasting alternating with periods of eating. The most studied forms of intermittent fasting include: alternate day fasting (0-500 kcal per 'fast day' alternating with ad libitum intake on 'feast days'); the 5:2 diet (two fast days and five feast days per week) and time-restricted eating (only eating within a prescribed window of time each day). Despite the recent surge in the popularity of fasting, only a few studies have examined the health benefits of these diets in humans. The goal of this Review is to summarize these preliminary findings and give insights into the effects of intermittent fasting on body weight and risk factors for cardiometabolic diseases in humans. This Review also assesses the safety of these regimens, and offers some practical advice for how to incorporate intermittent fasting diets into everyday life. Recommendations for future research are also presented.
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Affiliation(s)
- Krista A Varady
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL, USA.
| | - Sofia Cienfuegos
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL, USA
| | - Mark Ezpeleta
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL, USA
| | - Kelsey Gabel
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL, USA
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Dukay-Szabó S, Simon D, Varga M, Koller O, Pataki Z, Rigó J, Túry F. The applicability of the Eating Disorder Inventory in pregnancy. Eat Weight Disord 2022; 27:629-637. [PMID: 33961273 PMCID: PMC8933349 DOI: 10.1007/s40519-021-01197-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 04/15/2021] [Indexed: 11/26/2022] Open
Abstract
PURPOSE The aim of our study was validating Eating Disorder Inventory (EDI) among pregnant women, who are vulnerable to eating disorders (EDs). METHODS In 2012-2013, 1146 women (aged 18-47 years) completed a questionnaire including EDI during the first 3 days after delivery. We checked factorial validity of three diagnostic subscales of EDI with confirmative factor analysis and internal validity by Cronbach's alpha and item-total correlation. We also tested discriminative validity by comparing average of the three subscale of EDI in case of ED and non-ED groups. RESULTS When applying the EDI to pregnant women, it seems necessary to exclude five items on three diagnostic subscales: on the Drive for Thinness subscale, 4 items remain (out of 7); on the Bulimia subscale, 6 items remain (out of 7); the Body Dissatisfaction subscale decreases from 9 to 8 items. Cronbach's alpha and item-total correlation values meet the requirements defined by Garner et al. The internal consistency of the EDI has proved to be appropriate, indicating that it is a reliable screening tool. CONCLUSIONS Thinking, attitudes, and behaviors connected to eating, along with the relation to altering body weight change during pregnancy. Vomiting usually accompanies pregnancy; body weight gain within wide limits is also regarded as normal during pregnancy. These behaviors and changes are not feasible to use for measuring ED symptoms. These aspects cannot be neglected when screening eating disorders in pregnant women. LEVEL OF EVIDENCE Level IV evidence obtained from multiple time series with or without an intervention.
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Affiliation(s)
- Szilvia Dukay-Szabó
- Institute of Behavioural Sciences, Doctoral School of Mental Health Sciences, Semmelweis University, Nagyvárad tér 4, 1089, Budapest, Hungary.
| | - Dávid Simon
- Faculty of Social Sciences, Eötvös Loránd University, Budapest, Hungary
| | - Márta Varga
- Faculty of Humanities and Social Sciences, Pázmány Péter Catholic University, Budapest, Hungary
| | - Orsolya Koller
- Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
| | | | - János Rigó
- Department of Obstetrics and Gynaecology, Semmelweis University, Budapest, Hungary
- Department of Clinical Studies in Obstetrics and Gynaecology, Semmelweis University, Budapest, Hungary
| | - Ferenc Túry
- Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
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Stewart TM, Martin CK, Williamson DA. The Complicated Relationship between Dieting, Dietary Restraint, Caloric Restriction, and Eating Disorders: Is a Shift in Public Health Messaging Warranted? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:491. [PMID: 35010751 PMCID: PMC8745028 DOI: 10.3390/ijerph19010491] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 12/09/2021] [Accepted: 12/21/2021] [Indexed: 02/01/2023]
Abstract
The origins of theories specifying dietary restraint as a cause of eating disorders can be traced to the 1970s. This paper will present an overview of the origins of dietary restraint theories and a brief historical review of evidence will be summarized. Recent research will be presented, including the results from the CALERIE Phase 1 study, as well as CALERIE Phase 2, which were NIH-sponsored randomized controlled trials. CALERIE 2 provided a test of the effect of two years of caloric restriction (CR) on the development of eating disorder syndromes and symptoms in comparison to a control group that did not alter eating behavior or body weight. The intervention was effective for inducing a chronic (two-year) reduction in total energy expenditure and increased dietary restraint but did not increase symptoms of eating disorders. The results of this recent investigation and other studies have not provided experimental support for conventional dietary restraint theories of eating disorders. These findings are discussed in terms of potential revisions of dietary restraint theory, as well as the implications for a paradigm shift in public health messaging related to dieting.
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Affiliation(s)
- Tiffany M. Stewart
- Pennington Biomedical Research Center, Baton Rouge, LA 70808, USA; (C.K.M.); (D.A.W.)
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37
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Risk factors and prevention strategies in eating disorders. NUTR HOSP 2022; 39:16-26. [DOI: 10.20960/nh.04174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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38
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Kirk S, Ogata B, Wichert E, Handu D, Rozga M. Treatment of Pediatric Overweight and Obesity: Position of the Academy of Nutrition and Dietetics Based on an Umbrella Review of Systematic Reviews. J Acad Nutr Diet 2022; 122:848-861. [DOI: 10.1016/j.jand.2022.01.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 01/13/2022] [Indexed: 10/19/2022]
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Dettmer E, Grewal S, Regina A, Phung N, Steinegger C, Hamilton J, Toulany A. Development and Implementation of a Pilot Integrative Day Hospital Program for Youth with Severe Obesity and Mental Health Issues. Child Obes 2021; 17:563-572. [PMID: 34542323 DOI: 10.1089/chi.2021.0088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background: Adolescents with severe obesity and comorbid mental health issues are the most resistant to traditional weight management approaches and have poor treatment outcomes. Our objective was to implement and evaluate a pilot day hospital treatment program for adolescents with severe obesity, or risk for severe obesity, and significant mental health comorbidities. Methods: This was a prospective cohort study of adolescents 12-18 years of age with severe obesity (BMI >99th percentile), or at risk for severe obesity, and comorbid mental health issues. The intervention, focused on healthy lifestyle and mental health support, was implemented within an existing psychiatric day hospital at a pediatric quaternary care hospital. Anthropometric and mental health measures were analyzed pre- and postintervention. Results: Thirty-two adolescents with a mean age of 14.9 years [standard deviation (SD) 1.6] participated in the pilot integrative day hospital program for a mean duration of 5.2 months (SD 2.3). Eleven participants had primary severe obesity and comorbid mental health conditions (obesity subgroup) and 21 participants had primary mental illness and were at risk for obesity (psychiatry subgroup). We did not observe a significant difference between BMI pre- and postprogram among adolescents in both subgroups. In other words, adolescents in both subgroups achieved weight maintenance. Fear in losing control of overeating and/or being seen by others when eating decreased significantly in the obesity subgroup [mean difference (MD) 0.99; 95% confidence interval (CI): 0.27 to 1.71]. There was a significant decrease in participant-reported depression symptom severity, both overall and within program subgroups. Quality-of-life scores of study participants improved significantly within the obesity subgroup (MD -12.31; 95% CI: -21.69 to -2.93), but not within the psychiatry subgroup (MD -6.35; 95% CI: -13.37 to 0.67). Conclusions and Implications: A day hospital model of care may result in weight maintenance, decreased eating concerns, and improved mental health in adolescents with severe obesity or risk for severe obesity, and significant mental health comorbidities.
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Affiliation(s)
- Elizabeth Dettmer
- Department of Pediatrics and University of Toronto Faculty of Medicine, Toronto, Ontario, Canada.,Department of Psychology and The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Seena Grewal
- Department of Psychiatry, University of Toronto Faculty of Medicine, Toronto, Ontario, Canada.,Department of Psychiatry, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Andrea Regina
- Department of Psychology and The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Natalie Phung
- Divisions of Adolescent Medicine and Department of Pediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Cathleen Steinegger
- Department of Pediatrics and University of Toronto Faculty of Medicine, Toronto, Ontario, Canada.,Divisions of Adolescent Medicine and Department of Pediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Jill Hamilton
- Department of Pediatrics and University of Toronto Faculty of Medicine, Toronto, Ontario, Canada.,Divisions of Endocrinology, Department of Pediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Alene Toulany
- Department of Pediatrics and University of Toronto Faculty of Medicine, Toronto, Ontario, Canada.,Divisions of Adolescent Medicine and Department of Pediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada
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40
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Moore JM, Waldrop SW, Cree-Green M. Weight Management in Adolescents with Polycystic Ovary Syndrome. Curr Obes Rep 2021; 10:311-321. [PMID: 34043216 PMCID: PMC8898097 DOI: 10.1007/s13679-021-00437-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/19/2021] [Indexed: 12/26/2022]
Abstract
PURPOSE OF REVIEW Polycystic ovary syndrome (PCOS) is a common condition that clinically presents during adolescence. PCOS is associated with increased rates of overweight and obesity, as well as higher rates of metabolic disease, especially type 2 diabetes. Weight loss decreases PCOS symptoms and risk for metabolic disease. The goal of this review is to evaluate recent studies describing the hormonal, metabolic, and weight effects of different weight loss strategies: dietary, physical activity, pharmacotherapy, bariatric surgery, mood modification, and sleep. RECENT FINDINGS Calorie restriction continues to be supported as the primary nutrition intervention to achieve weight loss in individuals with PCOS, and a dietary macronutrient composition with lower compared to higher glycemic carbohydrates may be more effective. There is limited data that vitamins, nutraceuticals, and probiotics may improve hormonal and metabolic outcomes. Most types of physical activity are effective in improving outcomes in PCOS and lowering weight. Whereas there are promising data on anti-obesity medications such as glucagon-like peptide-1 receptor agonists in adults with PCOS and adolescents with obesity, further work is needed to know if these therapies are effective in youth with PCOS. Research is lacking on the effectiveness of other anti-obesity medications in PCOS. Bariatric surgery is especially promising for decreasing weight in adults and youth, and reversing type 2 diabetes in youth, though PCOS data are lacking. Treatment of depression in adolescents with insulin resistance and women with PCOS is associated with improved weight loss. Adolescents with PCOS and obesity may have greater sleep-related risks including circadian misalignment and obstructive sleep apnea, interventions for which have not yet been conducted. Clinical trials on weight loss strategies in adolescents with PCOS remain limited, with most information inferred from studies in women with PCOS or adolescents with obesity. However, there are multiple options to optimize weight loss in dietary, activity, pharmacotherapy, bariatric surgery, mood modification, and sleep domains.
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Affiliation(s)
- Jaime M Moore
- Department of Pediatrics, Section of Nutrition, University of Colorado School of Medicine Children's Hospital Colorado, Aurora, CO, 80045, USA
| | - Stephanie W Waldrop
- Department of Pediatrics, Section of Nutrition, University of Colorado School of Medicine Children's Hospital Colorado, Aurora, CO, 80045, USA
| | - Melanie Cree-Green
- Department of Pediatrics, Division of Pediatric Endocrinology, University of Colorado Anschutz Medical Campus, Aurora, CO, 80045, USA.
- Center for Women's Health Research, University of Colorado Anschutz Medical Campus, Aurora, CO, 80045, USA.
- Children's Hospital Colorado, University of Colorado Anschutz Medical Campus, PO Box 265, 13123 E 16th Ave, Aurora, CO, 80045, USA.
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Hoare JK, Jebeile H, Garnett SP, Lister NB. Novel dietary interventions for adolescents with obesity: A narrative review. Pediatr Obes 2021; 16:e12798. [PMID: 33955208 DOI: 10.1111/ijpo.12798] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 04/07/2021] [Indexed: 12/17/2022]
Abstract
Adolescent obesity is increasing and a range of treatment approaches are needed. Provision of tailored treatment options accounting for individual and family needs, preferences, and capacity may encourage adolescents with obesity to seek treatment, and/or improve treatment outcomes. Delivered by trained health care professionals, novel dietary interventions may have utility for adolescents not responding to conventional diets, adolescents with comorbidities or severe obesity, and/or when rapid or substantial weight loss is required. This review describes current evidence and clinical considerations relating to the use of very low energy diets, low carbohydrate diets, and intermittent energy restriction in the treatment of adolescent obesity. Emerging evidence on the use of these novel dietary interventions demonstrates short-term weight-related and cardiometabolic improvements. While the evidence is encouraging, and no serious adverse effects have been reported, monitoring of intervention safety is essential. Considerations for health care professionals providing care to adolescents include nutritional adequacy, psychosocial health and social relationships during the intervention. Furthermore, long-term weight-related, cardiometabolic and psychological health outcomes of these dietary interventions are not well understood. Large randomised controlled trials are warranted to inform clinical practice and future guidelines for the use of novel dietary interventions in adolescents with obesity.
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Affiliation(s)
- Johanna K Hoare
- The University of Sydney, Children's Hospital Westmead Clinical School, Westmead, New South Wales, Australia.,Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Hiba Jebeile
- The University of Sydney, Children's Hospital Westmead Clinical School, Westmead, New South Wales, Australia.,Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Sarah P Garnett
- The University of Sydney, Children's Hospital Westmead Clinical School, Westmead, New South Wales, Australia.,Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Westmead, New South Wales, Australia.,Kids Research, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Natalie B Lister
- The University of Sydney, Children's Hospital Westmead Clinical School, Westmead, New South Wales, Australia.,Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
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42
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Lister NB, Baur LA, Paxton SJ, Jebeile H. Contextualising Eating Disorder Concerns for Paediatric Obesity Treatment. Curr Obes Rep 2021; 10:322-331. [PMID: 33970441 DOI: 10.1007/s13679-021-00440-2] [Citation(s) in RCA: 1] [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] [Accepted: 04/26/2021] [Indexed: 02/02/2023]
Abstract
PURPOSE OF REVIEW Eating disorders are complex mental health conditions that share risk factors with obesity. This review outlines the context for concerns that paediatric obesity treatment presents a risk for eating disorder development. RECENT FINDINGS Most children and adolescents undergoing professionally supervised obesity treatment will have improvements or no change to eating disorder risk profiles. However, some may subsequently develop a clinical eating disorder, and this is proposed to relate to weight-focussed dietary interventions that are standard in paediatric obesity treatment. Nevertheless, dietary restraint may not be a strong predictor of eating disorder risk in the context of paediatric obesity treatment. Most international guidelines recommend weight maintenance or weight loss as a treatment goal, and weight loss is related to improvements in cardiometabolic health but not eating disorder risk in the short term. The risk of inducing or exacerbating an eating disorder during paediatric weight management is likely to be low; however, the serious consequences combined with increasing scale of obesity treatment, and lack of empirical evidence, are of concern. There is a need for further research to identify long-term predictors of eating disorder development for children and adolescents who seek treatment for their obesity.
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Affiliation(s)
- Natalie B Lister
- Children's Hospital Westmead Clinical School, The University of Sydney, Westmead, Australia.
- Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Westmead, Australia.
| | - Louise A Baur
- Children's Hospital Westmead Clinical School, The University of Sydney, Westmead, Australia
- Weight Management Services, The Children's Hospital at Westmead, Westmead, Australia
| | - Susan J Paxton
- School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Hiba Jebeile
- Children's Hospital Westmead Clinical School, The University of Sydney, Westmead, Australia
- Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Westmead, Australia
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Jebeile H, Cardel MI, Kyle TK, Jastreboff AM. Addressing psychosocial health in the treatment and care of adolescents with obesity. Obesity (Silver Spring) 2021; 29:1413-1422. [PMID: 34431234 DOI: 10.1002/oby.23194] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 02/12/2021] [Accepted: 03/01/2021] [Indexed: 01/22/2023]
Abstract
Obesity affects 158 million youth worldwide and is associated with psychosocial comorbidity. This review describes weight management options utilized by adolescents, including both self-directed weight loss and medically supervised obesity treatment interventions, and associated psychosocial impacts. A majority of adolescents with obesity attempt to manage weight on their own, primarily through attempting weight loss, sometimes with supplement use. Approaches such as these are associated with a degree of risk, disordered eating behaviors, and further weight gain. In contrast, medically supervised multicomponent interventions are associated with improved psychosocial health, including quality of life, self-esteem, and body image, and reduced symptoms of depression, anxiety, and eating disorders. Few studies utilizing antiobesity pharmacotherapy have reported psychosocial outcomes, and trials of bariatric surgery show some early improvements with a need for sustained psychological support following surgery. Greater access to medically supervised treatment services is required to facilitate obesity care for adolescents. Early data on psychosocial health and obesity treatment offer promising outcomes; however, larger randomized controlled trials and longer-term data are needed. Future research should include both physiological and psychosocial outcomes to assess impact of interventions on the holistic health of adolescents with obesity.
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Affiliation(s)
- Hiba Jebeile
- Children's Hospital Westmead Clinical School, The University of Sydney, Sydney, New South Wales, Australia
- Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Michelle I Cardel
- Department of Health Outcomes and Biomedical Informatics, University of Florida College of Medicine, Gainesville, Florida, USA
- Center for Integrative Cardiovascular and Metabolic Disease, University of Florida, Gainesville, Florida, USA
| | | | - Ania M Jastreboff
- Department of Internal Medicine (Endocrinology & Metabolism), Yale University School of Medicine, New Haven, Connecticut, USA
- Department of Pediatrics (Pediatric Endocrinology), Yale University School of Medicine, New Haven, Connecticut, USA
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Introducing Dietary Self-Monitoring to Undergraduate Women via a Calorie Counting App Has No Effect on Mental Health or Health Behaviors: Results From a Randomized Controlled Trial. J Acad Nutr Diet 2021; 121:2377-2388. [PMID: 34427188 DOI: 10.1016/j.jand.2021.06.311] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 05/17/2021] [Accepted: 06/30/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND Strong positive relationships between dietary self-monitoring and eating disorder risk are seen in population-based, observational studies. However, current evidence cannot establish causality. Furthermore, little is known about other mental and behavioral health consequences of dietary self-monitoring among college women, a population vulnerable to eating disorders. OBJECTIVE To determine if introducing dietary self-monitoring via a popular smartphone app to undergraduate women impacts eating disorder risk, other aspects of mental health, or health behaviors including dietary intake and physical activity. DESIGN Randomized controlled trial. PARTICIPANTS/SETTING Undergraduate women who had not engaged in dietary self-monitoring in the past year and who were at low-risk for an eating disorder participated between May and October 2019 (n = 200). INTERVENTION Participants were randomly assigned to engage in dietary self-monitoring via MyFitnessPal for approximately 1 month or to receive no intervention. MAIN OUTCOME MEASURES Self-report data on eating disorder risk, other mental health outcomes, and health behaviors were collected at baseline and post-intervention. STATISTICAL ANALYSES PERFORMED Linear and logistic regressions were utilized to test hypotheses. RESULTS Adherence to the intervention was high, with participants recording their dietary intake via MyFitnessPal on average 89.1% of days between baseline and post-intervention. Assignment to the intervention was not associated with changes in eating disorder risk, anxiety, depressive symptoms, body satisfaction, quality of life, nutritional intake, physical activity, screen time, or other forms of weight-related self-monitoring (all P > .05). CONCLUSIONS Among dietary self-monitoring naive undergraduate women with low-risk of an eating disorder, dietary self-monitoring via MyFitnessPal for 1 month did not increase eating disorder risk, impact other aspects of mental health, or alter health behaviors including dietary intake. The null results in our study may be due to the selection of a low-risk sample; future research should explore whether there are populations for whom dietary self-monitoring is contraindicated.
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Moustafa AF, Quigley KM, Wadden TA, Berkowitz RI, Chao AM. A systematic review of binge eating, loss of control eating, and weight loss in children and adolescents. Obesity (Silver Spring) 2021; 29:1259-1271. [PMID: 34227229 PMCID: PMC8319063 DOI: 10.1002/oby.23185] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 03/16/2021] [Accepted: 03/22/2021] [Indexed: 12/15/2022]
Abstract
OBJECTIVE This review synthesizes literature on changes in binge eating (BE) and loss of control eating (LOC) following weight loss and the association between BE/LOC and weight loss in children and adolescents. METHODS A systematic literature search was conducted in PubMed, Scopus, and PsycInfo. Eligible studies included all peer-reviewed journal articles of primary research that assessed BE/LOC and weight change following a weight-loss intervention in individuals under 18 years of age. RESULTS The 29 articles included studies on behavioral therapy, pharmacotherapy, and surgical interventions. Of the 14 studies that assessed the relationship between weight loss and BE/LOC at baseline, 4 showed that higher baseline BE/LOC was associated with less weight loss, whereas 10 showed no significant association. BE/LOC behaviors significantly decreased following weight-loss interventions in 20 of 21 studies. A greater decrease in BE/LOC was associated with improved weight loss in 4 of 9 studies that assessed this change. CONCLUSIONS Weight-loss interventions are associated with improved BE/LOC in youth with obesity. The persistence of BE/LOC symptoms may be associated with less weight loss. These results can aid in guiding future treatment for youth with BE/LOC seeking weight-loss treatment.
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Affiliation(s)
| | - Kerry M. Quigley
- Perelman School of Medicine at the University of Pennsylvania, Department of Psychiatry, Philadelphia, PA, US
| | - Thomas A. Wadden
- Perelman School of Medicine at the University of Pennsylvania, Department of Psychiatry, Philadelphia, PA, US
| | - Robert I. Berkowitz
- Perelman School of Medicine at the University of Pennsylvania, Department of Psychiatry, Philadelphia, PA, US
- The Children’s Hospital of Philadelphia, Department of Child and Adolescent Psychiatry and Behavioral Sciences, Philadelphia, PA, USA
| | - Ariana M. Chao
- Perelman School of Medicine at the University of Pennsylvania, Department of Psychiatry, Philadelphia, PA, US
- University of Pennsylvania School of Nursing, Department of Biobehavioral Health Sciences, Philadelphia, PA, USA
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46
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Lampe EW, Abber SR, Forman EM, Manasse SM. Guidelines for caregivers and healthcare professionals on speaking to children about overweight and obesity: a systematic review of the gray literature. Transl Behav Med 2021; 10:1144-1154. [PMID: 33044530 DOI: 10.1093/tbm/ibaa012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Caregivers and healthcare professionals (HPs) are increasingly concerned about childhood obesity. A critical consideration of caregivers and HPs is discussing weight status without provoking disordered eating. Given the complexity of these interacting concerns, major health advocacy groups have independently published guidelines for having conversations with children about overweight/obesity. The current investigation represented the first-ever systematic review of these guidelines to analyze their content, consistency, actionability, or scientific support. To conduct a systematic review, the authors performed a web-based search using the terms parent/HP, guidelines, child, and overweight/obesity that identified 59 guidelines on childhood obesity broadly, of which 13 provided explicit direction on how the caregiver or HP should approach a conversation about overweight with a child. Within these 13 guidelines, nine topic domains were identified: attitude modeling (covered by 31% of guidelines), behavior modeling (61%), dietary recommendations (54%), physical activity (46%), body acceptance and self-esteem (69%), conversation advice (92%), contact with HP (46%), talking about "weight" versus "overall health" (54%) and external factors (e.g., bullying, media) (54%). Although guidelines presented similar content, several inconsistencies in recommendations emerged. Notably, only three of the 13 guidelines referenced any scholarly sources and only a small minority of advice was actionable by caregivers or HPs. It is evident that guidelines for caregivers and HPs on speaking to children about obesity offer inconsistent advice, minimally based on empirical evidence. Future guidelines should aim to unify their messages for caregivers and HP and be better supported by empirical data.
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Affiliation(s)
- Elizabeth W Lampe
- Center for Weight, Eating, and Lifestyle Science, Drexel University, Philadelphia, PA 19104, USA.,Department of Psychology, Drexel University, Philadelphia, PA 19104, USA
| | - Sophie R Abber
- Center for Weight, Eating, and Lifestyle Science, Drexel University, Philadelphia, PA 19104, USA.,Department of Psychology, Drexel University, Philadelphia, PA 19104, USA
| | - Evan M Forman
- Center for Weight, Eating, and Lifestyle Science, Drexel University, Philadelphia, PA 19104, USA.,Department of Psychology, Drexel University, Philadelphia, PA 19104, USA
| | - Stephanie M Manasse
- Center for Weight, Eating, and Lifestyle Science, Drexel University, Philadelphia, PA 19104, USA
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McDonald JB, Rancourt D. Treating Bulimia Nervosa and Achieving Medically Required Weight Loss: A Case Study. COGNITIVE AND BEHAVIORAL PRACTICE 2021. [DOI: 10.1016/j.cbpra.2021.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Grammer AC, Best JR, Fowler LA, Balantekin KN, Stein RI, Conlon RPK, Saelens BE, Welch RR, Perri MG, Epstein LH, Wilfley DE. General and Eating Disorder Psychopathology in Relation to Short- and Long-Term Weight Change in Treatment-Seeking Children: A Latent Profile Analysis. Ann Behav Med 2021; 55:698-704. [PMID: 32914852 PMCID: PMC8240132 DOI: 10.1093/abm/kaaa076] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Concurrent general psychopathology (GP) and eating disorder psychopathology (EDP) are commonly reported among youth with overweight/obesity and may impact weight change. PURPOSE We identified patterns of GP and EDP in children with overweight/obesity and examined the impact on weight change following family-based behavioral obesity treatment (FBT) and maintenance interventions. METHODS Children (N = 172) participated in 4 month FBT and subsequent 8 month weight maintenance interventions. GP and EDP were assessed prior to FBT (baseline). Child percentage overweight was assessed at baseline, post-FBT (4 months), and post-maintenance (12 months). Latent profile analysis identified patterns of baseline GP and EDP. Linear mixed-effects models examined if profiles predicted 4- and 12-month change in percentage overweight and if there were two-way and three-way interactions among these variables, adjusting for relevant covariates. RESULTS Results indicated a three-profile structure: lower GP and EDP (LOWER); subclinically elevated GP and EDP without loss of control (LOC; HIGHER); and subclinically elevated GP and EDP with LOC (HIGHER + LOC). Across profiles, children on average achieved clinically meaningful weight loss (i.e., ≥9 unit change in percentage overweight) from baseline to 4 month FBT and sustained these improvements at 12 month maintenance. There was no evidence that latent profiles were related to percentage overweight change from baseline to FBT (p > .05) or baseline to maintenance (p > .05). There was no evidence for two-way or three-way interactions (p > .05). CONCLUSION Concurrent GP and EDP do not portend differential short- or long-term weight change following FBT and maintenance. Future research is warranted on the durability of weight change among youth with GP and EDP. TRIAL REGISTRATION NCT00759746.
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Affiliation(s)
- Anne Claire Grammer
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - John R Best
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Lauren A Fowler
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Katherine N Balantekin
- Department of Exercise and Nutrition Sciences, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, USA
| | - Richard I Stein
- Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Rachel P Kolko Conlon
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Brian E Saelens
- Department of Pediatrics, University of Washington and Seattle Children’s Research Institute, Seattle, WA, USA
| | - R Robinson Welch
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Michael G Perri
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Leonard H Epstein
- Department of Pediatrics, Division of Behavioral Medicine, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, USA
| | - Denise E Wilfley
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
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49
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Wang YY, Tian T, Pan D, Zhang JX, Xie W, Wang SK, Xia H, Dai Y, Sun G. The relationship between dietary patterns and overweight and obesity among adult in Jiangsu Province of China: a structural equation model. BMC Public Health 2021; 21:1225. [PMID: 34172040 PMCID: PMC8229268 DOI: 10.1186/s12889-021-11341-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 06/16/2021] [Indexed: 12/14/2022] Open
Abstract
Aims This study aimed to analyze the relationship between diet and overweight and obesity in Jiangsu Province by using structural equation modeling (SEM), and to determine dietary differences between genders in the model. Methods Data from 1739 individuals (53.8% female, n = 935) were analyzed. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to classify dietary patterns. SEM and multivariate logistic regression were used to explore the relationship between dietary patterns and overweight and obesity. Results Overweight and obesity was found in 49.1%, and no difference was found in gender (51.2% of men and 47.2% of women, respectively; P = 0.090). Three dietary patterns: the traditional dietary pattern (i.e., poultry, light-colored vegetables, red meat and its products, cereals and tubers products, condiment, oils and dark-colored vegetables), the fruit-egg dietary pattern (i.e., fruit, whole grains, pickled vegetables and eggs and eggs products) and nut-wine dietary pattern (i.e., nut, wine and pastry snacks) were established by using EFA and CFA. It was found that the traditional dietary pattern for adult male was positively associated with the overweight and obesity in Jiangsu Province of China through multivariate logistic regression and SEM (OR = 1.954; 95%CI: 1.258 ~ 3.036; β =0.121, P < 0.05, respectively). Conclusion The traditional dietary pattern only have positive association with overweight and obesity in men in Jiangsu Province, China.
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Affiliation(s)
- Yuan-Yuan Wang
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, and Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, 87 Ding Jia Qiao Road, Nanjing, 210009, China
| | - Ting Tian
- Institute of Food Safety and Assessment, Jiangsu Provincial Center for Disease Control and Prevention, No.172 Jiangsu Road, Nanjing, 210009, Jiangsu, China
| | - Da Pan
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, and Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, 87 Ding Jia Qiao Road, Nanjing, 210009, China
| | - Jing-Xian Zhang
- Institute of Food Safety and Assessment, Jiangsu Provincial Center for Disease Control and Prevention, No.172 Jiangsu Road, Nanjing, 210009, Jiangsu, China
| | - Wei Xie
- Institute of Food Safety and Assessment, Jiangsu Provincial Center for Disease Control and Prevention, No.172 Jiangsu Road, Nanjing, 210009, Jiangsu, China
| | - Shao-Kang Wang
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, and Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, 87 Ding Jia Qiao Road, Nanjing, 210009, China
| | - Hui Xia
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, and Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, 87 Ding Jia Qiao Road, Nanjing, 210009, China
| | - Yue Dai
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, and Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, 87 Ding Jia Qiao Road, Nanjing, 210009, China. .,Institute of Food Safety and Assessment, Jiangsu Provincial Center for Disease Control and Prevention, No.172 Jiangsu Road, Nanjing, 210009, Jiangsu, China.
| | - Guiju Sun
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, and Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, 87 Ding Jia Qiao Road, Nanjing, 210009, China.
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Williams K, Sutton J, Brown J. Cochrane commentaries. J Paediatr Child Health 2021; 57:953-955. [PMID: 34008242 DOI: 10.1111/jpc.15463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 03/18/2021] [Indexed: 12/01/2022]
Affiliation(s)
- Katrina Williams
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Julia Sutton
- Department of Paediatric Endocrinology, Monash Children's Hospital, Melbourne, Victoria, Australia
| | - Justin Brown
- Department of Paediatric Endocrinology, Monash Children's Hospital, Melbourne, Victoria, Australia.,Department of Paediatrics, Monash University, Melbourne, Victoria, Australia
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