The role of parents in adolescent obesity treatment: Results of the TEENS+ randomized clinical pilot trial.

Abstract

The optimal role for involving parents in adolescent obesity treatment is unknown. To demonstrate that two parent approaches within adolescent obesity treatment are distinct, as evidenced by differential parent outcomes, and determine the preliminary efficacy of each approach on adolescent weight loss. Adolescent/parent dyads (N=82; mean adolescent age=13.7 ± 1.2 years) participated in TEENS+, a 4-month behavioural weight loss treatment. Participants were randomized to: (1) TEENS+parents as coaches (PAC; parent skills training), or (2) TEENS+parent weight loss (PWL; adult behavioural weight loss). Assessments occurred at 0, 4 (post-treatment), and 7-months. Within- and between-group repeated measures general linear mixed models examined change in parent weight (∆kg; primary outcome); parenting, feeding, weight control strategies, home environment, and adolescent body mass index (∆BMI; secondary outcomes). PWL parents had greater 4-month weight losses (∆kg0-4m =-5.14 ± 4.87 kg) compared to PAC (-2.07 ± 3.89 kg; between-group p < 0.01). Key constructs differed between groups as expected. Both groups yielded significant within-group adolescent ∆BMI0-4m (PWL: -0.97 ± 1.38 kg/m2 vs. PAC: -0.93 ± 1.42 kg/m2 ; ps < 0.01); during maintenance, adolescents in PWL had ∆BMI4-7m increases (+0.41 ± 1.07 kg/m2 ; p=0.02) while PAC did not (+0.05 ± 1.31 kg/m2 ; p=0.82). Parent treatments were distinct in implementation and both yielded significant 4-month adolescent weight loss. Differential weight patterns were observed during maintenance, favouring PAC, warranting further exploration.