Treatment Of Adolescent Obesity Research Articles

Conservative Treatment for Childhood and Adolescent Obesity: Real World Follow-Up Profiling and Clinical Evolution in 1300 Patients.

Background: Limited therapeutic tools and an overwhelming clinical demand are the major limiting factors in pediatric obesity management. The optimal protocol, environment, body mass index (BMI) change targets and duration of obesity-oriented interventions remain to be elucidated. Aims: We aimed to characterize the singularities of follow-up, anthropometric and metabolic evolution of a large cohort of pediatric patients with obesity in a specialized university hospital outpatient obesity unit. Patients and methods: Follow-up duration (up to seven years), attrition rate and anthropometric and metabolic evolution of 1300 children and adolescents with obesity were studied. An individualized analysis was conducted in patients attaining a high level of weight loss (over 1.5 BMI-SDS (standard deviation score) and/or 10% of initial weight; n = 252; 19.4%) as well as in “metabolically healthy” patients (n = 505; 38.8%). Results: Attrition rate was high during the early stages (11.2% prior to and 32.5% right after their initial metabolic evaluation). Mean follow-up time was 1.59 ± 1.60 years (7% of patients fulfilled 7 years). The highest BMI reduction occurred in the first year (−1.11 ± 0.89 SDS, p < 0.001 in 72.5% of patients). At the end of the follow-up, improvements in glucose and lipid metabolism parameters were observed (both p < 0.05), that were highest in patients with the greatest weight reduction (all p < 0.01), independent of the time spent to achieve weight loss. The pubertal growth spurt negatively correlated with obesity severity (r = −0.38; p < 0.01) but patients attaining adult height exceeded their predicted adult height (n = 308, +1.6 ± 5.4 cm; p < 0.001). “Metabolically healthy” patients, but with insulin resistance, had higher blood pressure, glucose, uric acid and triglyceride levels than those without insulin resistance (all p < 0.05). Preservation of the “metabolically healthy” status was associated with BMI improvement. Conclusions: Behavioral management of children with obesity can be effective and does not impair growth but is highly conditioned by high attrition. The best results regarding BMI reduction and metabolic improvement are achieved in the first year of intervention and can be preserved if follow-up is retained.

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

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.

Effect of Physical Activity on Adolescent Obesity Status over Time: A Latent Growth Modeling Approach.

This study aims to examine the longitudinal influence of physical activity (PA) on obesity among normal-weight adolescents in South Korea. A total of 1347 data samples from the Korean Children and Youth Panel Survey from 2011 to 2014 were used. Latent growth modeling was applied. PA was assessed by the hours spent on PA during physical education (PE) classes in the last week. Body mass index for age was considered to determine obesity status. PA during PE positively predicted the intercept of obesity status, but it was not associated with the slope of obesity status. Although a longitudinal effect of PA was not identified, PA could influence the initial status of obesity. Because obesity in early years could steadily influence future obesity status, early detection and intervention for adolescent obesity are necessary. Moreover, more studies examining the effect of PA during PE on obesity status among adolescents should be conducted to identify the association between PA during PE and obesity status over time.

The effect and safety of high-intensity interval training in the treatment of adolescent obesity: a meta-analysis.

It's necessary to conduct meta-analysis to quantitatively evaluate the effect and safety of high-intensity interval training (HIIT) on obese adolescents, to provide a basis for the management of obesity in adolescents. Randomized controlled trials (RCTs) on the role of HIIT in the obese adolescents were searched from PubMed databases and so on up to Jan 15, 2021. Two researchers independently performed literature screening, literature quality evaluation and data extraction according to the inclusion and exclusion criteria. Revman 5.3 Software and Stata 12.2 Software were used for data analysis. A total of 11 RCTs with 488 obese adolescents were included. Meta-analysis indicated that HIIT can effectively reduce the body weight (MD =-1.73 kg, 95% CI: -3.25 to -0.21, P=0.02), BMI (MD =-1.42 kg/m2, 95% CI: -1.97 to -0.87, P<0.001), body fat percentage (MD =-1.70%, 95% CI: -2.94 to -0.45, P=0.007) and waist circumference (MD =-1.80 cm, 95% CI: -3.5 to -0.10, P=0.04). The "high-intensity short-interval" HIIT program can significantly reduce waist circumference (MD =-2.31 cm, 95% CI: -4.20 to -0.42, P=0.022), the "high-intensity long-interval" HIIT program is more beneficial to reduce the BMI (MD =-1.44 kg/m2, 95% CI: -2.03 to -0.84, P=0.001) and body fat percentage (MD =-0.56, 95% CI: -1.08 to -0.05, P=0.009). HIIT can effectively improve the body composition of obese adolescents and produce an effective fat-reducing effect, which should be promoted for the clinical treatment of adolescent obesity.

Can Antidiabetic Plants Used in Cameroon Play as Key for the Treatment of Childhood, Adolescent and Adult Obesity?

Can Antidiabetic Plants Used in Cameroon Play as Key for the Treatment of Childhood, Adolescent and Adult Obesity?

Running the Obstacle Course: Improving the Utilization of Bariatric Surgery in Adolescent Obesity

The obesity epidemic in the adolescent population continues to worsen despite increased awareness. Although there is an improved understanding of the role of bariatric surgery in the treatment of obesity in adolescents, a number of barriers still prevent its widespread utilization. The lack of formal obesity-focused education in the training curricula of primary care providers (PCPs), coupled with variable distribution of comprehensive resources, creates an inhospitable environment for effective anti-obesity treatment in adolescents. In addition, racial disparities and variability in insurance coverage contribute to the complexity of this problem. The coronavirus disease 2019 (COVID-19) pandemic has exacerbated the rate of childhood obesity and emphasized the need for bariatric surgery as an adjunctive treatment. This article highlights 3 barriers to bariatric surgery: (1) hesitation to refer for surgery; (2) limitation in available resources; and (3) racial disparities in anti-obesity treatment. Potential systemic solutions to such obstacles are examined.

Adapting pediatric obesity care to better suit adolescent patients: Design of a treatment platform and results compared with standard care in the national patient quality register.

BackgroundObesity constitutes a critical risk for adolescent health. This study aimed at identifying youth‐friendly components of obesity treatment.MethodsIn this feasibility study, an adolescent obesity treatment platform was implemented at two Pediatric outpatient clinics in Sweden. Body mass index (BMI), BMI z‐score, and the category of obesity (International Obesity Task Force) were compared before and after the intervention and with data on standard care from the Swedish Childhood Obesity Treatment Register.ResultsThe study included 99 participants (49 females) aged 13–18 years from 1 September 2014, to 31 December 2016. A pediatric nurse met the participants on average 6.5 times in the average inclusion period of 15 months. Physical activity sessions attracted 63 participants. Acceptance Commitment Therapy and In Real Life groups attracted 24 participants. At inclusion, 62 participants had obesity and 37 severe obesity, and 71/99 (72%) remained in the same category. The mean BMI increased from 32.0 to 33.4 kg/m2 (p < 0.01), but 56/94 (60%) participants lowered their BMI or increased less than 1 kg/m2 and 73% stayed to the end of the study. Participants who were new to treatment and participants coming for more than eight visits to the nurse did not increase in BMI. BMI did not change for the 221 out of 641 register patients who had two recordings of BMI in the study period.ConclusionsThe platform was successful in increasing retention, and 60% of participants lowered or maintained their BMI. Still, seven out of ten adolescents with obesity or severe obesity remained in the same weight category.

Evaluation of full-endoscopic lumbar discectomy in the treatment of obese adolescents with lumbar disc herniation: a retrospective study

BackgroundObese patients are at risk of complications after spinal surgery. Full-endoscopic lumbar discectomy (FELD) has advantages over conventional open surgery in the treatment of obese adult patients with lumbar disc herniation (LDH) because it can decrease perioperative complications and enhance the degree of patient satisfaction. However, no clinical studies have evaluated the efficacy of FELD in obese adolescents with LDH (ALDH). This study aimed to evaluate the efficacy of FELD for the treatment of obese ALDH.MethodsWe retrospectively collected clinical data from 208 patients with single-segment ALDH who underwent FELD in our hospital between January 2015 and December 2019. According to the WHO classification of obesity, the patients were divided into obese (BMI ≥30 kg/m2) and non-obese (BMI < 30 kg/m2) groups (control group). Based on the preoperative baseline data of the two groups, propensity score matching was performed to select patients from these groups for a comparative study. Perioperative data included operative time, intraoperative blood loss, and length of postoperative hospitalization. The visual analog scale (VAS), Oswestry disability index (ODI), and modified MacNab criteria were recorded as the main indicators of the surgical outcome. Recurrence rate and incidence of complications were recorded as minor indicators.ResultsTwenty-eight patients and 80 patients were included in the obese and non-obese groups, respectively, after 1:4 propensity score matching. Both groups showed improvements in VAS and ODI scores after surgery and at each follow-up time point (p < 0.05). However, there was no significant statistical difference in the surgical outcomes between the two groups at each follow-up time point (p > 0.05). The differences in operative time, intraoperative blood loss, and length of postoperative hospitalization were not statistically significant between the two groups (p > 0.05).ConclusionFELD is a safe and effective minimally invasive technique for treating obese patients with ALDH. The efficacy of FELD in obese and non-obese patients with ALDH was comparable.

Effect of a High-Intensity Dietary Intervention on Changes in Dietary Intake and Eating Pathology during a Multicomponent Adolescent Obesity Intervention.

Concerns remain about dietary changes during pediatric obesity treatment and eating pathology, which have not been investigated. This secondary data analysis from a randomized clinical trial examined associations between adolescents’ changes in energy intake and diet quality during obesity treatment with post-treatment eating pathology. Adolescents (N = 82: 13.7 ± 1.2 y, 34.9 ± 7.0 kg/m2, 63.4% female, 46.3% black) received TEENS+, a 4-month multicomponent intervention. TEENS+ provided individualized dietary goals (1200–1800 kcal/day; number of “Go” foods/day (low-energy, high-nutrient-dense foods)). At 0 and 4 months, 3-day food records assessed energy intake and diet quality (Healthy Eating Index 2015 (HEI-2015)). Two HEI-2015 subscores were created: components to increase (increase), and components to limit (decrease). The Eating Disorder Examination Questionnaire measured eating pathology (total score and subscales: restraint; and eating, weight, and shape concern). Corrected p-values are reported as q-values. Energy intake decreased (−292 ± 418 kcal/day; q < 0.001), while diet quality improved during treatment (total HEI-2015 (4.5 ± 15.1; q = 0.034) and increase (3.3 ± 9.4; q = 0.011)). Restraint increased (+0.6 ± 1.4; q < 0.001), whereas shape (−0.5 ± 1.3; q = 0.004) and weight (−0.5 ± 1.4; q = 0.015) concerns decreased. Greater decreases in energy intake were associated with greater restraint post-treatment (F = 17.69; q < 0.001). No other significant associations were observed. Changes in adolescents’ dietary intake during obesity treatment were unrelated to increased shape, weight, or eating concerns post-treatment.

Racial Disparities in Obesity Treatment Among Children and Adolescents.

Purpose of ReviewWith the growing obesity epidemic among children and adolescents, the evaluation of disease origin to slow disease progression is necessary. Racial disparities which are evident amid prevalence and treatment must be studied to counteract disease propagation.Recent FindingsDisparities are pronounced among Black and Hispanic pediatric patients prior to conception and birth due to genetic composition and fetal environment. Postnatal environment and psychosocial influences can further increase a child/adolescent’s propensity to increased weight. Current treatment options including nutrition, physical activity, behavior modification, pharmacotherapy, and surgery are underutilized in communities of color due to limited access to care and cost.SummaryData is limited to demonstrate disparities among treatment of obesity in children and adolescents. The reviewed studies show the role of race on disease treatment. Increased research efforts, especially in pharmacotherapy and metabolic and bariatric surgery (MBS), will help combat obesity in pediatric communities of color.

Novel dietary interventions for adolescents with obesity: A narrative review

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.

Mobile Health Interventions Addressing Childhood and Adolescent Obesity in Sub-Saharan Africa and Europe: Current Landscape and Potential for Future Research.

Child and adolescent overweight is a growing public health problem globally. Europe and low and middle-income (LMIC) countries in Sub-Saharan Africa provide sufficiently suitable populations to learn from with respect to the potential for mobile health (mHealth) interventions in this area of research. The aim of this paper is to identify mHealth interventions on prevention and treatment of childhood and adolescent obesity in Sub-Saharan Africa and Sweden and report on their effects, in order to inform future research in this area. A search of peer-reviewed publications was performed using PubMed, ScienceDirect, EBSCOhost, and Scopus. The search included all articles published up to August 2019. The search strings consisted of MeSH terms related to mHealth, overweight or obesity, children, adolescents or youth and individual countries in Europe and Sub-Saharan Africa. Second, a combination of free-text words; mobile phone, physical activity, exercise, diet, weight, BMI, and healthy eating was also used. Seven studies were reported from Europe and no eligible studies from Sub-Saharan Africa. The results of this narrative review indicate a lack of research in the development and testing of mHealth interventions for childhood and adolescent obesity. There is a need for an evidence base of mHealth interventions that are both relevant and appropriate in order to stem the epidemic of overweight and obesity among children and adolescents in these countries. Uptake of such interventions is likely to be high as there is high penetrance of mobile phone technology amongst adolescents, even within poor communities in Africa.

Behavioral Weight Loss Intervention Preferences of Adolescents with Overweight/Obesity.

Background: Behavioral lifestyle interventions are the foundation of adolescent obesity treatment. Tailoring an intervention using adolescent stakeholder engagement during the development process could improve intervention effectiveness. Methods: Adolescents with overweight/obesity ages 14-19 (n = 41) participated in 11 sex-specific focus groups (girls = 6, boys = 5) and were asked their preferences regarding who should lead the intervention and be involved, what the messaging of the program should be, how to make the program engaging and maintain participation, and how to best measure nutrition intake and activity. Transcripts were coded and analyzed for emergent themes. Results: Mean age was 16.0 ± 1.8 years and participants were racially/ethnically diverse. Adolescents preferred interventions that avoid a focus on "weight loss," and instead emphasize "healthy lifestyle," which represents a more comprehensive goal of targeting physical and mental well-being. Most participants indicated preferences for a relatable instructor with prior weight loss experience. Both sexes preferred optional parental involvement, as some parents were described as helpful, while others were perceived as a hindrance to success. Boys and girls identified incentives, engaging activities, and electronic communication as core components for engagement and retention, with girls emphasizing socialization and building relationships. Sex differences in preferences were observed. Girls had more concerns about intervention participation and preferred interventions to be sex stratified. Conclusions: Behavioral interventions to treat adolescent obesity should focus messaging/content on healthy lifestyles, rather than weight loss, and be sex stratified. Development and implementation of future behavioral interventions for adolescent obesity should consider tailoring to adolescent preferences when possible to improve feasibility, acceptability, and effectiveness.

Childhood obesity, effects on the cardiovascular system and quality of life: The role of physical therapy

Childhood obesity is a global problem, with its prevalence in the developed world increasing fourfold in recent decades. Obesity in children is defined by the Body Mass Index and is responsible for many physical and psychological problems, as well as for reduced perceived quality of life. In recent years, it has become increasingly worrying that diseases affecting adult populations, such as diseases of the cardiorespiratory system, also affect children, as well as the health of adults who have been obese children. The involvement of physiotherapists in the treatment of obesity in children and adolescents can lead to a more understandable assessment and improved care and treatment of obesity.

Impact of Baseline BMI and Adherence to Follow-Up on the Outcome of Sleeve Gastrectomy in Treatment of Adolescent Obesity.

Adolescent obesity is considered a public health challenge. Sleeve gastrectomy (SG) may be considered a safe option for treatment of adolescent obesity. This study aimed to assess the outcomes of SG in treatment of severe obesity in adolescents, with emphasis on the impact of baseline body mass index (BMI) and adherence to follow-up. This was a single-center retrospective cohort study on adolescents with severe obesity who underwent SG at a tertiary referral bariatric center. The main outcome measures were weight loss, improvement in comorbidities at 12 months postoperatively, and complications. A total of 72 adolescent patients (47 female) of a mean BMI of 47.9 ± 7.1 kg/푚2 were enrolled in the study. The mean %TWL was 34.94 ± 9.35 and the mean %EWL was 73.47 ± 22.12. Complete remission was recorded in all patients with type 2 diabetes mellitus (DM), pre-DM, and sleep apnea, in 80% of patients with hypertension, and 57% of patients with hypothyroidism. The long-term complication rate after SG was 18%. Patients with higher preoperative BMI had significantly (p = 0.018) lower %EWL at 1 year. SG is an effective and safe surgical procedure for adolescents with severe obesity. It was associated with a significant weight loss, high comorbidity remission rates, and no mortality or serious complications. Lower baseline BMI and better adherence to follow-up were associated with better outcome of SG.

Childhood Obesity Interventions by Setting

Background: To combat the global health crisis of obesity, many interventions have been implemented, including in children and adolescents. This age range is uniquely important because health behavior continues into adulthood, resulting in lifelong health risks or benefits. This narrative review aims to provide a cross section of the scientific literature regarding obesity interventions by setting, including school-based, daycare-based, home-based, healthcare-based, and digital-based, as well as to highlight gaps in research. Methods: Articles written in English addressing childhood and adolescent obesity interventions were sought online using PubMed and Google Scholar searches. Although some articles were from a global perspective, the majority focused on children in the United States. This search included reviews, individual studies, and other related papers. Results: School-based interventions are accessible to many, but there is limited evidence of long-term benefits. Home-based interventions were the only setting to have compelling evidence of long-term benefits, although there are several barriers to participation. Healthcare-based interventions are often successful when specific strategies and unique advantages of healthcare settings are utilized. Digital interventions have limited success now, but show potential for cost-effective scaling up as technology improves. Conclusion: The clearest gap in research is the lack of long-term studies, especially of school-based and healthcare-based interventions. Thus, it is imperative that investments are made into studies that include follow-up components continuing at least 1-2 years after the intervention. Additionally, home-based interventions have been more successful during early childhood while school-based interventions tend to be more successful during adolescence.

Role of genetic and epigenetic factors in formation of obesity and cardiometabolic disorders in boys

The literature review is devoted to modern ideas about the genetic and epigenetic factors of the formation of obesity and concomitant complications in boys. Risk factors for overweight are prepubertal age, male sex, and urban environment. Initial signs of metabolic disorders appear already in childhood and are more often recognized in children with excess body weight and family history. Increased body mass index in late pubertal is strongly associated with cardiovascular mortality (in young adults or in adulthood). Genetic factors for the development of obesity are family history of obesity, type 2 diabetes, hypertension, and adverse genotypes; epigenetic factors are diet pattern, level of physical activity, metabolic disorders in mother, etc. Encouraging higher levels of physical activity and less sedentary behavior may mitigate the effect of risk alleles on genetic predisposition to obesity. It was revealed that the development of severe forms of obesity is associated with an increased prevalence of metabolic and cardiovascular risk factors, especially among boys and young men. The presence of obesity and its progression are independent risk factors for cardiometabolic disorders in boys. An important role in the prevention and treatment of obesity in childhood and adolescence belongs to formation of a conscious attitude to health. The development of individual programs taking into account the presence of unfavorable genotypes and correction of the epigenome will significantly improve the system of obesity prevention at earlier age periods, will prevent or delay the manifestation of complications in adulthood.

The Efficacy of School-Based Interventions in Preventing Adolescent Obesity in Australia.

Current trends suggest that adolescent obesity is an on-going and recurrent decimal that is still on the rise in Australia and the social burden associated with it can significantly cause low self-esteem and lack of confidence in personal body image in adulthood. Nonetheless, evidence-based prevention programs are not widely implemented in schools, even though they are commonplace for easy access to adolescents. The primary objective of this systematic review was to assess the scope and efficacy of adolescent obesity intervention strategies in Australian schools, to guide future research. Seven electronic databases were searched for peer-reviewed school-based intervention articles written in the English language and targeting 12–18-year-old adolescents. Intervention characteristics were extracted, and quality, efficacy and outcome measures were assessed utilizing thirteen studies that met the inclusion criteria for this review. Most of the Australian adolescent obesity research emanated from the State of New South Wales and none were nationwide. Five studies successfully met all the requirements in all measured outcomes, four met at least one measured outcome and the remaining four were unsuccessful. Despite the weak evidence of intervention efficacy for most of the reviewed studies, school-based interventions with multi-component combinations of physical activity, nutrition and alignment to a theory yielded promising results. Our findings point to the need for future research to assess the perceptions of school stakeholders in relation to the barriers and enablers to establishing school-based prevention and intervention programs for adolescents.

Factors associated with dropout in a lifestyle modification program for weight management in children and adolescents

BackgroundSignificant dropout rates remain a serious concern in pediatric weight control program, but few studies have identified predictors of dropout. AimsThe objective of the study is to identify factors associated with dropout from a pediatric lifestyle modification weight control program at different phases. MethodsData on overweight and obese participants (n = 242) aged 11–18 years in the Intervention for Childhood and Adolescent Obesity via Activity and Nutrition (ICAAN) study were collected at baseline, 6-months, and 24-months through self-report and a laboratory test. Logistic regression analysis was performed for those who dropped out during the first 6-months, and multivariate generalized estimating equation analysis identified longitudinal factors associated with those who dropped out after 24 months. ResultsLower family functioning (OR = 2.30, 95% CI [1.18−4.46]), exercise group (OR = 0.36, 95% CI [0.15−0.86]), lower initial attendance rate (OR = 6.09, 95% CI [2.94−12.6]), and non-self -referral pathways (OR = 2.35, 95% CI [1.05−5.27]) were significantly associated with 6-month dropouts. For late dropout, lower family functioning (OR = 1.71, 95% CI [1.06−2.77]) and lower initial attendance rates (OR = 2.06, 95% CI [1.12−3.81]) remained significant. ConclusionFamily function and initial attendance rate were associated with lower dropout rates. Developing a supportive family environment and focusing on the early-stage factors at the intervention’s outset may reduce overall dropout rates in obesity prevention intervention.

Parents and Adolescents: What’s the Right Mix in Obesity Treatment?

Successful obesity treatment hinges on helping the patient shift to a healthier lifestyle in the context of their environment. For adolescents, this means taking into account their current health status and developmental stage in the context of family, peer, and societal influences. Parents play a pivotal role in helping adolescents negotiate the transition to adulthood, and their involvement is essential in obesity treatment. In this issue of Pediatrics , Bean et al,1 in a systematic review, identify how parents are included in adolescent obesity treatment and “which elements of parental involvement are positively associated with adolescent weight loss.” The studies they examine involve a wide range of intervention strategies that were designed to promote weight loss by addressing diet and exercise behaviors and included a parent component. In this review, the authors raise important questions for future study and highlight the lack of consistent and specific information about parental interventions in adolescent obesity treatment. The authors identify the need for research to further explore the specific role of parents in terms, their adherence to recommendations, and their own lifestyle behaviors and examine the association of parent and adolescent outcomes in longer and more diverse trials. They also note the need for future studies to examine the link between specific parental interventions and adolescent weight loss.1 In addition … Address correspondence to Sandra G. Hassink, MD, 2602 Pennington Dr, Wilmington, DE 19810. E-mail: shassink{at}aap.net