Weight Management Program For Adolescents Research Articles

Quality-of-life outcomes of a weight management program for adolescents based on motivational interviewing

ObjectiveTo compare motivational interviewing (MI) with conventional care regarding the health-related quality-of-life (HRQoL) of adolescents with overweight/obesity. MethodsRCT with parallel design, involving two groups: intervention group (MI group [MIG]) and control group (conventional intervention group [CIG]). The intervention included three 30-minute interviews 3 months apart. OutcomeChange in Pediatric Quality of Life Inventory (PedsQL) scores. A mixed repeated-measures analysis of variance was used to assess group versus time interactions. ResultsEighty-three participants finished the protocol (82% girls). MIG participants showed a significant average increase (+4.7) on the Psychosocial (t[41] = -2.388, p = .022, d = .37) and Emotional Subscales (+5.1) (t[41] = 5.733, p < .001, d = .88). CIG participants showed a significant average decrease on the Psychosocial (-6.1) (t[40] = 5.733, p < .001, d = .90), Emotional (-14.1) (t[40] = 7.249, p < .001, d = 1.13) and Social Subscales (-3.8) (t[40] = 3.782, p = .001, d = .59) and on the Total Score (–4.4) (t[40] = 3.535, p = .001, d = .55) ConclusionMI improved HRQoL among overweight adolescents participating in a weight management program. Practice implicationsMI increases HRQoL and has the potential to benefit weight management programs for adolescents.

Combining Activity Trackers With Motivational Interviewing and Mutual Support to Increase Physical Activity in Parent-Adolescent Dyads: Longitudinal Observational Feasibility Study.

BackgroundAn essential component of any effective adolescent weight management program is physical activity (PA). PA levels drop dramatically in adolescence, contributing to the rising prevalence of adolescent obesity. Therefore, finding innovative interventions to address this decline in PA may help adolescents struggling with weight issues. The growing field of health technology provides potential solutions for addressing chronic health issues and lifestyle change, such as adolescent obesity. Activity trackers, used in conjunction with smartphone apps, can engage, motivate, and foster support among users while simultaneously providing feedback on their PA progress.ObjectiveThe objective of our study was to evaluate the effect of a 10-week pilot study using smartphone-enabled activity tracker data to tailor motivation and goal setting on PA for overweight and obese adolescents and their parents.MethodsWe queried enrolled adolescents, aged 14 to 16 years, with a body mass index at or above the 85th percentile, and 1 of their parents as to behaviors, barriers to change, and perceptions about exercise and health before and after the intervention. We captured daily step count and active minutes via activity trackers. Staff made phone calls to dyads at weeks 1, 2, 4, and 8 after enrollment to set daily personalized step-count and minutes goals based on their prior data and age-specific US national guidelines. We evaluated dyad correlations using nonparametric Spearman rank order correlations.ResultsWe enrolled 9 parent-adolescent dyads. Mean adolescent age was 15 (SD 0.9) years (range 14-16 years; 4 female and 5 male participants); mean parent age was 47 (SD 8.0) years (range 36-66 years). On average, adolescents met their personalized daily step-count goals on 35% (range 11%-62%) of the days they wore their trackers; parents did so on 39% (range 3%-68%) of the days they wore their trackers. Adolescents met their active-minutes goals on 55% (range 27%-85%) of the days they wore their trackers; parents did so on 83% (range 52%-97%) of the days. Parent and adolescent success was strongly correlated (step count: r=.36, P=.001; active minutes: r=.30, P=.007). Parental age was inversely correlated with step-count success (r=–.78, P=.01).ConclusionsOur findings illustrate that parent-adolescent dyads have highly correlated PA success rates. This supports further investigation of family-centered weight management interventions for adolescents, particularly those that involve the parent and the adolescent working together.

Evaluation of ‘JenMe’, a Commercially‐Delivered Weight Management Program for Adolescents: a Randomised Controlled Trial

ObjectiveAdolescent obesity is difficult to treat and widely accessible treatment options with proven efficacy remain scarce. This study evaluated a commercially available, structured short‐term weight management program designed for obese adolescents delivered by non‐health professionals.MethodsA multi‐site parallel‐group randomised controlled trial was conducted to evaluate a commercial 12 week lifestyle behavioral program in commercial weight management centres in Australia. Eligible participants (13–17 years, BMI z score ≥1.282 with no presenting morbidities) were randomized (n=88) to intervention or wait‐list and the program was delivered by consultants at participating weight management centres. The primary outcome was change in BMI z score. Secondary outcomes included the psychometric variables quality of life, body esteem and self‐esteem. Data was analyzed according to intention‐to‐treat principles.ResultsOf 88 participants randomised, 74 enrolled into the program and 12‐week data was available for 55 individuals (74%). A significantly greater decrease in BMI z‐score in the intervention group (n=32) was observed when compared with the wait‐list control group (mean difference (MD) = −0.27 kg/m2; 95% confidence interval [CI], −0.37, −0.17; P&lt;0.001). Participants allocated to receive the lifestyle intervention reported a greater improvement in body esteem (MD=2.3, 95%CI, 0.6, 4.1; P=0.009) and quality of life (MD=7.8, 95%CI, 1.6, 14.0; P=0.01) compared with the wait‐list control group. Similarly, intervention group participants had greater physical activity levels (MD=0.09 metabolic equivalents, 95%CI, 0.02, 0.17; P=0.03) compared with the wait‐list control group.ConclusionsThis evaluation provides evidence that a structured lifestyle intervention delivered by a commercial provider in an adolescent population can result in clinically relevant weight loss and improvements in psychosocial outcomes in the short term. Further research is required to evaluate long term outcomesSupport or Funding InformationThe study was funded by Jenny Craig Weight Loss Centres Pty Ltd as a research grant to A/Prof Bonham and Prof Truby. By contractual agreement, scientists (MB, HT, AD) at Monash University and other participating institutions (RW) have responsibility and independence regarding data management, analysis and publication.

Evaluation of a Commercially Delivered Weight Management Program for Adolescents

To evaluate a commercially available, structured short-term weight management program designed for adolescents with obesity delivered by nonhealth professionals. A multisite parallel-group randomized controlled trial was conducted to evaluate a commercial 12-week lifestyle behavioral program in commercial weight management centers in Australia. Eligible participants (13-17 years, body mass index (BMI) z score ?1.282 with no presenting morbidities) were randomized (n?=?88) to intervention or wait-list, and the program was delivered by consultants at participating weight management centers. The primary outcome was change in BMI z score. Secondary outcomes included the psychometric variables quality of life, body-esteem, and self-esteem. Data was analyzed according to intention-to-treat principles. Of 74 participants who consented to enter the study, 66 provided baseline anthropometric data and 12-week data were available for 55 individuals (74%). A significantly greater decrease in BMI z score in the intervention group (n?=?32) was observed when compared with the wait-list control group, mean difference (MD)?=??0.27?kg/m2; 95% CI, ?0.37,?0.17; P?<?.001). Participants allocated to receive the lifestyle intervention reported a greater improvement in body esteem (MD = 1.7, 95% CI, 0.3, 3.1; P?=?.02) and quality of life (MD?=?5.9, 95% CI, 0.9, 10.9; P?=?.02) compared with the wait-list control group. A structured lifestyle intervention delivered by a commercial provider in an adolescent population can result in clinically relevant weight loss and improvements in psychosocial outcomes in the short term. Further research is required to evaluate long-term outcomes. International Clinical Trials Registry: ISRCTN13602313.

Use of Appreciative Inquiry To Engage Parents as Codesigners of a Weight Management Intervention for Adolescents.

Focus groups are often used to involve families as codesigners of weight management interventions. Focus groups, however, are seldom designed to elicit families' strengths and positive experiences. The purpose of this study was to describe the use of the Appreciative Inquiry process in the conduct of focus groups to engage families in the design of a weight management intervention for adolescents. A convenience sample of 44 parents (84% female; 82% minority) of adolescent children with a BMI ≥ 85th percentile, who were in the 6th-8th grade in a large urban school, participated in focus groups designed to elicit family-positive experiences and strengths regarding healthy living. A structured set of questions based on the Appreciative Inquiry process was used in the focus groups. Analyses consisted of the constant comparative method to generate themes. Parent-positive perceptions regarding their family's healthy living habits were reflected in five themes: (1) Having healthy children is a joy; (2) Becoming healthy is a process; (3) Engaging in healthy habits is a family affair; (4) Good health habits can be achieved despite obstacles; and (5) School, community, and social factors contribute to their family's health habits. Parents generated ideas to improve their families' health. Focus groups based on the Appreciative Inquiry process were found to be a useful approach to discover features that are important to low-income, urban-living parents to include in an adolescent weight management program. Recommendations for designing and conducting focus groups based on the Appreciative Inquiry process are provided.

Study protocol: evaluation of 'JenMe', a commercially-delivered weight management program for adolescents: a randomised controlled trial.

BackgroundEarly lifestyle intervention with overweight and obese adolescents could help to avoid serious health events in early adulthood, ultimately alleviating some of the strain on the public health system due to obesity-related morbidity. Commercial weight loss programs have wide reach into the community setting, and have demonstrated success in long term weight management in adults, beyond that of current public health care. Commercial weight-management programs have not been evaluated as a method of delivery for overweight and obese adolescents. This study aims to evaluate the efficacy of a new adolescent weight management program in a commercial environment.MethodsOne hundred and forty adolescents, 13 to 17 years old, will be randomised to either a weight management program intervention or a wait-listed group for 12 weeks. The commercial program will consist of a combined dietary and lifestyle approach targeting improved health behaviours for weight-loss or weight-stability. Participants will be overweight or obese (above the 85th percentile for BMI) and without existing co-morbidities. Outcome measures will be assessed at baseline and after 12 weeks. Primary outcome measures will be changes in BMI Z-score and waist-height ratio. Secondary outcome measures will include changes in behaviour, physical activity and psychosocial wellbeing. Intervention participants will be followed up at 6 months following completion of the initial program. Ethics approval has been granted from the Monash University Human Research Ethics Committee (CF11/3687–2011001940).DiscussionThis independent evaluation of a weight management program for adolescents, delivered in a commercial setting, will provide initial evidence for the effectiveness of such programs; which may offer adolescents an avenue of weight-management with ongoing support prior to the development of obesity related co-morbidities.Trial registrationThe protocol for this study is registered with the International Clinical Trials Registry ISRCTN13602313.

A Collaborative Effort to Address Adolescent Obesity in Primary Care

Adolescent obesity is a growing national healthcare concern. Barriers to effective treatment, such as limited time for office visits and limited reimbursement for obesity counseling, leave both patient and practitioner feeling frustrated and unsupported. This article will discuss the adolescent weight management program, Triple E: Eat, Exercise, and Enjoy. This program was created in collaboration with a pediatric primary care practice, a local university, an affiliated pediatric practice within the health system, the local middle school, and the community. Triple E was developed, with minimal funding, to combat the adolescent obesity epidemic occurring in a primary care practice.

Adolescent and parent views of an adolescent weight management program: Lessons from the Loozit® randomised controlled trial

group (under 17 years at follow-up) higher levels of PA were associated with higher HRQoL. In the older group both PA and SBM were associated with HRQoL. Among overweight/obese adolescents, positive relationships existed between SBM and HRQoL and for normal weight adolescents similar relationships existed between PA and HRQoL. Conclusion: Physical activity or less frequent use of SBM was associated with higher HRQoL scores. This suggests that, independent of the effects of PA or SBM on body weight, it is important that these behaviours are targeted as maintaining high levels of HRQoL is critical especially in adolescence.

Preparing Adolescents for Bariatric Surgery: Foundational Elements Applying Erikson's Theory of Human Development

Obesity prevention is a national initiative with the attention of First Lady Michelle Obama and is being addressed on many levels with a multifactorial approach. However, many children and adolescents are beyond the benefit of prevention efforts and need treatment. Bariatric surgery in the adolescent population is a broadly debated topic that generates valuable discussion about the management of childhood obesity. This article seeks to describe the unique and pertinent developmental aspects of preparation and support given to obese adolescents and their families, and to present the experience at the University of Illinois Medical Center Adolescent Weight Management Program in Chicago, Illinois. There is a lack of scientific evidence in the current literature addressing what factors influence an adolescent's success with weight loss surgery, or clinical practice guidelines that outline recommendations for preparation of adolescents for bariatric surgery. It is the hope that reporting this experience will stimulate more scientific inquiry in this area. The purpose of this article is to encourage the provider to focus toward assisting the adolescent through the educational and psychosocial stages, with a goal of creating a solid foundation for success with bariatric surgery. The following stages and themes are noted from our clinical and management experience with adolescents in a weight management program that included the option of bariatric surgery. Erikson's Psychosocial Theory of Human Development1 was the construct for the developmental care provided in this novel program at the University of Illinois Medical Center.

77. Outcomes of a Pilot Study of a Physician and Nurse Delivered Adolescent Weight Management Program

Successful weight management in children and adolescents requires a multidisciplinary program based around behavior modification and motivation. Doctors and nurses manage substantial numbers of young people with obesity each year. There are currently no evidence-based behavioral interventions for young people that can be delivered in the office setting by physicians and nurses. Multidisciplinary programs for children and young people are usually labor intensive and expensive, and behavior changes are often difficult to maintain once they cease.

Design of a family-based lifestyle intervention for youth with type 2 diabetes: the TODAY study

Type 2 diabetes is associated with obesity and is increasing at an alarming rate in youth. Although weight loss through lifestyle change is one of the primary treatment recommendations for adults with type 2 diabetes, the efficacy of this approach has not been tested with youth. This paper provides a summary of the reviews and meta-analyses of pediatric weight-loss interventions that informed the design and implementation of an intensive, family-based lifestyle weight management program for adolescents with type 2 diabetes and their families developed for the Treatment Options for type 2 Diabetes in Adolescents and Youth (TODAY) study. A total of 1092 youth have been screened, and 704 families have been randomized for inclusion in this 15-center clinical trial sponsored by the National Institutes of Health. The TODAY study is designed to test three approaches (metformin, metformin plus rosiglitazone and metformin plus an intensive lifestyle intervention) to the treatment of a diverse cohort of youth, 10–17 years of age, within 2 years of their diagnosis. The principal goal of the TODAY Lifestyle Program (TLP) is to decrease baseline weight of youth by 7–10% (or the equivalent for children who are growing in height) through changes in eating and physical activity habits, and to sustain these changes through ongoing treatment contact. The TLP is implemented by interventionists called Personal Activity and Nutrition Leaders (PALs) and delivered to youth with type 2 diabetes, and at least one family support person. The TLP provides a model for taking a comprehensive, continuous care approach to the treatment of severe overweight in youth with comorbid medical conditions such as type 2 diabetes.