Article

Behavioral Weight Control Treatment with Supervised Exercise or Peer-Enhanced Adventure for Overweight Adolescents

Department of Psychiatry, Rhode Island Hospital, Alpert Medical School of Brown University, Providence, RI, USA.
The Journal of pediatrics (Impact Factor: 3.79). 12/2010; 157(6):923-928.e1. DOI: 10.1016/j.jpeds.2010.05.047
Source: PubMed

ABSTRACT

To evaluate the efficacy of behavioral weight control intervention with a peer-enhanced activity intervention versus structured aerobic exercise in decreasing body mass index (BMI) and z-BMI in overweight adolescents.
Participants were randomized to 1 of 2 group-based treatment conditions: (1) cognitive behavioral treatment with peer-enhanced adventure therapy or (2) cognitive behavioral weight control treatment with supervised aerobic exercise. Participants included 118 overweight adolescents, ages 13 to 16 years, and a primary caregiver. Changes in BMI, standardized BMI, percent over BMI, and waist circumference were examined.
Analysis of variance on the basis of intent-to-treat indicated significant decreases in all weight change outcomes at the end of treatment, with significant decreases maintained at the 12-month follow-up. No differences in treatment conditions were observed. Secondary analyses indicated that adherence with attendance and completion of weekly diet records contributed significantly to reductions in BMI.
A cognitive behavioral weight control intervention combined with supervised aerobic exercise or peer-enhanced adventure therapy is equally effective in short-term reduction of BMI and z-BMI in overweight adolescents. Adherence, as measured with session attendance and self-monitoring, is a key dimension of weight change.

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Available from: Robyn S. Mehlenbeck, Feb 12, 2014
    • "Additional predictors are included next. Other predictors of improved outcomes include early treatment response (Goldschmidt et al., 2012; Jelalian et al., 2008), greater social support (Braet, 2006; Epstein et al., 1994; Moens et al., 2010), lower parental psychopathology (Epstein et al., 1994; Frohlich, Pott, Albayrak, Hebebrand, & Pauli-Pott, 2011; E. Moens et al., 2010), higher session attendance (Jelalian et al., 2010), and self-monitoring (Epstein, Valoski, Wing, & McCurley, 1990; Jelalian et al., 2010). It has also been shown that, whereas boys and girls show similar weight loss outcomes in the initial stages of treatment, girls are more successful at longer term weight loss and maintenance (5-and 10- year follow-up; Epstein et al., 1990). "
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    ABSTRACT: Childhood obesity is associated with increased medical and psychosocial consequences and mortality and effective interventions are urgently needed. Effective interventions are urgently needed. This article reviews the evidence for psychological treatments of overweight and obesity in child and adolescent populations. Studies were identified through searches of online databases and reference sections of relevant review articles and meta-analyses. Treatment efficacy was assessed using established criteria, and treatments were categorized as well-established, probably efficacious, possibly efficacious, experimental, or of questionable efficacy. Well-established treatments included family-based behavioral treatment (FBT) and Parent-Only Behavioral Treatment for children. Possibly efficacious treatments include Parent-Only Behavioral Treatment for adolescents, FBT-Guided Self-Help for children, and Behavioral Weight Loss treatment with family involvement for toddlers, children, and adolescents. Appetite awareness training and regulation of cues treatments are considered experimental. No treatments are considered probably efficacious, or of questionable efficacy. All treatments considered efficacious are multicomponent interventions that include dietary and physical activity modifications and utilize behavioral strategies. Treatment is optimized if family members are specifically targeted in treatment. Research supports the use of multicomponent lifestyle interventions, with FBT and Parent-Only Behavioral Treatment being the most widely supported treatment types. Additional research is needed to test a stepped care model for treatment and to establish the ideal dosage (i.e., number and length of sessions), duration, and intensity of treatments for long-term sustainability of healthy weight management. To improve access to care, the optimal methods to enhance the scalability and implementability of treatments into community and clinical settings need to be established.
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    • "Overweight status was defined as percent overweight—i.e., adolescents' percent >50th percentile body mass index for age and sex (OW). Previous manuscripts reported significant decreases in weight for both treatment conditions, but no significant differences between conditions (Jelalian et al., 2010;Lloyd-Richardson et al., 2012). To simplify the presentation of these data, we will combine the two treatment conditions. "
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    ABSTRACT: To introduce and illustrate recent advances in statistical approaches to simultaneous modeling of multiple change processes. Provide a general overview of how to use structural equations to simultaneously model multiple change processes and illustrate the use of a theoretical model of change to guide selection of an appropriate specification from competing alternatives. The selected latent change score model is then fit to data collected during an adolescent weight-control treatment trial. A latent change score model is built starting with the foundation of repeated-measures analysis of variance and illustrated using graphical notation. The assumptions behind using structural equations to model change are discussed as well as limitations of the approach. Practical guidance is provided on matching the statistical model to the theory underlying the observed change processes and the research question(s) being answered by the analyses.
    Full-text · Article · Nov 2013 · Journal of Pediatric Psychology
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    • "Several of the manuscripts in this special issue outline novel approaches for intervening with obese children and adolescents. Overweight/obese adolescents present a particular challenge for intervention stemming from developmentally normative striving for autonomy, the ambiguous role of parents in initiating and supporting weight control, and decreased body satisfaction (Jelalian et al., 2010). Walpole, Dettmer, Morrongiello, McCrindle, and Hamilton (2013) randomized youth with a mean age of 13.9 years to six sessions of motivational interviewing (MI) or social skills training combined with standard care. "

    Preview · Article · Sep 2013 · Journal of Pediatric Psychology
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