Family Weight School treatment: 1-year results in obese adolescents

Childhood Obesity Unit, University Hospital Malmö, Sweden.
International Journal of Pediatric Obesity (Impact Factor: 3.03). 02/2008; 3(3):141-7. DOI: 10.1080/17477160802102475
Source: PubMed


The aim was to evaluate the efficacy of a Family Weight School treatment based on family therapy in group meetings with adolescents with a high degree of obesity.
Seventy-two obese adolescents aged 12-19 years old were referred to a childhood obesity center by pediatricians and school nurses and offered a Family Weight School therapy program in group meetings given by a multidisciplinary team. Intervention was compared with an untreated waiting list control group. Body mass index (BMI) and BMI z-scores were calculated before and after intervention.
Ninety percent of the intervention group completed the program (34 boys, 31 girls; baseline age = 14.8 +/- 1.8 years [mean +/- standard deviation, SD], BMI = 34 +/- 4.0, BMI z-score = 3.3 +/- 0.4). In the control group 10 boys and 13 girls (baseline age = 14.3 +/- 1.6, BMI = 34.1 +/- 4.8, BMI z-score = 3.2 +/- 0.4) participated in the 1-year follow-up. Adolescents in the intervention group with initial BMI z-score < 3.5 (n = 49 out of 65, baseline mean age = 14.8, mean BMI = 33.0, mean BMI z-score = 3.1), showed a significant decrease in BMI z-scores in both genders (-0.09 +/- 0.04, p = 0.039) compared with those in the control group with initial BMI z-score < 3.5 (n = 17 out of 23, mean baseline age = 14.1, mean baseline BMI = 31.6, mean baseline BMI z-score = 3.01). No difference was found in adolescents with BMI z-scores > 3.5.
Family Weight School treatment model might be suitable for adolescents with BMI z-score < 3.5 treated with a few sessions in a multidisciplinary program.

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    • "The degree of overweight has been shown to affect outcomes, with numerous studies having shown that higher initial body weight is associated with improved outcomes (Braet, 2006; Epstein, Valoski, Wing, & McCurley, 1994; Goossens, Braet, Van Vlierberghe, & Mels, 2009; Moens, Braet, & Van Winckel, 2010). One study also showed that increased overweight is related to poorer weight loss outcomes (Nowicka et al., 2008). This discrepancy in the literature is possibly because a higher degree of overweight is predictive of improved outcomes to a point, but once children become severely obese, their outcomes are not as robust. "
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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.
    No preview · Article · Dec 2014 · Journal of Clinical Child & Adolescent Psychology
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    • "The recruited sample of children, although not overweight, had BMI z-scores almost one SD above the population mean that reduced by −0.13 (CI −0.20 to 0.05, p = 0.001) to a mean (SD) BMI z-score of 0.66 (1.19) 20 weeks post-intervention. An earlier study, adopting a diet and physical activity behavioural intervention in children [45] reported a slightly smaller reduction in BMI z-scores, as did a similar study in obese adolescents [46]. Compared to the two above mentioned studies, the reduction in BMI z-scores reported in the current study are important given the fact that our sample of children were not overweight/obese. "
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    ABSTRACT: The current study aimed to examine the changes following a sleep hygiene intervention on sleep hygiene practices, sleep quality, and daytime symptoms in youth. Participants aged 10–18 years with self-identified sleep problems completed our age-appropriate F.E.R.R.E.T (an acronym for the categories of Food, Emotions, Routine, Restrict, Environment and Timing) sleep hygiene programme; each category has three simple rules to encourage good sleep. Participants (and parents as appropriate) completed the Adolescent Sleep Hygiene Scale (ASHS), Pittsburgh Sleep Quality Index (PSQI), Sleep Disturbance Scale for Children (SDSC), Pediatric Daytime Sleepiness Scale (PDSS), and wore Actical® monitors twice before (1 and 2 weeks) and three times after (6, 12 and 20 weeks) the intervention. Anthropometric data were collected two weeks before and 20 weeks post-intervention. Thirty-three youths (mean age 12.9 years; M/F = 0.8) enrolled, and retention was 100%. ASHS scores significantly improved (p = 0.005) from a baseline mean (SD) of 4.70 (0.41) to 4.95 (0.31) post-intervention, as did PSQI scores [7.47 (2.43) to 4.47 (2.37); p < 0.001] and SDSC scores [53.4 (9.0) to 39.2 (9.2); p < 0.001]. PDSS scores improved from a baseline of 16.5 (6.0) to 11.3 (6.0) post- intervention (p < 0.001). BMI z-scores with a baseline of 0.79 (1.18) decreased significantly (p = 0.001) post-intervention to 0.66 (1.19). Despite these improvements, sleep duration as estimated by Actical accelerometry did not change. There was however a significant decrease in daytime sedentary/light energy expenditure. Our findings suggest the F.E.R.R.E.T sleep hygiene education programme might be effective in improving sleep in children and adolescents. However because this was a before and after study and a pilot study with several limitations, the findings need to be addressed with caution, and would need to be replicated within a randomised controlled trial to prove efficacy. Trial registration Australian New Zealand Clinical Trials Registry: ACTRN12612000649819
    Full-text · Article · Dec 2012 · BMC Pediatrics
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