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Programs show short-term benefits in helping children maintain weight loss
October 10, 2007Children who lost weight were able to keep it off more effectively by participating in maintenance treatment programs that emphasized behavioral skills or social facilitation, although the effectiveness lessened over time, according to a study in the October 10 issue of JAMA.
The prevalence of overweight among children in the United States has tripled in recent decades and related health care costs have nearly quadrupled, according to background information in the article. "Lifestyle interventions remain the most well-established interventions for overweight 7- to 12-year-olds. Although some evidence supports long-term efficacy, maintaining weight loss remains a challenge, with most interventions marked by considerable relapse," the authors write.
Denise E. Wilfley, Ph.D., of Washington University School of Medicine, St. Louis, and colleagues evaluated the effects of two interventions following standard family-based behavioral weight loss treatment: a behavioral skills maintenance (BSM) and a social facilitation maintenance (SFM) intervention, compared to no intervention.
The BSM approach is based on the premise that specific strategies are needed for weight loss maintenance, emphasizing self-regulation behaviors and relapse-prevention strategies. The SFM approach is based on the premise that relapse results from the absence of a social environment supportive of continued weight control. This approach also targets peer (e.g., teasing) and self-perceptual (e.g., body image) factors identified as barriers to overweight children's physical activity.
The randomized controlled trial, conducted between October 1999 and July 2004 in a university-based weight control clinic, included 204 healthy 7- to 12-year-olds, 20 percent to 100 percent above median (midpoint) body mass index (BMI) for age and sex, with at least one overweight parent. Children enrolled in five months of weight loss treatment and 150 were randomized to one of three maintenance conditions: control group or four months of BSM or SFM treatment. Follow-up assessments occurred immediately following maintenance treatments and 1 and 2 years following randomization.
The researchers found that children receiving either BSM or SFM maintained relative weight significantly better than children assigned to the control group from randomization to postweight maintenance. Active maintenance treatment effectiveness relative to the control group declined during follow-up, but the effects of SFM alone and when analyzed together with BSM were significantly better than the control group when examining certain BMI score outcomes from baseline to 2-year follow-up. Baseline child social problem scores moderated child relative weight change from baseline to 2-year follow-up, with low social problem children in SFM vs. the control group having the best outcomes. There were no significant differences in child weight outcomes between BSM and SFM in either the short-term or long-term.
"The alarming prevalence of child overweight necessitates the development of more effective long-term intervention strategies. Our study demonstrated that extended treatment contact with either a continued BSM focus or a novel SFM focus improves weight loss maintenance in a childhood overweight population in comparison with a weight loss program alone at least in the short-term, with some evidence for sustained long-term efficacy among more socially adept children receiving an SFM treatment," the researchers write.
JAMA and Archives Journals
The BSM approach is based on the premise that specific strategies are needed for weight loss maintenance, emphasizing self-regulation behaviors and relapse-prevention strategies. The SFM approach is based on the premise that relapse results from the absence of a social environment supportive of continued weight control. This approach also targets peer (e.g., teasing) and self-perceptual (e.g., body image) factors identified as barriers to overweight children's physical activity.
The randomized controlled trial, conducted between October 1999 and July 2004 in a university-based weight control clinic, included 204 healthy 7- to 12-year-olds, 20 percent to 100 percent above median (midpoint) body mass index (BMI) for age and sex, with at least one overweight parent. Children enrolled in five months of weight loss treatment and 150 were randomized to one of three maintenance conditions: control group or four months of BSM or SFM treatment. Follow-up assessments occurred immediately following maintenance treatments and 1 and 2 years following randomization.
The researchers found that children receiving either BSM or SFM maintained relative weight significantly better than children assigned to the control group from randomization to postweight maintenance. Active maintenance treatment effectiveness relative to the control group declined during follow-up, but the effects of SFM alone and when analyzed together with BSM were significantly better than the control group when examining certain BMI score outcomes from baseline to 2-year follow-up. Baseline child social problem scores moderated child relative weight change from baseline to 2-year follow-up, with low social problem children in SFM vs. the control group having the best outcomes. There were no significant differences in child weight outcomes between BSM and SFM in either the short-term or long-term.
"The alarming prevalence of child overweight necessitates the development of more effective long-term intervention strategies. Our study demonstrated that extended treatment contact with either a continued BSM focus or a novel SFM focus improves weight loss maintenance in a childhood overweight population in comparison with a weight loss program alone at least in the short-term, with some evidence for sustained long-term efficacy among more socially adept children receiving an SFM treatment," the researchers write.
JAMA and Archives Journals
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A new study by researchers from The Miriam Hospital's Centers for Behavioral and Preventive Medicine suggests increased physical activity after bariatric surgery can yield better postoperative outcomes.
Adalimumab may reduce health-care costs for Crohn's disease patients
Inflammatory bowel disease (IBD) is a term that refers to both ulcerative colitis (UC) and Crohn's disease (CD). IBD occurs most frequently in people in their late teens and twenties. There have been cases in children as young as two years old and in older adults in their seventies and eighties; men and women have an equal chance of getting the disease.
Plastic surgeons warn of malnutrition in body contouring patients
Identifying malnutrition before surgery in massive weight loss patients seeking body contouring will significantly decrease surgical complications, accelerate wound healing, improve scar quality and boost patient energy levels, according to a study in the December issue of Plastic and Reconstructive Surgery.
UNC study: text messaging may help children fight off obesity
A new study from the University of North Carolina at Chapel Hill suggests that cell phone text messaging could be used to reduce children's chances of becoming overweight or obese later in life, by helping them monitor and modify their own behaviors now.
Melanin Production Discovered in Fat Tissue May Protect Some Individuals Against Chronic Diseases Associated with Obesity
A two-year study conducted by researchers at George Mason University, INOVA Fairfax Hospital and the National Cancer Institute may open the door to new therapies for combating chronic diseases associated with obesity, a condition that affected more than 33 percent of American adults in 2005-06 according to the Centers for Disease Control and Prevention.
Research shows that the Pill does not deserve its reputation for causing weight gain
Research has not proven that the Pill causes weight gain. But many women are put off using contraceptive pills because this has been listed as one of their adverse effects.
New promising obesity drug may have huge potential
According to trials, a new obesity drug, Tesofensine, which may be launched on the world market in a few years, can produce weight loss twice that of currently approved obesity drugs.
Selecting appropriate massive weight loss patients for body contouring critical
The importance of pre-operative screening for patients seeking body contouring after massive weight loss will be assessed in three studies presented at the American Society of Plastic Surgeons (ASPS) Plastic Surgery 2008 conference, Oct. 31 - Nov. 5, in Chicago.
Guidelines urge physical activity during pregnancy
Moderate physical activity during pregnancy does not contribute to low birth weight, premature birth or miscarriage and may actually reduce the risk of complications, according to a Michigan State University professor who contributed to the U.S. government's first-ever guidelines on physical activity.
How much are you really exercising?
People struggling with obesity often underestimate how many calories they are actually consuming, which can hinder weight loss efforts. It should follow that the same person would overestimate the amount of exercise they're doing, right?
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