Behavioral Interventions for Weight Management in Overweight and Obese Adolescents: A Comparison Between a Motivation-based Educational Program and Conventional Dietary Counseling

EASO and EFAD Position Statement on Medical Nutrition Therapy for the Management of Overweight and Obesity in Children and Adolescents

INTRODUCTION

This position statement on medical nutrition therapy in the management of overweight or obesity in children and adolescents was prepared by an expert committee convened by the European Association for the Study of Obesity (EASO) and developed in collaboration with the European Federation of the Associations of Dietitians (EFAD).

METHODS

It is based on the best evidence available from systematic reviews of randomized controlled trials on child and adolescent overweight and obesity treatment and other relevant peer-reviewed literature.

RESULTS

Multicomponent behavioural interventions are generally considered to be the gold standard treatment for children and adolescents living with obesity. The evidence presented in this position statement confirms that dietary interventions can effectively improve adiposity-related outcomes. Dietary strategies should focus on the reduction of total energy intake through promotion of food-based guidelines that target modification of usual eating patterns and behaviours. These should target increasing intakes of nutrient-rich foods with a lower energy density, specifically vegetables and fruits, and a reduction in intakes of energy-dense nutrient-poor foods and beverages. In addition, higher intensity, longer duration treatments, delivered by interventionists with specialized dietetic-related skills and co-designed with families, are associated with greater treatment effects.

DISCUSSION

Such interventions should be resourced adequately so that they can be implemented in a range of settings and in different formats, including digital or online delivery, to enhance accessibility.

Financial incentive strategy for weight loss and maintenance of weight loss

Introduction

The aim of this study was to investigate the effect of financial incentives on weight loss, maintain in obese women and biochemical factors.

Methods

This quasi-experimental study was conducted on 103 women with body mass index (BMI) ≥ 30 kg/m². The participants were assessed over a 12-month follow-up in eight phases. Money payment for losing weight was incentive intervention in this study. The participants were given diet and physical activity.

Results

Mean of BMI was 34.78 ± 4.29 kg/m² in baseline, that reduced to 32.41 ± 3.51 kg/m² in the sixth phase, and 31.64 ± 3.71 kg/m² in the final phase (P < 0.001). At baseline, mean of percentage of body fat (PBF) was 40.77 ± 2.81 that reduced to 37.34±4.02 at the end of the study (P < 0.001). Waist to hip ratio (WHR) and lean body mass (LBM) decreased significantly over the 12-month (P < 0.001). At the end of each phase, the mean of BMI reduction of 0.39 units was observed in the subjects, and 9 units of change were achieved by the end of the study compared to the baseline. The mean of triglyceride in the first, fourth and seventh phases were 128.57 ± 13.33, 101.43 ± 57.99 and 87.40 ± 57.59 mg/dl, respectively (P = 0.003). The mean of serum glutamic oxaloacetic transaminase (SGOT) and serum glutamate-pyruvate transaminase (SGPT) decreased significantly over the 12-month, P = 0.052 and P = 0.005, respectively.

Conclusions

Financial incentives can effectively help to weight loss and maintenance of weight, and improve lipid profiles; blood sugar and liver enzymes. The use of motivational factors with proper training (diet and physical activity) will have a better result.

Theater Performing Arts (TPA): Community Empowerment to Improve Blood Glucose Control Behavior in Yogyakarta

BACKGROUND

Poor self-management behavior is one of the causes of the high number of patients with type 2 diabetes mellitus (T2DM) in Indonesia.

OBJECTIVES

The aim of this study was to measure the effectiveness of TPA-based community empowerment as a form of education in improving the blood glucose control practices of patients with T2DM in Yogyakarta.

METHODS

This study used quantitative methods with a quasi-experimental non-equivalent pre-posttest control group design. The subjects of this study were "Prolanis member" patients with T2DM in the four primary health care centers in Sleman, Yogyakarta, Indonesia. Purposive sampling was done at four primary care in Sleman, Yogyakarta, Indonesia. From 138 T2DM patients, only 102 were eligible to become respondents. The questionnaires were adapted to the recommendations of endocrine experts' associations to measure the level of T2DM patients' knowledge, attitude and practices. Intervention was done for three months, from October to December 2019. Measurements were made before and after the TPA.

RESULTS

Attitude and behavior scores showed a significant increase (P < 0.05) after TPA intervention. Meanwhile, the average score of knowledge after the TPA intervention showed no significant increase (P > 0.05). Good self-management behavior in patients with T2DM was observed in Sleman Regency. Education through TPA based community empowerment should be considered as an appropriate intervention to improve DM management practice. Patients can receive material that is delivered easily because of the relaxed and pleasant environment during TPA.

CONCLUSIONS

TPA-based community empowerment can create a relaxed and pleasant environment to improve blood glucose control practices in patients with T2DM.