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Skeldon M, Harris D, Dent R, Shiau JY. A comparison of virtual and in person delivery of a full meal replacement program for obesity. Obes Sci Pract 2024; 10:e718. [PMID: 38259352 PMCID: PMC10801667 DOI: 10.1002/osp4.718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 10/10/2023] [Accepted: 10/12/2023] [Indexed: 01/24/2024] Open
Abstract
Objective Full meal replacement (FMR) Intensive Lifestyle Interventions (ILI) have been used for weight management. However, predictors of efficacy with these programs are less clear. The primary objective was to assess weight loss predictors in a community-based FMR ILI program. A secondary objective was to determine if weight loss was different between virtual and in person ILI. Methods This was a retrospective cohort study involving 234 patients who started the program between 1 January 2016 and 3 March 2021. In the 24-week program, patients spent 12 weeks on FMR and then transitioned back to food for the remainder, with weekly follow up with a physician and group sessions with a dietitian. Visits were in person prior to March 2020 and virtual afterward. Results Patients' average age was 47.5 years (SD = 12.0) and 73.5% were female. Average weight loss was 14.3% (SD = 6.2%). There was no significant difference in weight loss between virtual and in person programs. Patients on a Glucagon-like Peptide-1 Receptor Agonist prior lost less weight. Other significant associations between groups were baseline Hemoglobin A1C, classes attended, as well as the age since peak weight. Conclusion Weight loss from virtual ILI was not significantly different from person ILI. More research is needed to determine how to best stratify care as virtual or in person using FMR programs.
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Affiliation(s)
- Matthew Skeldon
- Division of General Internal MedicineDepartment of MedicineUniversity of SaskatchewanSaskatoonSaskatchewanCanada
| | - David Harris
- LEAF Weight Management ClinicDivision of Endocrinology and MetabolismUniversity of OttawaOttawaOntarioCanada
- Richmond Metabolic & Bariatric Surgery ProgramRichmondBritish ColumbiaCanada
| | - Robert Dent
- LEAF Weight Management ClinicDivision of Endocrinology and MetabolismUniversity of OttawaOttawaOntarioCanada
- The Ottawa Hospital Weight Management ClinicUniversity of OttawaOttawaOntarioCanada
| | - Judy Y. Shiau
- LEAF Weight Management ClinicDivision of Endocrinology and MetabolismUniversity of OttawaOttawaOntarioCanada
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2
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C McSweeney Z, McSweeney MD, Huang SH, G Hill S. Predictors of successful weight loss in children treated at a community hospital-based tertiary care pediatric weight management program. J Child Health Care 2022; 26:612-624. [PMID: 34372677 DOI: 10.1177/13674935211037535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Childhood obesity is a major public health concern. However, predictors of successful outcomes for patients treated at multidisciplinary community hospital-based pediatric weight management programs remain poorly understood. We conducted a retrospective analysis to evaluate 633 pediatric patients from ages 2 to 18 at a tertiary pediatric weight management program in 2018. Predictors were evaluated in univariate comparisons, and significant variables were included in a linear regression analysis to identify factors associated with improvements in body mass index relative to the age- and sex-specific 95th percentile body mass index (%BMIp95). We found that male sex and increased number of clinical visits were independently and significantly associated with reductions in %BMIp95. Baseline %BMIp95, age, preferred language, and insurance status were not significant predictors of outcomes. A total of 398 (63%) patients experienced a decrease in %BMIp95 from baseline to follow-up. One quarter (24.8%) of patients experienced a decrease in %BMIp95 of at least 5%, a threshold associated with cardiometabolic improvements. Further, we observed significant improvements in cholesterol, triglycerides, alanine aminotransferase, aspartate aminotransferase, HbA1c, and waist circumference. These findings support a potential need for sex- and gender-tailored care as well as the benefits of increased access to pediatric weight management programs.
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Affiliation(s)
- Zina C McSweeney
- Memorial Healthcare System, 23454Joe DiMaggio Children's Hospital, Hollywood, FL, USA
| | | | - Shirley H Huang
- Pediatric Weight Management Program, 10848WakeMed Health and Hospitals, Raleigh, NC, USA
- Campbell University School of Osteopathic Medicine, Lillington, NC, USA
| | - Samareh G Hill
- Pediatric Weight Management Program, 10848WakeMed Health and Hospitals, Raleigh, NC, USA
- Campbell University School of Osteopathic Medicine, Lillington, NC, USA
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3
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Skelly LE, Barbour-Tuck EN, Kurgan N, Calleja M, Klentrou P, Falk B, Josse AR. Neutral Effect of Increased Dairy Product Intake, as Part of a Lifestyle Modification Program, on Cardiometabolic Health in Adolescent Girls With Overweight/Obesity: A Secondary Analysis From a Randomized Controlled Trial. Front Nutr 2021; 8:673589. [PMID: 34095194 PMCID: PMC8175852 DOI: 10.3389/fnut.2021.673589] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 04/22/2021] [Indexed: 12/28/2022] Open
Abstract
Background: The presence of obesity and some cardiometabolic disease risk factors in childhood and adolescence track into adulthood. Intake of dairy products has been shown to be inversely related to adiposity and cardiometabolic variables in youth. However, limited research has examined cardiometabolic disease risk factors following increased dairy product consumption as part of a lifestyle modification intervention in youth with overweight/obesity. This secondary analysis aimed to determine whether 12 weeks of increased dairy consumption, as part of a lifestyle modification program, affects cardiometabolic variables in adolescent females (range: 10-18 years) with overweight/obesity (BMI > 85th centile). Methods: Participants were randomized into two groups: higher dairy intake (RDa; four servings/day [to reflect previous Canada's Food Guide recommendations]; n = 23) or low dairy intake (LDa; 0-2 servings/day; n = 23). Both RDa and LDa participated in a 12-week, eucaloric, lifestyle modification intervention consisting of exercise training, and nutritional counseling. Adiposity (percent body fat [%BF]), dietary intake, and measures of cardiometabolic health were measured pre- and post-intervention. Results: There were no significant changes over time within groups or differences over time between groups for triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL), TC/HDL ratio, low-density lipoprotein cholesterol (LDL), glucose, insulin, homeostatic model assessment of insulin resistance, adiponectin, and tumor necrosis factor alpha (TNF-α) (main effects of time and interactions, p > 0.05). Leptin decreased over the 12-week lifestyle intervention in both groups (main effect of time, p = 0.02). After combining the groups (n = 46), significant correlations were found between change in %BF and change in some cardiometabolic variables (HDL [r = -0.40], TC/HDL ratio [r = 0.42], LDL [r = 0.36], and TNF-α [r = 0.35], p < 0.05). After controlling for change in dairy product intake, the correlations were unchanged. Conclusion: Our findings demonstrate that increased dairy product consumption, as part of a lifestyle modification, weight management intervention, had a neutral effect on cardiometabolic disease risk factors in adolescent females with overweight/obesity. Change in dairy product intake did not influence the relationships between change in adiposity and change in cardiometabolic variables. Future research designed to primarily assess the effect of increased dairy product consumption on cardiometabolic disease risk factors in this population is warranted. Clinical Trial Registration: Clinicaltrials.gov; NCT#02581813.
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Affiliation(s)
- Lauren E Skelly
- School of Kinesiology and Health Science, Faculty of Health, York University, Toronto, ON, Canada
| | - Erin N Barbour-Tuck
- School of Kinesiology and Health Science, Faculty of Health, York University, Toronto, ON, Canada
| | - Nigel Kurgan
- Department of Kinesiology, Faculty of Applied Health Sciences, Brock University, St. Catharines, ON, Canada.,Centre for Bone and Muscle Health, Faculty of Applied Health Sciences, Brock University, St. Catharines, ON, Canada
| | - Melissa Calleja
- Department of Kinesiology, Faculty of Applied Health Sciences, Brock University, St. Catharines, ON, Canada
| | - Panagiota Klentrou
- Department of Kinesiology, Faculty of Applied Health Sciences, Brock University, St. Catharines, ON, Canada.,Centre for Bone and Muscle Health, Faculty of Applied Health Sciences, Brock University, St. Catharines, ON, Canada
| | - Bareket Falk
- Department of Kinesiology, Faculty of Applied Health Sciences, Brock University, St. Catharines, ON, Canada.,Centre for Bone and Muscle Health, Faculty of Applied Health Sciences, Brock University, St. Catharines, ON, Canada
| | - Andrea R Josse
- School of Kinesiology and Health Science, Faculty of Health, York University, Toronto, ON, Canada.,Centre for Bone and Muscle Health, Faculty of Applied Health Sciences, Brock University, St. Catharines, ON, Canada
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4
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Eastman A, Dixon BN, Ross KM. Associations between effort, importance, and self-monitoring during and after a 12-week behavioural weight management program. Obes Sci Pract 2020; 6:447-453. [PMID: 33082986 PMCID: PMC7556417 DOI: 10.1002/osp4.431] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 04/15/2020] [Accepted: 05/10/2020] [Indexed: 11/09/2022] Open
Abstract
Objective Self‐monitoring of weight and caloric intake has been associated with improved weight loss and weight loss maintenance in behavioural weight loss programs; however, participants' adherence to self‐monitoring tends to decrease over time. To identify potential barriers to self‐monitoring adherence, the current study examined week‐to‐week associations between ratings of perceived effort, relative importance of weight loss goals, and adherence to self‐monitoring of weight and caloric intake during and after a behavioural weight loss programme. Method Participants were 74 adults with overweight and obesity enrolled in a 12‐week, Internet‐based weight loss programme followed by a 40‐week “maintenance” period during which no additional intervention was provided. Participants self‐reported adherence to self‐monitoring and completed ratings of effort and importance on a study website weekly throughout the study period (1 year). Results Longitudinal multilevel models demonstrated that higher ratings of effort were associated with fewer days of self‐monitoring of weight, β = −0.100, p < .0001, and caloric intake, β = −0.300, p < .0001. Conversely, higher ratings of importance were associated with more frequent self‐monitoring of weight, β = 0.360, p < .0001, and caloric intake, β = 0.742, p < .0001. Moreover, the magnitude of these associations were stronger during the maintenance period than during initial intervention, ps < .01. Conclusions Perceptions of effort and importance are both independently associated with adherence to self‐monitoring weight and caloric intake, and this effect appears to be stronger after the end of initial intervention. Future research should investigate whether tailoring intervention content based on these constructs can improve adherence to self‐monitoring.
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Affiliation(s)
- Abraham Eastman
- Department of Clinical and Health Psychology, College of Public Health & Health Professions University of Florida Gainesville FL USA
| | - Brittney N Dixon
- Social & Behavioral Sciences Programme, College of Public Health & Health Professions University of Florida Gainesville FL USA
| | - Kathryn M Ross
- Department of Clinical and Health Psychology, College of Public Health & Health Professions University of Florida Gainesville FL USA.,Social & Behavioral Sciences Programme, College of Public Health & Health Professions University of Florida Gainesville FL USA.,The Miriam Hospital's Weight Control & Diabetes Research Center, Department of Psychiatry and Human Behavior Warren Alpert Medical School of Brown University Providence RI USA
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5
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Ross KM, Eastman A, Wing RR. Accuracy of Self-Report Versus Objective Smart-Scale Weights During a 12-Week Weight Management Intervention. Obesity (Silver Spring) 2019; 27:385-390. [PMID: 30703282 PMCID: PMC6410568 DOI: 10.1002/oby.22400] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Accepted: 11/26/2018] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Greater frequency of self-weighing has been associated with greater weight loss in weight management interventions, but little is known regarding the accuracy of self-reported weight data. METHODS Agreement between objective smart-scale and self-reported weight data was assessed in 74 adults (age = 50.7 years; BMI = 31.2 kg/m2 ) enrolled in a 12-week, Internet-based weight management program. Participants were asked to self-weight daily using a study-provided smart scale and to self-report weights via the study website. RESULTS There was strong agreement between smart-scale and self-reported weight values (intraclass correlation = 0.982) but only moderate agreement regarding frequency of self-weighing assessed via each method (κ = 0.491; P < 0.0001). Greater self-weighing frequency was associated with greater weight loss across measures (all P < 0.001). Compared with days when participants did both, weights were 0.66 kg higher on days when participants self-weighed via the smart scale but did not self-report weight (8% of days) and 0.58 kg higher on days when they self-reported weight but did not self-weigh via the smart scale (4% of days; all P < 0.0001). CONCLUSIONS Results suggest that self-reported weight values are similar to smart-scale measurements; however, either method alone may underestimate self-weighing frequency. Furthermore, missing self-weighing data should not be treated as ignorable because weights may be higher than those observed on nonmissing days.
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Affiliation(s)
- Kathryn M. Ross
- Department of Clinical & Health Psychology, College of
Public Health & Health Professions, University of Florida
- Department of Psychiatry and Human Behavior, Alpert Medical
School of Brown University & The Miriam Hospital
| | - Abraham Eastman
- Department of Clinical & Health Psychology, College of
Public Health & Health Professions, University of Florida
| | - Rena R. Wing
- Department of Psychiatry and Human Behavior, Alpert Medical
School of Brown University & The Miriam Hospital
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6
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Drouin O, Sharifi M, Gerber M, Horan C, Orav EJ, Marshall R, Taveras EM. Parents' Willingness to Pay for Pediatric Weight Management Programs. Acad Pediatr 2019; 19:764-772. [PMID: 31128381 PMCID: PMC6731996 DOI: 10.1016/j.acap.2019.05.124] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 04/19/2019] [Accepted: 05/18/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To examine parents' interest in continuing and willingness to pay (WTP) for 2 pediatric weight management programs following their participation. METHODS Participants were parents of 2- to 12-year-old children with body mass index ≥ 85th percentile who participated in the Connect for Health trial. One group received enhanced primary care (EPC) and the other received EPC plus individualized coaching (EPC+C). At 1 year, we assessed parents' self-reported WTP for a similar program and the maximum amount ($/month) they would pay. We used multivariable regression to examine differences in WTP and WTP amount by intervention arm and by individual and family-level factors. RESULTS Of 638 parents who completed the survey, 85% were interested in continuing and 38% of those parents were willing to pay (31% in the EPC group and 45% in the EPC+C group). The median amount parents were willing to pay was $25/month (interquartile range, $15-$50). In multivariable models, the EPC+C parents were more likely to endorse WTP than the EPC parents (odds ratio, 1.53; 95% confidence interval, 1.05-2.22). Parents of children with Hispanic/Latino versus white ethnicity and those reporting higher satisfaction with the program were also more likely to endorse WTP. CONCLUSIONS Most parents of children in a weight management program were interested in continuing it after it ended, but fewer were willing to pay out of pocket for it. A greater proportion of parents were willing to pay if the program included individualized health coaching.
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Affiliation(s)
- Olivier Drouin
- Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital for Children, Boston, MA, USA,Harvard-wide Pediatric Health Services Research Fellowship, Boston, MA, USA,Division of General Pediatrics, Department of Pediatrics, CHU Sainte-Justine, Montreal, QC, Canada
| | - Mona Sharifi
- Section of General Pediatrics, Department of Pediatrics, Yale University School of Medicine, New Haven, CT, USA
| | - Monica Gerber
- Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital for Children, Boston, MA, USA
| | - Christine Horan
- Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital for Children, Boston, MA, USA
| | - E. John Orav
- Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA
| | - Richard Marshall
- Department of Pediatrics, Harvard Vanguard Medical Associates, Boston, MA, USA
| | - Elsie M. Taveras
- Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital for Children, Boston, MA, USA,Harvard-wide Pediatric Health Services Research Fellowship, Boston, MA, USA,Department of Nutrition, Harvard T.H. Chan School of Public Health; Boston, MA, USA
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7
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Stubblefield S, Datto G, Phan TLT, Werk LN, Stackpole K, Siegel R, Stratbucker W, Tucker JM, Christison AL, Hossain J, Gentile DA. Problem Video Gaming Among Children Enrolled in Tertiary Weight Management Programs. Cyberpsychol Behav Soc Netw 2017; 20:109-116. [PMID: 28170312 DOI: 10.1089/cyber.2016.0386] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Prior studies show seven percent to nine percent of children demonstrate gaming behaviors that affect a child's ability to function (e.g., problem gaming), but none have examined the association between problem gaming and weight status. The objective of this study was to determine the prevalence of problem gaming among children enrolled in tertiary weight management programs. We administered a computer-based survey to a convenience sample of children aged 11-17 years enrolled in five geographically diverse pediatric weight management (PWM) programs in the COMPASS (Childhood Obesity Multi-Program Analysis and Study System) network. The survey included demographics, gaming characteristics, and a problem gaming assessment. The survey had 454 respondents representing a diverse cohort (53 percent females, 27 percent black, 24 percent Hispanic, 41 percent white) with mean age of 13.7 years. A total of 8.2 percent of respondents met criteria for problem gaming. Problem gamers were more likely to be white, male, play mature-rated games, and report daily play. Children in PWM programs reported problem gaming at the same rate as other pediatric populations. Screening for problem gaming provides an opportunity for pediatricians to address gaming behaviors that may affect the health of children with obesity who already are at risk for worsened health and quality of life.
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Affiliation(s)
- Sam Stubblefield
- 1 Department of General Pediatrics, Nemours/Alfred I. duPont Hospital for Children , Wilmington, Delaware
| | - George Datto
- 1 Department of General Pediatrics, Nemours/Alfred I. duPont Hospital for Children , Wilmington, Delaware
| | - Thao-Ly T Phan
- 1 Department of General Pediatrics, Nemours/Alfred I. duPont Hospital for Children , Wilmington, Delaware
| | - Lloyd N Werk
- 2 Department of General Pediatrics, Nemours Children's Hospital , Orlando, Florida
| | - Kristin Stackpole
- 3 Center for Better Health and Nutrition/HealthWorks!, Cincinnati Children's Hospital Medical Center , Cincinnati, Ohio
| | - Robert Siegel
- 3 Center for Better Health and Nutrition/HealthWorks!, Cincinnati Children's Hospital Medical Center , Cincinnati, Ohio
| | - William Stratbucker
- 4 Healthy Weight Center, Helen DeVos Children's Hospital, Michigan State University , Grand Rapids, Michigan.,5 Department of Pediatrics and Human Development, Michigan State University , Grand Rapids, Michigan
| | - Jared M Tucker
- 4 Healthy Weight Center, Helen DeVos Children's Hospital, Michigan State University , Grand Rapids, Michigan.,5 Department of Pediatrics and Human Development, Michigan State University , Grand Rapids, Michigan
| | - Amy L Christison
- 6 Department of Pediatrics, University of Illinois College of Medicine at Peoria , Peoria, Illinois
| | - Jobayer Hossain
- 7 Nemours Research, Nemours/Alfred I. duPont Hospital for Children , Wilmington, Delaware
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8
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Tanenbaum ML, Ross KM, Wing RR. Overeat today, skip the scale tomorrow: An examination of caloric intake predicting nonadherence to daily self-weighing. Obesity (Silver Spring) 2016; 24:2341-2343. [PMID: 27619935 PMCID: PMC5093049 DOI: 10.1002/oby.21650] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Revised: 07/15/2016] [Accepted: 07/16/2016] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Daily self-weighing is an effective weight loss strategy. Little is known about "micro" factors influencing nonadherence to self-weighing (e.g., daily overeating). It was hypothesized that increased caloric intake on a given day would increase odds of not self-weighing the following day. METHODS Daily self-reports of weight and caloric intake were collected from 74 adults with overweight and obesity (mean BMI = 31.2 ± 4.5 kg/m2 , age = 50.6 ± 10 years, 69% female, 87% Caucasian) throughout a 12-week Internet-based weight management intervention. Multilevel logistic regression investigated odds of nonadherence to self-weighing on a given day based on the previous day's caloric intake. RESULTS Self-monitoring adherence was high (weights: 87%; calories: 85%); adherence was associated with greater 12-week weight loss (weighing: r = -0.24, P = 0.04; calories: r = -0.26, P = 0.04). Increased caloric intake on a given day, relative to the individual's average intake, was associated with increased odds of nonadherence to self-weighing the next day (F(1,5106) = 12.66, P = 0.0004, β = 0.001). For example, following a day of eating 300 calories more than usual, odds of not self-weighing increased by 1.33. CONCLUSIONS Odds of nonadherence to self-weighing increased following a day with higher-than-usual caloric intake. Weight management interventions collecting daily self-monitoring data could provide support to participants who report increased caloric intake to prevent self-weighing nonadherence.
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Affiliation(s)
- Molly L Tanenbaum
- Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA
| | - Kathryn M Ross
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, The Miriam Hospital/Weight Control and Diabetes Research Center, Providence, Rhode Island, USA
- Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida, USA
| | - Rena R Wing
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, The Miriam Hospital/Weight Control and Diabetes Research Center, Providence, Rhode Island, USA.
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9
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Browning MG, Bean MK, Wickham EP, Stern M, Evans RK. Cardiometabolic and Fitness Improvements in Obese Girls Who Either Gained or Lost Weight during Treatment. J Pediatr 2015; 166:1364-9. [PMID: 25890676 PMCID: PMC4446179 DOI: 10.1016/j.jpeds.2015.03.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Revised: 02/03/2015] [Accepted: 03/05/2015] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To evaluate the quality of weight change (change in fat mass vs fat-free mass [FFM]), changes in cardiorespiratory fitness (CRF), and frequencies of metabolic risk factors in adolescent females with obesity who either lost or gained weight following lifestyle treatment. STUDY DESIGN Fifty-eight girls (mean age = 13.0 ± 1.6 years; 77% black; mean body mass index = 36.5 ± 4.5 kg/m(2)) completed a 6-month lifestyle intervention combining dietary and behavioral counseling with aerobic and resistance exercise training. We examined baseline to 6-month differences in weight (kg), body composition, CRF, and frequencies of metabolic risk factors between weight loss and weight gain groups. RESULTS In the weight loss group, body weight (-4.50 ± 3.53 kg, P < .001), fat mass (-4.50 ± 2.20 kg, P < .001), and body fat percentage (-2.97% ± 1.45%, P < .001) decreased, and FFM was unchanged at 6 months. In the weight gain group, body weight (4.50 ± 2.20 kg, P < .001), fat mass (1.52 ± 3.16 kg, P < .024), and FFM (2.99 ± 2.45 kg, P < .001) increased, and body fat percentage was unchanged. Both groups improved CRF (P < .05). Frequencies of metabolic risk factors were reduced across all participants after the 6-month treatment. CONCLUSIONS Participation in a weight management program might elicit health improvements in obese adolescent females who increase weight and fat mass, provided that FFM gains are sufficient to negate increases in body fat percentage. TRIAL REGISTRATION ClinicalTrials.gov: NCT00167830.
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Affiliation(s)
- Matthew G. Browning
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, VA
| | - Melanie K. Bean
- Healthy Lifestyle Center, Department of Pediatrics, Children's Hospital of Richmond at Virginia Commonwealth University, Richmond, VA
| | - Edmond P. Wickham
- Healthy Lifestyle Center, Department of Pediatrics, Children's Hospital of Richmond at Virginia Commonwealth University, Richmond, VA,Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA
| | - Marilyn Stern
- Department of Rehabilitation and Mental Health Counseling, University of South Florida, Tampa, FL
| | - Ronald K. Evans
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, VA,Healthy Lifestyle Center, Department of Pediatrics, Children's Hospital of Richmond at Virginia Commonwealth University, Richmond, VA
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10
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Zhang JP, Weiss JJ, McCardle M, Klopchin H, Rosendahl E, Maayan L, Convit A, Kane JM, Manu P, Correll CU. Effectiveness of a cognitive behavioral weight management intervention in obese patients with psychotic disorders compared to patients with nonpsychotic disorders or no psychiatric disorders: results from a 12-month, real-world study. J Clin Psychopharmacol 2012; 32:458-64. [PMID: 22722502 DOI: 10.1097/JCP.0b013e31825cccd2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Studies of behavioral weight loss intervention in patients with psychotic disorders are sparse, and its efficacy compared to other obese patients is unknown. Therefore, we compared the effect of a cognitive-behavioral weight loss intervention in obese subjects with psychotic disorders, other psychiatric diagnoses, and without psychiatric disorders. METHODS A 12-month naturalistic study of weekly group or individual cognitive-behavioral weight management in 222 consecutively enrolled obese patients (body mass index [BMI], 43.7 ± 9.6 kg/m2) with psychotic spectrum disorders (PSDs, n = 47), other psychiatric disorders (OPDs, n = 49), and no psychiatric disorder (NPD, n = 126). RESULTS Patients with PSD had greater treatment persistence (48.9%) and longer treatment duration (8.7 ± 4.4 months) than those with OPD (22.4% and 5.4 ± 4.3 months) and NPD (22.2% and 4.9 ± 4.7 months) (P < 0.01 for all; number needed to treat, 3). In last-observation-carried-forward analyses, patients with PSD had greater percent baseline weight loss at 12 months (5.1% ± 9.3%) than patients with OPD and with NPD (2.7% ± 5.5% and 2.4% ± 6.3%); greater percent BMI loss at 9 and 12 months than both groups (P < 0.05 for all) and greater BMI loss at 9 months (2.1 ± 3.5 kg/m2) and 12 months (2.3 ± 4.1 kg/m2) than NPD patients (1.1 ± 2.3 and 1.2 ± 2.4 kg/m2). Furthermore, weight loss of 5% or more occurred in 42.6% of patients with PSD versus 18.4% and 23.0% in OPD and NPD patients (P < 0.01 for all; numbers needed to treat, 5 and 6). The strongest weight loss predictor was treatment duration (β = 0.51-0.54; P < 0.001). Attrition was predicted by NPD (P = 0.001) and OPD group status (P = 0.036), lower proportion of group sessions (P = 0.002), higher depression (P = 0.028), and lower baseline BMI (P = 0.030). CONCLUSIONS Patients with PSD had greater weight loss than other obese patients. Nonadherence and depression should be targeted to enhance weight loss success.
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