The Effects of Anti-obesity Pharmacotherapy Interventions on Psychosocial Factors Among Adolescents with Obesity: a Scoping Review

PURPOSE OF REVIEW

The purpose of this review was to investigate and synthesize psychosocial outcomes from pharmacotherapy experimental trials for weight loss among adolescents with obesity.

RECENT FINDINGS

There is a paucity of research regarding pharmacological interventions for adolescents with obesity. These studies have typically reported reductions in weight, and side effects have been inconsistently described. Overall, medication seems to be a safe and effective obesity treatment modality for adolescents with obesity. Six articles were included in this review. Studies varied in medication type, medication dosing, lifestyle components, psychosocial measures, measurement intervals, and psychosocial outcomes. All studies found a reduction in weight and/or BMI. Studies were often underpowered to detect differences in psychosocial variables, which were always considered secondary or exploratory outcomes. Future research should include psychosocial outcomes as a primary endpoint of pharmacological interventions for adolescent obesity. Ultimately, the treatment of the complex disease of obesity deserves to be assessed through multiple health domains extending beyond weight reduction.

Perceived barriers/facilitators to a healthy lifestyle among diverse adolescents with overweight/obesity: A qualitative study

Objective

Effectiveness of behavioural obesity treatments in adolescents is modest. Thus, incorporating participant feedback may lead to improvement of intervention acceptability. This qualitative study's objective was to assess perceived barriers/facilitators to weight loss and healthy lifestyles among diverse adolescents with overweight/obesity (OW/OB).

Methods

Adolescents ages 14-19 with BMI ≥ 85th percentile participated in focus groups and identified perceived barriers/facilitators to weight loss and healthy lifestyles.

Results

Ten sex-stratified focus groups (n = 41; n = 13 males, n = 28 females) were conducted in 2018 and 2019. Females reported experiencing weight struggles, whereas males often stated no struggles with weight, despite all participants meeting criterion for OW/OB. Barriers included eating behaviours, family members and internal motivation, with additional barriers of physical activity, friends, time and support cited in females. Facilitators included parental, familial and peer support of healthy eating and exercise, modelling behaviours, internal motivation and organized sports. Two additional findings regarding adolescents' perceived barriers/facilitators include substantial overlap and sex differences of perceived barriers/facilitators.

Conclusions

Adolescent males and females with OW/OB experience weight status differently, affecting their perceived barriers/facilitators to weight loss and healthy lifestyles. Tailoring weight management interventions to the unique needs of adolescent females versus adolescent males has the potential to improve intervention quality and effectiveness.

Delayed dispersal and prolonged brood care in a family-living beetle

Delayed juvenile dispersal is an important prerequisite for the evolution of family-based social systems, such as cooperative breeding and eusociality. In general, young adults forego dispersal if there are substantial benefits to remaining in the natal nest and/or the likelihood of dispersing and breeding successfully is low. We investigate some general factors thought to drive delayed juvenile dispersal in the horned passalus beetle, a family-living beetle in which young adults remain with their families in their natal nest for several months before dispersing. Fine-scale population genetic structure indicated high gene flow between nest sites, suggesting that constraints on mobility are unlikely to explain philopatry. Young adults do not breed in their natal log and likely disperse before reaching breeding age, suggesting that they do not gain direct reproductive benefits from delayed dispersal. We also examined several ways in which parents might incentivize delayed dispersal by providing prolonged care to adult offspring. Although adult beetles inhibit fungal growth in the colony by manipulating both the nest site and deceased conspecifics, this is unlikely to be a major explanation for family living as both parents and adult offspring seem capable of controlling fungal growth. Adult offspring that stayed with their family groups also neither gained more mass nor experienced faster exoskeleton development than those experimentally removed from their families. The results of these experiments suggest that our current understanding of the factors underlying prolonged family living may be insufficient to explain delayed dispersal in at least some taxa, particularly insects.