Bright Bodies

BRIGHT BODIES

OVERVIEW

Bright Bodies is a family-based weight management program designed for children and adolescents whose body mass index (BMI) is above the 95^th percentile. Participants in this intensive lifestyle intervention attend sessions on exercise and nutrition. An experimental evaluation found impacts on weight, body fat, BMI, total cholesterol, fasting insulin, and insulin resistance at the six- and 12-month assessments.

DESCRIPTION OF PROGRAM

Target population: Children and adolescents (8-16 years) with a body mass index (BMI) above the 95^th percentile.

Bright Bodies is a family-based weight management program designed for children and adolescents whose body mass index (BMI) is above the 95^th percentile. This intensive lifestyle intervention takes place over the course of 12 months, where participants attend sessions twice a week for the first six months and then every other week for the remaining six months. As part of the first six months, the program comprises 50-minute exercise routines twice a week and 40-minute nutrition and behavior modification sessions once a week. Participants and caregivers attend all classes together and separately attend behavior modification classes. Participants are weighed approximately every other week during the first six months and every two weeks for the remaining six months.

A registered nurse or social worker delivers the behavior modification component of the Bright Bodies program. Using the Smart Moves workbook manual, sample topics include: “Ready, Set, Goal!,” “Bullies, Teasers, and Other Annoying People,” and “Oops I Slipped—Understanding a Relapse.” Concepts covered in these topics include: self-awareness, goal setting, stimulus control, coping skills training, cognitive behavior strategies, and contingency management. For the parents/caregivers, behavior modification sessions stress the important role parents can play to establish healthy behavior change in the home.

Exercise physiologists deliver the exercise component of the program. Sessions include a warm-up period, followed by high intensity aerobic exercise, and conclude with a cool-down period. During high-intensity aerobic exercises, participants engage in games such as Swim Fish Swim, obstacle courses, basketball, flag football, sprinting games, basic sport drills, and Dance Dance Revolution in which participants follow dance patterns and compete with one another. Additionally, participants are encouraged to exercise at home three days a week and to decrease sedentary behaviors.

Using the Smart Moves workbook, a registered dietician delivers the nutrition education component of the program to participants. These sessions rely on a non-diet approach to food consumption to emphasize low-fat, nutrient-dense foods and portion control. Topics addressed in these sessions include: “Determining Portion Sizes,” “Making Sense of a Food Label,” and “Bag It!—The Pros to brining Lunch to School.”

The authors of the evaluation below note that the costs incurred by this program were substantial and are currently conducting a cost-benefit analysis of this program.

EVALUATION(S) OF PROGRAM

Savoye, M., Shaw, M., Dziura, J., Tamborlane, W. V., Rose, P., Buandalini, C., Goldberg-Gell, R., Burgert, T. S., Cali, A. M. G., Weiss, R., & Caprio, S. (2007). Effects of a weight management program on body composition and metabolic parameters in overweight children: A randomized controlled trial. Journal of the American Medical Association, 24, 2697-2704.

Evaluated population: A total of 174 participants from New Haven, CT were enrolled in this program study, with an average age of 12 years. Among those in the intervention group, 38% were white, 38% were black, and 24% were Latino, and 56% were female.

Approach: Participants were recruited from the Yale Pediatric Obesity Clinic, located in New Haven, Connecticut. Study inclusion criteria were limited to those who had a BMI above the 95^th percentile; were between the ages of eight and 16 years; spoke English; demonstrated an interest in weight management; were not already enrolled in a weight management program; and had a caregiver willing to participate in the educational component of the program. Individuals with chronic health conditions such as diabetes were excluded from the program as were those with any psychiatric conditions such as severe autism. Additionally, individuals currently taking medications that may increase weight or taking weight-loss medications were excluded. Individuals were randomized to either the intervention group (n=105) or the control group (n=69). Control group participants received diet, exercise, and psychosocial counseling every six months at the clinic, and after the conclusion of the intervention, went on to receive the Bright Bodies intervention.

The following clinical measures were collected: weight and height, to calculate BMI; blood pressure; and blood samples, to assess glucose, insulin, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and triglyceride levels. Outcome measures were collected at six months and at the 12-month post-test.

Originally, a total of 209 participants were enrolled in this study, as there were three arms to the evaluation: 1) structured meal plan only; 2) weight management and better food choices; and 3) the control group. Due to a large dropout rate of the structured meal plan only group (83%), this study arm was discontinued, and the analysis focuses on the 174 participants randomized in the study.

Results: At the six-month assessment period, there were impacts on weight, body fat, BMI, total cholesterol, fasting insulin, and insulin resistance; these findings were sustained at the 12-month post-test. There were no impacts on blood pressure, both systolic and diastolic, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, triglycerides, and fasting glucose.

SOURCES FOR MORE INFORMATION

For more information about the Bright Bodies program, please visit: www.brightbodies.org.

For more information, including purchasing information, about the Smart Moves Workbook used throughout the Bright Bodies program, please visit: http://smartmovesforkids.com/_wsn/page2.html

References

SUMMARY & CATEGORIZATION

Program categorized in this guide according to the following:

Evaluated participant age: Children (3-11), Adolescents (12-17)

Program component: Clinic-/Provider-based

Measured outcomes: Physical Health

KEYWORDS: Children (3-11), Adolescents (12-17), Clinic-/Provider-based, Parent/Family Component, Parent Training/Education, Counseling/Therapy, Health status, Other physical Health, Manual Available

Program information last updated 10/5/2010.