A behavioral weight loss program was developed for obese adolescents. This program could be delivered to adolescents alone, to adolescents and their mothers separately, or to adolescents and their mothers together. In a random assignment study, adolescents were assigned to receive the program in one of its three formats. At the conclusion of the 16-week treatment period, adolescents in the parent-child separately group had decreased their percentage overweight to a greater extent than had adolescents in either of the other two groups. Adolescents in this group decreased their percentage overweight to an even greater extent during a one-year follow-up period.
DESCRIPTION OF PROGRAM
Target population: obese adolescents
All subjects received a program of behavior modification, nutrition education, exercise instruction, and social support. This program was provided in 16 weekly sessions, lasting 45-60 minutes each.
The behavioral component of the intervention included sections on monitoring food intake, physical activity, and behavior change; stimulus control and cue elimination; behavior chains and preplanning; attitude restructuring and cognitive control; and using alternatives to overeating. The nutrition education component included information on the basic food groups; maintaining a balanced diet low in sugar, salt, and fat; specific methods for buying, preparing, storing, and serving food; and misconceptions about diet and nutrition. Exercise instruction consisted of discussions of the caloric expense of exercise; aerobic conditioning; and methods for gradually increasing energy expenditure.
The social support component of the intervention varied between treatment groups. Subjects assigned to the mother-child together treatment group attended treatment sessions with their mothers. Subjects and their mothers were told that they should work to understand one another and practice program components together. Subjects assigned to the mother-child separately treatment group attended treatment sessions with their mothers; however, adolescents and mothers met in separate treatment groups. Mothers were told that they should support other parents in promoting their children’s success. Subjects assigned to the child-alone treatment group attended treatment sessions without their mothers. These subjects were told that they would do best if they could learn to control their eating on their own.
The program also included six follow-up sessions. These sessions occurred once every two months for a year. Follow-up sessions primarily focused on strategies for maintaining weight loss.
EVALUATION(S) OF PROGRAM
Evaluated population: 42 obese adolescents from Williamsport, Pennsylvania served as the study sample for this investigation. All adolescents were white and between the ages of 12 and 16. 33 were female and 9 were male. Most came from lower middle class families.
Approach: Subjects were randomly assigned to one of three treatment groups: a mother-child together group, a mother-child separately group, and a child-alone group. All adolescents received the same weight loss program, but parental involvement differed between groups, as described above. Treatment groups included five to eight subjects and met for 46-60 minutes a week for 16 weeks. Thereafter, follow-up sessions were held once every two months for one year.
At each treatment session and follow-up session, adolescents were weighed, measured, and had their BMI, percentage above average weight, and developmental index of weight computed. Blood pressures were taken at the beginning of the treatment period and again at the one-year follow-up.
Results: At the outset of the study, treatment groups did not significantly differ from one another in weight, percentage overweight, or body mass index. During the 16-week treatment period, adolescents in the mother-child separately group decreased their percentage overweight to a greater extent than did adolescents in either of the other two treatment groups. During this same time period, absolute weight loss was significantly greater for the mother-child separately group, when compared with the child-alone group, but not the mother-child together group.
During the year-long follow-up period that followed the 16-week treatment, the mother-child separately group decreased their percentage overweight to an even greater extent. At the one-year follow-up, adolescents from the mother-child separately group had lost significantly more weight than adolescents from either of the other two groups.
SOURCES FOR MORE INFORMATION
Brownell, K.D. (1979). Behavior Therapy for Weight Control: A Treatment Manual. Thesis, University of Pennsylvania, Philadelphia, PA.
Brownell, K.D., Kelman, J.H., & Stunkard, A.J. (1983). Treatment of Obese Children With and Without Their Mothers: Changes in Weight and Blood Pressure. Pediatrics, 71(4), 515-523.
Program categorized in this guide according to the following:
Evaluated participant ages: 12-16
Program age ranges in the guide: Adolescence, Youth
Program components: Parent or Family Component
Measured outcomes: Physical Health
KEYWORDS: Nutrition; Physical Health; White/Caucasian; Adolescents (12-17); Counseling/Therapy; Co-ed.
Program information last updated on 12/5/07.