Elsevier

The Journal of Pediatrics

Volume 157, Issue 6, December 2010, Pages 923-928.e1
The Journal of Pediatrics

Original Article
Behavioral Weight Control Treatment with Supervised Exercise or Peer-Enhanced Adventure for Overweight Adolescents

https://doi.org/10.1016/j.jpeds.2010.05.047Get rights and content

Objective

To evaluate the efficacy of behavioral weight control intervention with a peer-enhanced activity intervention versus structured aerobic exercise in decreasing body mass index (BMI) and z-BMI in overweight adolescents.

Study design

Participants were randomized to 1 of 2 group-based treatment conditions: (1) cognitive behavioral treatment with peer-enhanced adventure therapy or (2) cognitive behavioral weight control treatment with supervised aerobic exercise. Participants included 118 overweight adolescents, ages 13 to 16 years, and a primary caregiver. Changes in BMI, standardized BMI, percent over BMI, and waist circumference were examined.

Results

Analysis of variance on the basis of intent-to-treat indicated significant decreases in all weight change outcomes at the end of treatment, with significant decreases maintained at the 12-month follow-up. No differences in treatment conditions were observed. Secondary analyses indicated that adherence with attendance and completion of weekly diet records contributed significantly to reductions in BMI.

Conclusions

A cognitive behavioral weight control intervention combined with supervised aerobic exercise or peer-enhanced adventure therapy is equally effective in short-term reduction of BMI and z-BMI in overweight adolescents. Adherence, as measured with session attendance and self-monitoring, is a key dimension of weight change.

Section snippets

Methods

A total of 118 overweight adolescents were randomized to treatment (Figure; available at www.jpeds.com). Participants were recruited from local newspaper advertisements and referrals from area pediatricians. Eligibility requirements included age between 13 and 16 years, between 30% and 90% overweight as defined with reference to median BMI for age and sex, at least one parent available to participate, and English speaking. Adolescents were excluded when they met the criteria for a major

Results

Participant demographic and baseline weight status data are presented in Table I. There were no significant differences in adolescents randomized to the two treatment conditions on baseline variables of BMI, percent over BMI, or demographics.

One hundred of the 118 participants (85%) randomized to treatment conditions completed the end-of-treatment assessment, and 93 participants (79%) were available for 12-month follow-up. Participants in both treatment conditions who completed the 12-month

Discussion

BMI reductions in this study were comparable with those observed in a small 10- week trial comparing CBT with a control condition in overweight adolescents8 and to findings based on prescription of a reduced glycemic index diet for obese adolescents.20 A lifestyle intervention that reported superior outcomes with adolescents required greater weekly time commitment with a longer active intervention phase.21 Thus, this study adds to an increasing body of evidence demonstrating significant

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    • Cited by (0)

    Supported by the National Institute of Diabetes and Digestive and Kidney Diseases (grant R01DK062916 to E.J.) and the National Institutes of Health and the National Heart, Lung, and Blood Institute (grant K23HL069987 to E.L-R).

    Registered at www.ClinicalTrials.gov, Clinical Trial #: NCT00285558.

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