Primary care program helps obese teen girls manage weight, improve body image and behavior

Teenage girls gained less weight, improved their body image, ate less fast food, and had more family meals after participating in a 6- month program that involved weekly peer meetings, consultations with primary care providers and separate meetings for parents. Those results from a study published online today in the journal Pediatrics.

Funded by the National Institutes of Health, the study is the first to report long-term results from a weight management program designed specifically for teenage girls. Most other programs have included younger children and interventions focused on the entire family. This program included separate meetings for parents with the rationale that teens are motivated more by peer acceptance than parental influence. Unlike previous programs, this one was conducted in a primary-care setting, rather than an academic or specialty-care environment.

"Nearly one-third of teenage girls are overweight or obese, and many of them are likely to become obese adults," said Lynn DeBar, PhD, MPH, lead author and senior investigator with the Kaiser Permanente Center for Health Research. "Our study shows that intervention programs can help these girls achieve long-term success managing their weight and also learning new habits that will hopefully carry over into their adult life."

"Many teenage girls are still growing taller, so for them, maintaining weight or slowing weight gain is an acceptable goal," said Phil Wu, MD, a pediatrician who leads Kaiser Permanente's effort to prevent and treat childhood obesity and is also a co-author of the study. "Girls in the program gained less weight than those who weren't in the program, and they reduced their overall body mass index, improved their self-image and developed healthy lifestyle habits, so all of these are successes."

The study included 208 girls, ages 12-17, in Oregon and Washington during 2005-2009. All of the girls were classified as overweight or obese, according to standards set by the Centers for Disease Control and Prevention standards. Half of the girls were assigned to the intervention group and half to usual care.

Girls in the intervention group met weekly with their peers and a behavioral counselor during the first three months, and then every other week during months four and six. The girls were weighed and asked to keep a food and activity diary, which they discussed during each meeting. The program focused on decreasing portion size, limiting consumption of energy-rich foods, establishing regular meal patterns, substituting water for sugar-sweetened beverages, reducing fast food, increasing fruit and vegetable consumption, and having more family meals.

The girls were encouraged to exercise at least 5 days a week for 30-60 minutes, and to limit screen time to 2 hours a day. They also received yoga instruction, and a physical-activity video game to use at home. Discussion topics included ways to avoid disordered eating, coping with family and peer teasing and developing strategies to combat negative self-talk.