Obesity Clinical Trial
To evaluate the efficacy of peer-based skills training to enhance weight control and improve psychosocial functioning in overweight adolescents.
BACKGROUND:
The prevalence of obesity in children, adolescents, and adults has increased significantly
over the last two decades. Adolescents who are obese are at great risk for remaining obese
into adulthood. Given the difficulty of treating adult obesity, intervening with adolescents
before they reach adulthood is critical. Decreasing obesity during adolescence provides an
opportunity to prevent the continuance of pediatric onset obesity into adulthood. There are
well-established weight control interventions for children between 8 and 12 years of age.
However, treatment findings with overweight adolescents are not as robust and are difficult
to replicate. One potential limitation of existing weight control interventions for
adolescents is the minimal attention given to the peer group as an active component of
treatment.
The study was in response to an initiative issued by the National Institute of Diabetes and
Digestive and Kidney Diseases and entitled "Innovative Approaches to the Prevention of
Obesity". The resulting grant was later reassigned to the National Heart, Lung, and Blood
Institute.
DESIGN NARRATIVE:
A total of 119 adolescents between the ages of 13 and 16 years and between 20 and 80%
overweight were randomized to one of three treatment conditions: (1) cognitive-behavioral
treatment (CBT); (2) cognitive-behavioral treatment with the addition of peer-based skills
training (CBT + PBST); or 3) standard care (SC). The cognitive-behavioral intervention
consisted of 16 weekly sessions followed by four monthly maintenance sessions. Adolescents
randomized to CBT + PBST received the cognitive-behavioral treatment as well as an intensive
32 session peer-based intervention. The peer-based intervention combined problem-solving
therapy with principles from Outward Bound to address self-reliance, social competence and
physical self-worth. One way analyses of variance was conducted at the end of treatment and
at 6-months after the end of treatment to compare the three groups on initial reduction in
percent overweight and maintenance of decreases in percent overweight at follow-up. Analysis
of variance was also used to compare the three groups on measures of social functioning,
self-esteem, physical activity level, and physical self-worth.
The study completion date listed in this record was obtained from the "End Date" entered in
the Protocol Registration and Results System (PRS) record.
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