Children who lost weight were able to keep it off more effectively by participating in maintenance treatment programs that emphasized behavioral skills or social facilitation, although the effectiveness lessened over time, according to a study in the October 10 issue of JAMA: The Journal of the American Medical Association.
The prevalence of overweight among children in the United States has tripled in recent decades and related health care costs have nearly quadrupled, according to background information in the article. “Lifestyle interventions remain the most well-established interventions for overweight 7- to 12-year-olds. Although some evidence supports long-term efficacy, maintaining weight loss remains a challenge, with most interventions marked by considerable relapse,” the authors write.
Denise E. Wilfley, Ph.D., of Washington University School of Medicine, St. Louis, and colleagues evaluated the effects of two interventions following standard family-based behavioral weight loss treatment: a behavioral skills maintenance (BSM) and a social facilitation maintenance (SFM) intervention, compared to no intervention.
The BSM approach is based on the premise that specific strategies are needed for weight loss maintenance, emphasizing self-regulation behaviors and relapse-prevention strategies. The SFM approach is based on the premise that relapse results from the absence of a social environment supportive of continued weight control. This approach also targets peer (e.g., teasing) and self-perceptual (e.g., body image) factors identified as barriers to overweight children's physical activity.
The randomized controlled trial, conducted between October 1999 and July 2004 in a university-based weight control clinic, included 204 healthy 7- to 12-year-olds, 20 percent to 100 percent above median (midpoint) body mass index (BMI) for age and sex, with at least one overweight parent. Children enrolled in five months of weight loss treatment and 150 were randomized to one of three maintenance conditions: control group or four months of BSM or SFM treatment. Follow-up assessments occurred immediately following maintenance treatments and 1 and 2 years following randomization.