Does an Age-Specific Treatment Program Augment the Efficacy of a Cognitive-Behavioral Weight Loss Program in Adolescence and Young Adulthood? Results from a Controlled Study

Abstract

Research on weight-loss interventions in emerging adulthood is warranted. Therefore, a cognitive-behavioral group treatment (CBT), including development-specific topics for adolescents and young adults with obesity (YOUTH), was developed. In a controlled study, we compared the efficacy of this age-specific CBT group intervention to an age-unspecific CBT group delivered across ages in an inpatient setting. The primary outcome was body mass index standard deviation score (BMI-SDS) over the course of one year; secondary outcomes were health-related and disease-specific quality of life (QoL). 266 participants aged 16 to 21 years (65% females) were randomized. Intention-to-treat (ITT) and per-protocol analyses (PPA) were performed. For both group interventions, we observed significant and clinically relevant improvements in BMI-SDS and QoL over the course of time with small to large effect sizes. Contrary to our hypothesis, the age-specific intervention was not superior to the age-unspecific CBT-approach.

Beyond bariatric surgery and weight loss medicaments. A systematic review of the current practice in obesity rehabilitative inpatient programs in adults and pediatrics

“…Among exclusion criteria, syndromic and secondary obesity were the most frequently declared ( 44 – 51 , 54 , 58 ). Most of the studies applied a single-arm open-label design ( 44 , 45 , 48 – 55 , 58 , 59 ) with the remaining ones being non-randomized interventions against control or comparable groups ( 46 , 47 , 56 ); only one study was an RCT ( 57 ). The prevailing dietary treatment was a balanced low-calorie diet, although in certain studies an ad libitum buffet approach ( 46 , 57 ) or a normocaloric diet accompanied by physical activity were used ( 53 , 58 ).…”

“…Most of the studies applied a single-arm open-label design ( 44 , 45 , 48 – 55 , 58 , 59 ) with the remaining ones being non-randomized interventions against control or comparable groups ( 46 , 47 , 56 ); only one study was an RCT ( 57 ). The prevailing dietary treatment was a balanced low-calorie diet, although in certain studies an ad libitum buffet approach ( 46 , 57 ) or a normocaloric diet accompanied by physical activity were used ( 53 , 58 ). Physical activity was part of the multidisciplinary treatment in all studies, while psychotherapy, generally with a behavioral approach, was provided for less than half of the interventions ( 44 , 46 – 48 , 52 , 54 , 58 ).…”

“…Nutritional education was also present in five studies (44, [46][47][48]58). Three studies reported follow-up data up to 14 months after the intervention (46,48,52).…”

“…Also, all studies shared a moderate level of risk for bias for missing data, for the same reasons explained above. Some studies (46,53,58) have been judged as a possible source of deviation bias (serious risk) since no fixed diet was provided and ad libitum or normocaloric diets were chosen instead. The risk of bias in the measurement of outcomes was, as previously explained, substantially high in most studies (moderate risk), with six studies classified as serious risk due to the characteristics of evaluated outcomes (46,50,(52)(53)(54)(55).…”

Juvenile obesity in terms of various evaluation methods

“…These include stress management, personal well-being, and good resilience [36]. Interventions should include a school or external psycholo-gist who implements a cognitive-behavioural group treatment, which improves not only BMI SDS but also quality of life [37].…”