Treatment of Morbid Obesity in Low‐income Adolescents: Effects of Parental Self‐monitoring

Abstract

KIRSCHENBAUM, DANIEL S., JULIE N. GERMANN, AND BARRY H. RICH. Treatment of morbid obesity in low-income adolescents: effects of parental self-monitoring. Obes Res. 2005;13:1527-1529. Objective: This study examined the extent to which consistency of self-monitoring by participants and their parents was related to weight control over an initial period of 3 months within the context of a treatment program for morbidly obese low-income minority adolescents. Research Methods and Procedures: Eighty-three obese adolescents (mean age, 13.0 years; 51% boys; 92% African American; mean BMI, 43.0 kg/m 2 ; mean BMI z-score, 6.0) and at least one parent participated in a long-term treatment program that included a very-low-fat dietary focus, weekly group cognitive-behavior therapy, monthly nutrition education classes, a 12-week physical therapy class, and medical monitoring. Results: Participants who self-monitored on the majority of days compared with those who did not self-monitor at all or who self-monitored infrequently attended more sessions and generally lost more weight over the first 3 months. Although parents signed behavioral contracts committing to self-monitor their own eating and exercising over the first month, only 12% did so. Nonetheless, participants whose parents self-monitored were much more likely to self-monitor consistently and lose weight during the first 3 months. Discussion: These results indicate that self-monitoring is a cornerstone of successful weight control even for morbidly obese low-income minority adolescents; targeting consistency of self-monitoring among these high-risk weight controllers and their parents should be just as important as it is for more affluent and less overweight adolescents.

Use of Text Messaging for Monitoring Sugar-sweetened Beverages, Physical Activity, and Screen Time in Children: A Pilot Study

“…Despite the robust literature on the importance of monitoring for weight loss success, both adults and children often do not adhere (12)(13)(14)(15). In the first month of a weight control intervention for morbidly overweight children, 44% self-monitored at least 3.5 days per week (14,15); however, only 25% continued at six months (14).…”

“…In the first month of a weight control intervention for morbidly overweight children, 44% self-monitored at least 3.5 days per week (14,15); however, only 25% continued at six months (14). Thus, approaches are needed to enhance adherence to self-monitoring.…”

Evaluating Parents and Adult Caregivers as “Agents of Change” for Treating Obese Children: Evidence for Parent Behavior Change Strategies and Research Gaps

“…136,137 However, adherence to self-monitoring is often less than ideal and declines over time. 133,138,139 The advent of computer-based technology, including the Internet and handheld devices, has stimulated the development of several studies evaluating their use for self-monitoring, with the expectation that these devices will improve adherence.…”

Evidence Update on the Treatment of Overweight and Obesity in Children and Adolescents

“…Behavioral strategies are utilized to facilitate both weight loss and maintenance of weight change by promoting small, successive changes in behaviors (TODAY Study Group, 2010). Behavioral strategies that are commonly employed include selfmonitoring (Helsel, Jakicic, & Otto, 2007;Kirschenbaum, Germann, & Rich, 2005), goal setting Nothwehr & Yang, 2007), reinforcement for goal achievement (Foreyt & Goodrick, 1993;Williamson & Perrin, 1996), stimulus control (Epstein, Paluch, Kilanowski, & Raynor, 2004), social support (Wilfley, Stein, et al, 2007), problem solving (Perri et al, 2001), and motivational techniques (Resnicow & Blackburn, 2005).…”