The role of parents in adolescent obesity treatment: Results of the TEENS+ randomized clinical pilot trial.

ABSTRACT

BACKGROUND: The optimal role for involving parents in adolescent obesity treatment is unknown. OBJECTIVE: To demonstrate that two parent approaches within adolescent obesity treatment are distinct, as evidenced by differential parent outcomes, and determine the preliminary efficacy of each approach on adolescent weight loss. METHODS: Adolescent/parent dyads (N = 82; mean adolescent age = 13.7 ± 1.2 years) participated in TEENS+, a 4-month behavioural weight loss treatment. Participants were randomized to (1) TEENS+parents as coaches (PAC; parent skills training), or (2) TEENS+parent weight loss (PWL; adult behavioural weight loss). Assessments occurred at 0, 4 (post-treatment), and 7-months. Within- and between-group repeated measures general linear mixed models examined change in parent weight (∆kg; primary outcome); parenting, feeding, weight control strategies, home environment, and adolescent body mass index (∆BMI; secondary outcomes). RESULTS: PWL parents had greater 4-month weight losses (∆kg0-4m  = -5.14 ± 4.87 kg) compared to PAC (-2.07 ± 3.89 kg; between-group p < 0.01). Key constructs differed between groups as expected. Both groups yielded significant within-group adolescent ∆BMI0-4m (PWL -0.97 ± 1.38 kg/m2 vs. PAC -0.93 ± 1.42 kg/m2 ; ps < 0.01); during maintenance, adolescents in PWL had ∆BMI4-7m increases (+0.41 ± 1.07 kg/m2 ; p = 0.02) while PAC did not (+0.05 ± 1.31 kg/m2 ; p = 0.82). CONCLUSION: Parent treatments were distinct in implementation and both yielded significant 4-month adolescent weight loss. Differential weight patterns were observed during maintenance, favouring PAC, warranting further exploration.