Can obesity prevention work for our children?

The prevalence of obesity in children and adolescents is higher than 20 years ago in all racial-ethnic, age, and gender groups. Research has lead to the discovery of many risk factors for obesity, which may help practitioners target at-risk individuals. Insight concerning obesity prevention can come from examining other public health programs, which center on prevention; such as smoking, seat belt use, and sexually transmitted disease. Another guide when establishing obesity prevention is evaluation of currently successful programs. Prevention and treatment interventions for childhood obesity should promote the replacement of unhealthy eating and exercise practices with healthier behaviors. The goal of prevention should always be maintenance of normal growth patterns, rather than weight loss. In predisposed children, sedentary, non-nutritious environments challenge metabolic capacity and promote overweight conditions, further inactivity and increased sedentary behaviors. This results in clinically significant obesity, reduced insulin sensitivity and ultimately type 2 diabetes later in life. Prevention of future chronic disease in children and adults may depend on our ability to prevent the onset of obesity in young children. This should be a primary goal of pediatricians, family health care professionals, and public health professionals.

Mediators of weight loss in a family-based intervention presented over the internet.

OBJECTIVE: To assess the process variables involved in a weight loss program for African-American adolescent girls. Several process variables have been identified as affecting success in in vivo weight loss programs for adults and children, including program adherence, self-efficacy, and social support. The current study sought to broaden the understanding of these process variables as they pertain to an intervention program that is presented using the Internet. It was hypothesized that variables such as program adherence, dietary self-efficacy, psychological factors, and family environment factors would mediate the effect of the experimental condition on weight loss. RESEARCH METHODS AND PROCEDURES: Participants were 57 adolescent African-American girls who joined the program with one obese parent; family pairs were randomized to either a behavioral or control condition in an Internet-based weight loss program. Outcome data (weight loss) are reported for the first 6 months of the intervention. RESULTS: Results partially supported the hypotheses. For weight loss among adolescents, parent variables pertaining to life and family satisfaction were the strongest mediating variables. For parental weight loss, changes in dietary practices over the course of 6 months were the strongest mediators. DISCUSSION: The identification of factors that enhance or impede weight loss for adolescents is an important step in improving weight loss programs for this group. The current findings suggest that family/parental variables exert a strong influence on weight loss efforts for adolescents and should be considered in developing future programs.