Study 1. The most effective treatment for adolescent obesity appears to be a program of behavior modification, nutrition education, and physical activity combined with social support. Use of this program with minority children, known to have a high prevalence of obesity, has not been adequately investigated, however. We will evaluate the efficacy of three methods of involving mothers in the treatment of their children: (1) no parent involvement; (2) children and mothers treated together in the same session; and (3) children and mothers treated in separate sessions. Subjects will be 90 Black females, 12 to 16 years old, who are 20% to 70% overweight for their age and height. Subjects will be randomly assigned to one of the above conditions after having completed measurements of body composition (by hydrostatic weighing) and fat cell size and number. All subjects will attend 16-weekly treatment sessions and 10-monthly follow-up meetings. The effectiveness of these three interventions will be measured by changes in the adolescents': (1) weight; (2) body composition (fat and lean tissue); (3) blood pressure; (4) behavior; and (5) psychological functioning. Weight change will also be measured in relation to pretreatment measures of fat cell size and number. Changes in fat cell number will be investigated at 10 months' follow-up in the 20 children losing the most and least amounts of weight. Study 2. Clinical studies similar to the above are needed to increase our understanding of obesity and to develop new treatment techniques. But new settings for the delivery of treatment must be found in order to reach as many children as possible. Several studies have indicated that schools are a promising treatment site. This study will investigate the effectiveness of a 12-week school-based program by comparing weight losses in 50 treated subjects (in grades 3-6 and at least 15% overweight) with those in 50 control subjects. The efficacy of a 12-week program of weight loss maintenance will then be investigated in one-half of the treated subjects, assigned at random.
| Wadden, T A; Stunkard, A J; Rich, L et al. (1990) Obesity in black adolescent girls: a controlled clinical trial of treatment by diet, behavior modification, and parental support. Pediatrics 85:345-52 |
| Foster, G D; Wadden, T A; Feurer, I D et al. (1990) Controlled trial of the metabolic effects of a very-low-calorie diet: short- and long-term effects. Am J Clin Nutr 51:167-72 |
| Wadden, T A; Foster, G D; Letizia, K A et al. (1990) Long-term effects of dieting on resting metabolic rate in obese outpatients. JAMA 264:707-11 |
| Wadden, T A; Stunkard, A J; Day, S C et al. (1987) Less food, less hunger: reports of appetite and symptoms in a controlled study of a protein-sparing modified fast. Int J Obes 11:239-49 |
