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Doctors play key role in sustaining weight loss among teen girls

Physicians can help overweight adolescent girls lose weight and keep it off by identifying lifestyle habits that need improvement and encouraging their efforts, a study says.

"Some primary care physicians don't think they have a lot of influence over patients because they have such a short period of time to meet with them, but they do have a very powerful presence in the lives of teenagers and their families," said lead study author Lynn L. DeBar, PhD, MPH, clinical psychologist and behavioral health researcher at the Kaiser Permanente Center for Health Research in Portland, Ore. "By just encouraging a healthy lifestyle among their patients, they make a difference."

Teenage girls who participated in a six-month program that included weekly peer meetings and consultations with their primary care physician had a lower body mass index and better self-esteem than females who did not take part in the program, said a study posted online Feb. 13 in Pediatrics.

DeBar recommends that physicians ask overweight patients how much time they spend watching TV and using a computer and what activities they could do instead. She also encourages doctors to talk with patients about modest dietary changes and practical ways to increase their physical activity.

About 17% of U.S. children and adolescents ages 2 to 19 (12.5 million) are obese, according to the Centers for Disease Control and Prevention. Since 1980, the prevalence of obesity in this age group has nearly tripled.

For the Pediatrics study, researchers examined the weight and health behaviors of 208 overweight and obese girls 12 to 17 between September 2005 and May 2009. The girls, who were members of a large health maintenance organization in the Pacific Northwest, were assigned to one of two groups -- intervention or usual care.

Those in the intervention group met weekly with peers and a behavioral counselor for the first three months, then every other week during the fourth and fifth months. At each meeting, the girls were weighed, and they discussed the food they consumed and the physical activity they engaged in since their last session.

Participants were encouraged to exercise at least five days a week for 30 to 60 minutes and limit TV and computer screen time to two hours a day. The girls' parents attended separate weekly meetings to learn how to support their daughters' health goals.

Pediatricians who had patients in the intervention group received training on motivational techniques and got summaries of their patients' health habits. Physicians met with the girls at the study's start to help them choose one or two behaviors to improve. A second visit was scheduled about six months later to check a patient's progress in meeting her goals.

Girls assigned to the usual-care group received information on evidence-based approaches to weight management and a list of online reading materials about lifestyle changes. They met with their pediatricians at the beginning of the study, but the doctors did not have health habit summaries for those girls.

Study participants received health assessments and lab tests at the start of the study, then at six months and one year after the study began.

Researchers found participants in both groups had a mean BMI percentile of 97 at the start of the study. After one year, mean BMI levels declined to the 95th percentile for girls in the intervention group and to the 96th percentile for those who received usual care.

The CDC defines obesity as having a BMI in the 95th percentile or greater.

Girls in the intervention group were more likely to eat breakfast, less likely to drink sugar-sweetened beverages and more satisfied with their bodies than those who received usual care.

DeBar said the data show that participants sustained their modest weight loss and healthy behaviors beyond the program.

"That's a good start, but it's not enough," she said. More intensive intervention programs probably will lead to even better health outcomes among participants, she added.

The full and original article can be found at: http://www.ama-assn.org/amednews/2012/02/20/hlsd0224.htm

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