Early intervention of eating- and weight-related problems via the Internet in overweight adolescents: A randomized controlled trial.

摘要

More than one out of seven adolescents are currently overweight or obese and the majority of these adolescents are expected to experience compromised mental and physical health over their lifetimes. Body dissatisfaction and the elevated rates of eating disordered behaviors in this population have rarely been addressed in obesity treatment programs. This study evaluated the efficacy of an integrated, Internet-delivered, early intervention approach targeting weight loss, body dissatisfaction, and reduction of eating disordered behaviors in an overweight adolescent sample. Sixty-one 12- to 18-year olds who were overweight or obese (mean BMI percentile = 97.71 +/- 2.51) were randomly assigned to Student Bodies 2 (SB2), a 16-week Internet-delivered program utilizing a cognitive-behavioral approach, or typical care (TC). Each week during the program, SB2 participants logged on to the website to read psychoeducational materials, complete online food, physical activity, weight, and body image journals, and participate in an asynchronous group discussion. Assessments were conducted at baseline and at post-treatment. A statistically significant reduction in BMI z-score was found when compared to the TC group (F[1,58] = 6.29, p = .015; ES = 0.19). No statistically significant differences were noted between groups on measures of eating disordered attitudes and behaviors, with the exception of an increase in dietary restraint in the SB2 group (F [1,55] = 4.88, p = .031), which reflected program recommendations. SB2 participants reduced consumption of high-fat foods ( F[1,52] = 6.09, p = .017); ES = 0.61), and increased eating-related (F[1,58] = 11.34, p = .001; ES = 0.94) and physical activity-related cognitive and behavioral skills use (F[1,58] = 7.43, p = .008; ES = 0.78). However, none of these variables were shown to be mediators of outcome. SB2 participants also reported reduced stress levels compared to increases in stress in the TC group (F [1,51] = 9.41, p = .003; ES = 0.53). Findings suggest that an Internet-delivered intervention yields a modest reduction in weight status and that body image and eating disordered behaviors are not negatively impacted. Implications include the acceptability of the Internet as a potentially effective modality in the treatment of adolescent obesity and associated conditions.