Excess Weight Gain Prevention in Adolescents: Three-Year Outcome Following a Randomized Controlled Trial

• Published in: Journal of consulting and clinical psychology Vol. 85; no. 3; pp. 218 - 227
• Main Authors: Tanofsky-Kraff, Marian, Shomaker, Lauren B, Wilfley, Denise E, Young, Jami F, Sbrocco, Tracy, Stephens, Mark, Brady, Sheila M, Galescu, Ovidiu, Demidowich, Andrew, Olsen, Cara H, Kozlosky, Merel, Reynolds, James C, Yanovski, Jack A
• Format: Journal Article
• Language: English
• Published: United States American Psychological Association 01-03-2017
• Subjects: Adjustment; Adolescent; Adolescent girls; Anxiety; At risk; Binge eating; Binge-Eating Disorder - psychology; Body Mass Index; Bulimia; Child; Clinical trials; Eating disorders; Efficacy; Female; Follow-Up Studies; Girls; Health Education; Health Education - methods; High risk; Human; Humans; Interpersonal Psychotherapy; Obesity; Obesity - prevention & control; Obesity - psychology; Prevention; Prevention programs; Prone; Psychosocial factors; Psychosocial problems; Psychotherapy; Psychotherapy - methods; Risk; Risk assessment; Self-Control; Social Adjustment; Social anxiety; Test anxiety; Trait anxiety; Treatment Outcome; Weight control; Weight Gain; anxiety; adiposity; BMIz; social-adjustment problems; preventive adolescent IPT
• ISSN: 0022-006X; 1939-2117; 1939-2117
• DOI: 10.1037/ccp0000153

Objective: Interpersonal psychotherapy (IPT) prevents weight gain in adults with obesity and binge-eating-disorder, and is especially effective among those with increased psychosocial problems. However, IPT was not superior to health education (HE) to prevent excess weight gain at 1-year follow-up in 113 adolescent girls at high-risk for excess weight gain because of loss-of-control eating and high body mass index (BMI; kg/m2; Tanofsky-Kraff et al., 2014). Method: Participants from the original trial were recontacted 3 years later for assessment. At baseline, adolescent- and parent-reported social-adjustment problems and trait anxiety were evaluated. At baseline and follow-ups, BMIz and adiposity by dual-energy x-ray absorptiometry were obtained. Results: Nearly 60% were reassessed at 3 years, with no group differences in participation (ps ≥ .70). Consistent with 1 year, there was no main effect of group on change in BMIz/adiposity (ps ≥ .18). In exploratory analyses, baseline social-adjustment problems and trait-anxiety moderated outcome (ps < .01). Among girls with high self-reported baseline social-adjustment problems or anxiety, IPT, compared to HE, was associated with the steepest declines in BMIz (p < .001). For adiposity, girls with high or low anxiety in HE and girls with low anxiety in IPT experienced gains (ps ≤ .03), while girls in IPT with high anxiety stabilized. Parent-reports yielded complementary findings. Conclusion: In obesity-prone adolescent girls, IPT was not superior to HE in preventing excess weight gain at 3 years. Consistent with theory, exploratory analyses suggested that IPT was associated with improvements in BMIz over 3 years among youth with high social-adjustment problems or trait anxiety. Future studies should test the efficacy of IPT for obesity prevention among at-risk girls with social-adjustment problems and/or anxiety.
What is the public health significance of this article?
This study suggests that an adapted preventive group interpersonal psychotherapy prevents excess weight gain among adolescents with social-adjustment problems or high anxiety. Youth with lower social-adjustment problems and anxiety may benefit from other forms of obesity prevention approaches.