Treatment of morbid obesity in low-income adolescents: effects of parental self-monitoring.
OBJECTIVE
This study examined the extent to which consistency of self-monitoring by participants and their parents was related to weight control over an initial period of 3 months within the context of a treatment program for morbidly obese low-income minority adolescents.


METHODS
Eighty-three obese adolescents (mean age, 13.0 years; 51% boys; 92% African American; mean BMI, 43.0 kg/m2; mean BMI z-score, 6.0) and at least one parent participated in a long-term treatment program that included a very-low-fat dietary focus, weekly group cognitive-behavior therapy, monthly nutrition education classes, a 12-week physical therapy class, and medical monitoring.


RESULTS
Participants who self-monitored on the majority of days compared with those who did not self-monitor at all or who self-monitored infrequently attended more sessions and generally lost more weight over the first 3 months. Although parents signed behavioral contracts committing to self-monitor their own eating and exercising over the first month, only 12% did so. Nonetheless, participants whose parents self-monitored were much more likely to self-monitor consistently and lose weight during the first 3 months.


CONCLUSIONS
These results indicate that self-monitoring is a cornerstone of successful weight control even for morbidly obese low-income minority adolescents; targeting consistency of self-monitoring among these high-risk weight controllers and their parents should be just as important as it is for more affluent and less overweight adolescents.
Kirschenbaum
Daniel S
DS
La Rabida Children's Hospital, Chicago, IL 60611, USA. dkirschenbaum@healthylivingacademies.com
Germann
Julie N
JN
Rich
Barry H
BH
D000293:Adolescent; D001521:Behavior Therapy / Q000379:methods*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008913:Minority Groups; D009767:Obesity, Morbid / Q000208:ethnology / Q000628:therapy*; D010287:Parent-Child Relations; D011203:Poverty