Preventing Excessive Weight Gain in Adolescent Girls at High Risk for Adult Obesity
Obesity is a serious health problem in America today. People
suffering from this condition find themselves at increased risk
for a variety of ailments, such as Type 2 Diabetes, cardiovascular
disease and some types of cancer—not to mention the increased
costs of health care throughout the lifespan. Researchers at
the NIH Clinical Center are constantly seeking new and better
ways to combat this national epidemic.
Schmalfeldt: A new clinical research study at the NIH will examine whether interpersonal psychotherapy can help reduce excessive weight gain in adolescent girls. Dr. Marian Tanofsky-Kraff, an investigator from the Eunice Kennedy Shriver National Institute of Child Health and Human Development at the NIH, said the study will compare the effectiveness of interpersonal psychotherapy with a teen education program in preventing excessive weight gain.
Tanofsky-Kraff: We're trying to prevent the onset of obesity and our work in the past has looked at psychological behavioral variables that predict excessive weight gain as kids grow. And one of the key things we found is that loss-of-control eating—some people refer to it as "binge eating," but really that experience that they can't stop eating—is predictive longitudinally of excess weight gain. So the idea came about a few years ago, I thought, "Wow, if we can take kids who we know are at risk of gaining too much as they grow because they engage in these behaviors, we may be able to prevent excessive weight gain."
Schmalfeldt: Adolescent girls between 12 and 17 years of age who are at risk for becoming overweight adults, by virtue of above-average weight and having experienced episodes of loss-of-control over eating, may be eligible for the study. Dr. Tanofsky-Kraff said 110 girls will be enrolled in the study over four years. After a telephone evaluation, the girls and their parents are invited to Bethesda for further screening.
Tanofsky-Kraff: We get an estimated height and weight to see if they're within the range we're looking for. With children and adolescents we look at body mass index percentile as opposed to body mass index because kids are still growing. So we like to compare girls to all the other girls their age. If it looks like they're in the range, we do a consent and then we do an interview to determine if they do indeed have this loss-of-control eating.
Schmalfeldt: According to the study protocol, all participants will have a 1 to 1-1/2 hour individual session with the group leaders, after which they will be assigned at random to 12 weekly group sessions in either a teen health education program, or interpersonal psychotherapy. Dr. Tanofsky-Kraff explained that aspect of the protocol.
Tanofsky-Kraff: We refer to it as "the relationship group." It's actually based on something called interpersonal psychotherapy that was designed for depression, and it's been show to be effective not only for the treatment of depression in adolescents but also the prevention of depression in kids at high risk. It's also been shown to be effective for something called "binge eating disorder" in adults.Schmalfeldt: At the end of the program, the girls will be assessed with questionnaires and body measurements. Six months later, they will return to the clinic for more body measurements and tests, followed by another visit six months later. If you would like more information about clinical trials, log on to http://clinicalresearch.nih.gov, or e-mail email@example.com. You may also call, toll free, 1-866-999-5553. I'm Bill Schmalfeldt, National Institutes of Health, Bethesda, Maryland.