Maintenance of Weight Loss in Adolescents: Current Status and Future Directions

There is a dearth of research on the long-term efficacy and safety of treatments for adolescent obesity. This narrative review examined several approaches to treatment, focusing on long-term effectiveness data in adolescents, as well as relevant findings from studies of adults. The available research suggests that lifestyle modification has promise in obese adolescents, although it is not clear that any particular dietary or physical activity approach is more effective than another. Meal replacements are quite effective in adults and deserve further research in adolescents. Extending the length of treatment to teach weight loss maintenance skills is likely to improve long-term outcomes in adolescents, and delivering treatment via the Internet or telephone is a novel way of doing so. Treatment that combines lifestyle modification with the medication orlistat generally appears to be safe but only marginally superior to lifestyle modification alone. More research is needed on the management of adolescent obesity, which has been overlooked when compared with research on the treatment of obesity in children and adults

Motivations of Young Adults for Improving Dietary Choices: Focus Group Findings Prior to the MENU GenY Dietary Change Trial

BACKGROUND: Young adulthood is often associated with poor dietary habits that may increase risk of obesity and chronic diseases. As independence grows, little is known about strategies to help balance social, work, and education commitments that may override desires to incorporate healthful food choices. OBJECTIVE: In advance of a randomized trial to test an online intervention targeting young adults, we sought to identify views and experiences with healthy eating, and specifically, eating more fruits and vegetables. METHODS: We conducted 13 focus groups with 68 young adults in metropolitan Detroit (Henry Ford Health System) and rural Pennsylvania (Geisinger Health System). Randomly selected adults aged 21 to 30 years, using health system automated data, were sent recruitment letters. Questions were grounded in social cognitive theory and self-determination theory. Audiotapes were transcribed, content themes identified, coded, verified for reliability, and analyzed qualitatively. RESULTS: Young adults\u27 efforts to eat healthfully included three major themes of (1) motivations to create a healthy lifestyle, teach by example, feel better, and manage weight and future health problems; (2) learning to eat well from childhood, independent living, and peers; and (3) strategies to eat better through planning, tracking, and commitment. DISCUSSION: We uncovered theory-based factors that facilitate healthy dietary behavior change among young adults, including managing their behavior through self-monitoring, goal-setting, small steps, meaningful reinforcements, and social opportunities. CONCLUSIONS: Targeted interventions encouraging reflection on personal values related to meaningful contemporary health benefits are likely to resonate with young adults, as will opportunities to receive and share new information

5-2-1-0 Lifestyle risk factors predict obesity in Millennials

The Making Effective Nutritional Choices Generation Y (MENU GenY) study is a web-based intervention trial aimed at improving food choices in those aged 21-30 years. We report baseline levels of the 5-2-1-0 healthy lifestyle patterns to predict a body mass index (BMI) \u3e/=30 vs \u3c30 kg m(-2) . Overall, 1674 young adults (69% female) from two large health systems enroled and completed an online survey asking questions about lifestyle habits. A multivariable binary logistic regression model was utilized to predict a BMI \u3e/=30 while controlling for known predictors of obesity. Consuming \u3e3 daily servings of fruits/vegetables (odds ratio, OR = 0.90, 95% confidence interval, CI = 0.81, 0.99), and reporting \u3e2.5 hours/week of vigorous physical activity (OR = 0.93, 95% CI = 0.89-0.96, P \u3c 0.001) was associated with a BMI \u3c30. Conversely, time sitting (OR = 1.07, 95% CI = 1.04, 1.11) and consuming sugar-sweetened beverages (OR = 1.08, 95% CI = 1.00, 1.15) were related to a BMI \u3e/=30. In this cohort of 20-30-year-olds, we observed a consistent relationship between obesity and the 5-2-1-0 healthy lifestyle patterns previously reported among children and adolescents