Preventing Obesity in Military Communities, Adolescents
Condition: Obesity; Weight Gain; Disordered Eating; Eating Disorder
MeSH terms: Obesity; Weight Gain; Feeding and Eating Disorders
Study type: Interventional

Summary: 
      This research study is aimed at the prevention of excessive weight gain in female military
      dependents at high risk for adult obesity. The purpose of this study is to determine whether
      reducing Loss of Control (LOC) eating and associated indicators through use of interpersonal
      psychotherapy (IPT) will be feasible and acceptable to female adolescent dependents who
      report such behaviors. Moreover, patterns in the data will be examined to assess whether IPT
      influences body weight gain trajectories and prevent worsening disordered eating and
      metabolic functioning among female military dependents at heightened risk for unhealthy
      weight gain.
    

Detailed description: 
      The increased prevalence of obesity among the children of military personnel has paralleled
      that observed in the civilian population. Disordered eating, especially binge or loss of
      control (LOC) eating, is common among adolescents and is a salient risk factor for obesity
      and the development of exacerbated disordered eating and depressive symptoms. The goal of
      this study is to test the effectiveness of interpersonal psychotherapy (IPT) to slow the
      trajectory of weight gain in adolescent girls at high-risk for adult obesity by virtue of
      elevated body mass index (BMI) percentile and LOC eating. IPT targets the difficult social
      functioning and stressful events that are associated with LOC and highly relevant to the
      adolescent youth from military families. Adolescent military dependents will be randomized to
      receive either the IPT weight gain prevention program or a health education (HE) control
      condition, for 12 weekly group sessions. Adolescents' weight status, eating behaviors, and
      mood will be assessed at baseline, immediately following the prevention program (12-weeks),
      and at 1-year follow-up. At 2-year and 3-year follow-up time points, participants' BMI and
      physiologic data will be collected via the Military Health System's electronic medical record
      system. It is hypothesized that adolescents who receive the IPT group program will show
      significantly less weight gain (or more weight loss) relative to those randomized to HE at
      3-year follow-up. Additionally, it is hypothesized that adolescents receiving IPT (as
      compared to HE) will demonstrate improvements on secondary outcomes of interest, including
      the presence and frequency of classic binge eating episodes, as well as obesity-related
      physiological measures of health (e.g., fasting insulin). The overall goal of the study is to
      prevent excess weight gain and adult obesity, and to prevent worsening disordered eating and
      metabolic functioning among overweight military dependents at risk for adult obesity and
      binge eating disorders.
    

Intervention name(s): Interpersonal Psychotherapy-Weight Gain; Health Education
Intervention type(s): Behavioral; Other
Intervention description(s): Participants will have 1 individual pre-group session when each participant meets with the group leaders so that they can learn about each girl's significant relationships, set goals for the program, and so each girl can learn about group participation and format. Participants then will begin IPT-WG which is designed to decrease excessive weight gain among adolescents ages 12-17 years who are at risk for adult obesity. The IPT-WG program has been adapted to be appropriate for military dependents. The IPT-WG group meets for 12 consecutive, weekly group meetings and involves developing strategies for dealing with the problems girls struggle with that may lead to increased eating. At the 6th week of the group, the group leaders meet with each participant to review their progress and goals.; The health education group will follow the "HEY-Durham" health program designed by researchers at Duke University. This program, designed to be delivered to youth attending community high schools, was adapted to a 12-week program (each with a 90 minute session). Girls will come in for a 1.5-hour group meeting once a week for 12 weeks (12 times total). Before beginning the group, girls will meet with group leaders to review each adolescent's family health history. The curriculum includes focus on various health topics, including avoiding alcohol, drug and tobacco use, nutrition and body image, nonviolent conflict resolution, sun safety, exercise, and domestic violence.
Other intervention name(s): IPT-WG; HEY-Durham (edited for POMC-A)
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: Adolescent; Obesity/Psychology; Loss of Control Eating; Child; Female; Follow-Up Studies; Health Behavior; Health Education; Humans; Intervention Studies; Prospective Studies; Psychotherapy; Risk Factors; Weight Loss; Weight Gain; Military