Skip to main content
Log in

Efficacy of an internet-based behavioral weight loss program for overweight adolescent African-American girls

  • Original Research Paper
  • Published:
Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity Aims and scope Submit manuscript

Abstract

Objective: This randomized controlled trial tested the efficacy of an internetbased lifestyle behavior modification program for weight management in African-American girls. Design: African-American girls were randomly assigned to an interactive behavioral internet program or an internet health education program, the control condition. The behavioral intervention included internet counseling and was highly interactive. The control intervention was a passive (non-interactive) educational program. Parents were also participants in the study. Participants in both treatment groups met in face-to-face sessions on four occasions over the first 12 weeks of a 6-month intervention. Subjects: The study enrolled 57 African-American adolescent girls (ages 11 to 15 years) who were overweight or obese and had at least one biological parent who was obese [body mass index (BMI) >30 kg/m2]. Of the 57 participants, 50 (88%) completed the 6-month trial. Measurements: Outcome data, including BMI, body weight, body composition, dietary intake, and weight loss behaviors were collected at baseline and 6-months later. A computer server tracked utilization of the websites. Participation in the program was measured by number of “hits” on the website. Results: Compared to the control condition, adolescents in the behavioral treatment lost more body fat (group difference =1.6% body fat) and parents lost significantly more body weight (group difference =2.1 kg). Utilization of the behavioral website by adolescents and parents was associated with positive outcome. Dietary fat intake was lowered for adolescents and parents in the behavioral treatment group. Conclusion: An internet-based behavioral intervention was superior to internet-based health education and yielded decreased body fat for adolescent girls and decreased body weight for parents.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Flegal K.M., Carroll M.D., Kuczmarski R.J., Johnson C.L.: Overweight and obesity in the United States: prevalence and trends, 1960–1994. Int. J. Obes. Relat. Metab. Disord., 22, 39–47, 1998.

    Article  PubMed  CAS  Google Scholar 

  2. National Heart Lung and Blood Institute: NHLBI report of the Task Force on Behavioral Research in cardiovascular disease. Available at: http://www.nhlbi.nih.gov/ resources/docs/taskforc.htm. Accessed 2001.

    Google Scholar 

  3. World Health Organization Consultation of Obesity. Obesity: preventing and managing the global epidemiology: Geneva 1998.

  4. Wolf A.M., Colditz G.A.: Current estimates of the economic cost of obesity in the United States. Obes. Res., 6, 97–106, 1998.

    Article  PubMed  CAS  Google Scholar 

  5. Serdula M.K., Ivery D., Coates R.J., Freedman D.S., Williamson D.F., Byers T.: Do obese children become obese adults? A review of the literature. Prev. Med., 22, 167–177, 1993.

    Article  PubMed  CAS  Google Scholar 

  6. Himes J.H., Dietz W.H.: Guidelines for overweight in adolescent preventive services: recommendations from an expert committee. The Expert Committee on Clinical Guidelines for Overweight in Adolescent Preventive Services. Am. J. Clin. Nutr., 59, 307–316, 1994.

    PubMed  CAS  Google Scholar 

  7. Kumanyika S.K.: Minisymposium on obesity: overview and some strategic considerations. Annu. Rev. Public Health, 22, 293–308, 2001.

    Article  PubMed  CAS  Google Scholar 

  8. Kumanyika S.K., Obarzanek E., Stevens V.J., Hebert P.R., Whelton P.K., Kumanyaka S.K.: Weight-loss experience of black and white participants in NHLBIsponsored clinical trials. Am. J. Clin. Nutr., 53 (6 Suppl.), 1631S–1638S, 1991.

    PubMed  CAS  Google Scholar 

  9. Malarcher A.M., Casper M.L., Matson Koffman D.M., Brownstein J.N., Croft J., Mensah G.A.: Women and cardiovascular disease: addressing disparities through prevention research and a national comprehensive state-based program. J. Womens Health Gend. Based Med., 10, 717–724, 2001.

    Article  PubMed  CAS  Google Scholar 

  10. Harsha D.W., Bray G.A.: Body composition and childhood obesity. Endocrinol. Metab. Clin. North Am., 25, 871–885, 1996.

    Article  CAS  Google Scholar 

  11. Yanovski J.A., Yanovski S.Z.: Treatment of pediatric and adolescent obesity. JAMA, 289, 1851–1853, 2003.

    Article  PubMed  Google Scholar 

  12. Wadden T.A., Stunkard A.J., Rich L., Rubin C.J., Sweidel G., McKinney S.: Obesity in black adolescent girls: a controlled clinical trial of treatment by diet, behavior modification, and parental support. Pediatrics, 85, 345–352, 1990.

    PubMed  CAS  Google Scholar 

  13. Zabinski M.F., Celio A.A., Jacobs M.J., Manwaring J., Wilfley D.E.: Internet-based prevention of eating disorders. Eur. Eat. Disord. Rev., 11, 183–197, 2003.

    Article  Google Scholar 

  14. 14. Suler J.: The psychology of cyberspace. Available at: http://www.rider.edu/users/suler/psycyber/psycyber.html. Accessed 2001.

    Google Scholar 

  15. Harvey-Berino J., Pintauro S., Buzzell P., Di Giulio M., Casey Gold B., Moldovan C., Ramirez E.: Does using the Internet facilitate the maintenance of weight loss? Int. J. Obes. Relat. Metab. Disord., 26, 1254–1260, 2002.

    Article  PubMed  CAS  Google Scholar 

  16. Harvey-Berino J., Pintauro S., Buzzell P., Gold E.C.: Effect of internet support on the long-term maintenance of weight loss. Obes. Res., 12, 320–329, 2004.

    Article  PubMed  Google Scholar 

  17. Tate D.F., Jackvony E.H., Wing RR.: Effects of Internet behavioral counseling on weight loss in adults at risk for type 2 diabetes: a randomized trial. JAMA, 289, 1833–1836, 2003.

    Article  PubMed  Google Scholar 

  18. Tate D.F., Wing R.R., Winett R.A.: Using Internet technology to deliver a behavioral weight loss program. JAMA, 285, 1172–1177, 2001.

    Article  PubMed  CAS  Google Scholar 

  19. Baranowski T., Baranowski J.C., Cullen K.W., Thompson D.I., Nicklas T., Zakeri I.E., Rochon J.: The Fun, Food, and Fitness Project (FFFP): the Baylor GEMS pilot study. Ethn. Dis., 13 (1 Suppl. 1), S30–S39, 2003.

    PubMed  Google Scholar 

  20. Wing R.R.: Behavioral weight control. In: Wadden T.A., Stunkard A.J., (Eds.), Handbook of Obesity Treatment. New York, Guilford, 2002, pp. 301–316.

    Google Scholar 

  21. National Center for Health Statistics. Prevelance of overweight and obesity among adults: United States. Available at: http://www.cdc.gov/nchs/products/pubs/pubd/hestats/obese/obse99.htm. Accessed 2001.

    Google Scholar 

  22. Epstein L.H., Wing R.R., Koeske R., Andrasik F., Ossip D.J.: Child and parent weight loss in family-based behavior modification programs. J. Consult. Clin. Psychol., 49, 674–685, 1981.

    Article  PubMed  CAS  Google Scholar 

  23. Epstein L.H., Valoski A., Wing R.R., McCurley J.: Tenyear outcomes of behavioral family-based treatment for childhood obesity. Health Psychol., 13, 373–383, 1994.

    Article  PubMed  CAS  Google Scholar 

  24. Kutlesic V., Williamson D.A., Gleaves D.H., Barbin J.M., Murphy-Eberenz K.P.: The Interview for the Diagnosis of Eating Disorders-IV: Application to DSMIV Diagnostic Criteria. Psychol. Assess., 10, 41–48, 1998.

    Article  Google Scholar 

  25. Johnson R.K., Driscoll P., Goran M.I.: Comparison of multiple-pass 24-hour recall estimates of energy intake with total energy expenditure determined by the doubly labeled water method in young children. J. Am. Diet. Assoc., 96, 1140–1144, 1996.

    Article  PubMed  CAS  Google Scholar 

  26. Block G., Woods M., Potosky A., Clifford C.: Validation of a self-administered diet history questionnaire using multiple diet records. J. Clin. Epidemiol., 1327–1335, 1990.

    Google Scholar 

  27. Smith C.F., Williamson D.A., Womble L.G., Johnson J., Burke L.E.: Psychometric development of a multidimensional measure of weight-related attitudes and behaviors. Eat. Weight Disord., 5, 73–86, 2000.

    Article  PubMed  CAS  Google Scholar 

  28. Parcel G.S., Edmundson E., Perry C.L., Feldman H.A., O’Hara-Tompkins N., Nader P.R., Johson C.C., Stone E.J.: Measurement of self-efficacy for diet-related behaviors among elementary school children. J. Sch. Health, 65, 23–27, 1995.

    Article  PubMed  CAS  Google Scholar 

  29. Parcel G.S., Simons-Morton B., O’Hara N.M., Baranowski T., Wilson B.: School promotion of healthful diet and physical activity: impact on learning outcomes and self-reported behavior. Health Educ. Q., 16, 181–199, 1989.

    Article  PubMed  CAS  Google Scholar 

  30. Maloney M.J., McGuire J.B., Daniels S.R.: Reliability testing of a children’s version of the Eating Attitude Test. J. Am. Acad. Child Adolesc. Psychiatry, 27, 541–543, 1988.

    Article  PubMed  CAS  Google Scholar 

  31. Diener E., Emmons R.A., Larsen R.J., Griffin S.: The satisfaction with life scale. J. Person. Assess., 49, 71–75, 1985.

    Article  CAS  Google Scholar 

  32. Kovacs M.: The Children’s Depression Inventory (CDI). Toronto, Ontario, Canada, Multi-Health Systems, Inc., 1992.

    Google Scholar 

  33. Rosenberg M.: Self-Esteem Measure. Princeton, Princeton University Press, 1965.

    Google Scholar 

  34. Schumm W.R., McCollum E.E., Bugaighis M.A., Jurich A.P., Bollman S.R.: Characteristics of the Kansas Family Life Satisfaction Scale in a Regional Sample. Psychological Reports, 58, 975–980, 1986.

    Article  Google Scholar 

  35. Derogatis L.R.: SCL-90: administration scoring procedures manual-I for the (revised) version. Baltimore, MD, Johns Hopkins University School of Medicine, Clinical Psychometrics Research Unit, 1977.

    Google Scholar 

  36. Saelens B.E., Sallis J.F., Wilfley D.E., Patrick K., Cella J.A., Buchta R.: Behavioral weight control for overweight adolescents initiated in primary care. Obes. Res., 10, 22–32, 2002.

    Article  PubMed  Google Scholar 

  37. Berkowitz R.I., Wadden T.A., Tershakovec A.M., Cronquist J.L.: Behavior therapy and sibutramine for the treatment of adolescent obesity: a randomized controlled trial. JAMA, 289, 1805–1812, 2003.

    Article  PubMed  CAS  Google Scholar 

  38. Goldfield G.S., Raynor H.A., Epstein L.H.: In: Wadden T.A., Stunkard A.J. (Eds.), Handbook of Obesity Treatment. New York, Guilford, 532–554, 2002.

  39. Beaton G.H., Burema J., Ritenbaugh C.: Errors in the interpretation of dietary assessments. Am. J. Clin. Nutr., 65 (4 Suppl.), 1100S–1107S, 1997.

    PubMed  CAS  Google Scholar 

  40. Kretsch M.J., Fong A.K., Green M.W.: Behavioral and body size correlates of energy intake underreporting by obese and normal-weight women. J. Am. Diet. Assoc., 99, 300–306, quiz 307–308, 1999

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to D. A. Williamson.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Williamson, D.A., Davis Martin, P., White, M.A. et al. Efficacy of an internet-based behavioral weight loss program for overweight adolescent African-American girls. Eat Weight Disord 10, 193–203 (2005). https://doi.org/10.1007/BF03327547

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03327547

Keywords

Navigation