Reduction of overweight and eating disorder symptoms via the Internet in adolescents: A randomized controlled trial

Purpose: Overweight in adolescence is a significant problem which is associated with body dissatisfaction and eating disorder (ED) behaviors. Cost-effective methods for early intervention of obesity and prevention of ED are important because of the refractory nature of both. This mulfisite RCT evaluated an Intemet-delivered program targeting weight loss and ED attitudesibehaviors in adolescents. Methods: A total of 80 overweight adolescents 12-17 years of age completed Student Bodies 2 (SB2), a 16-week cognitive- behavioral program, or usual care (UC). Results: Body mass index (BMI) z-scores were reduced in the SB2 group compared with the UC group from baseline to post-intervention (p, =.027; TIP2 =.08). The SB2 group maintained this reduction in BMI z-scores at 4-month follow-up, but significant differences were not observed because of improvement in the UC group. The SB2 group evidenced greater increases in dietary restraint post-intervention (p =.016) and less improvement on shape concerns at follow-up (p = .044), however these differences were not clinically significant. No other statistically significant differences were noted between groups on ED attitudes or behaviors. The SB2 participants reported using healthy eating-related and physical activity-related skills more frequently than UC participants post-intervention (p =.001) and follow-up (p =.012). Conclusions: Findings suggest that an Intemet-delivered intervention yielded a modest reduction in weight status that continued 4 months after treatment and that ED attitudes/behaviors were not significantly improved. Group differences on weight loss were not sustained at 4-month follow-up because of parallel improvements in the groups. Future studies are needed to improve program adherence and to further explore the efficacy of Internet-delivery of weight control programs for adolescents. (c) 2008 Society for Adolescent Medicine. All rights reserved.