Treatment and follow-up of obesity in adolescent girls.

An intervention program was conducted for 12 postmenarche, 12-15-year-old obese girls. Weight Winners, a multicomponent and multidisciplinary after-school intervention program, was developed in which behavior modification, aerobic exercise, and modeling appropriate behaviors for weight control were emphasized. Evaluation made before and immediately after the intervention and at a nine-month follow-up suggested that the after-school treatment program was successful in: 1) reducing the rate of gain and decreasing body weight by 11% while maintaining lean tissue and resting energy expenditure (REE), and 2) improving eating and exercise behaviors. Significant changes in eating behaviors (p less than 0.05) were: more low-calorie, nutritionally dense foods were consumed; the frequency and amount eaten decreased; and the speed of eating slowed. Implementing a fee contingent on attendance and on record keeping appeared to reduce attrition. Subjects cited the Weight Winners program, aerobic exercise, changes in eating behaviors, group and family support, and encouragement and praise from the group leaders as important contributions to their success in weight control. Barriers to change were reported by participants as boredom, hunger, lack of family and peer support, and having food in sight. An increase in lean tissue was associated with both improved self-esteem (p less than 0.05) and improved self-control (p less than 0.05). Subjects who had been obese the longest were the most responsive to hunger cues (p less than 0.05).