Lifestyle interventions 15
Table 1
Treatment-Control Comparisons, with Weight-Related Effect Size d at End of Treatment
Study / Definition of Overweight / Age / % F / ID / Treatment / Comparison / TreatmentLength / N for
ES / Weight-Related ES
Blomquist et al. (1965) / Weight at 2 SD for ht. / 8-10 / 100 / 1 / Physical Activity / Control / 16w / 40 / 0.30
Christakis et al. (1966) / 10% OW / 13-14 / 100 / 2 / Multi-Component / Control / 72w / 82 / 0.07
Seltzer & Mayer (1970) / Skinfold (cutoff varied by age and sex) / 8-14 / 70 / 3 / Physical Activity,
Diet Education / Control / 20w / 117 / -0.39*
Howard et al. (1971) / Referred by physician / 4-19 / 66 / 4 a / Diet Loaf / Control / 24w / 73 / 0.45
4 b / Regular Diet / Control / 24w / 70 / -0.38
Welch (1971) / 10% OW / 15-17 / 100 / 5 / Reality Therapy / Control / 6w / 16 / -0.65
Gillick (1974) / 10% OW / 6-12 / 68 / 6 a / Parent Training / Control / 5w / 35 / 1.73*
6 b / Minimal Tx / Control / 1w / 30 / 0.06
Aragona et al. (1975) / Physician referral / 5-10 / 100 / 7 a / Response-Cost
+ Reinforcement / Control / 12w / 9 / 0.21
7 b / Response-Cost / Control / 12w / 8 / 0.19
Parks (1975) / 60th percentile for wt. / 8-15 / 58 / 8 a / Nutrition Ed, Parent Involved / Control / 8w / 20 / 0.42
8 b / Minimal Tx / Control / 8w / 14 / 0.10
Reidy (1975) / Self-referred, screened by researcher / M =15 / 100 / 9 / Peer Facilitation / Control / 6w / 24 / -.0.18
Shapiro (1975) / 80th percentile for wt. / 7-12 / 10 a / Token Economy / Control / 9w / 26 / 1.33*
10 b / Self-Praise / Control / 9w / 26 / 0.77
Stoner et al. (1976) / 20 lbs. OW / 15-18 / 100 / 11 / Self-Concept Tx. / Control / 16w / 15 / 1.94*
Wheeler & Hess(1976) / Physician referral / 2-11 / 53 / 12 a / Successive Approximation / Control / 29w / 40 / 0.51
12 b / Successive
Approximation / Matched Control / 29w / 22 / 0.65
Jetté et al. (1977) / 30% body fat / M= 15 / 0 / 13 / Physical Activity / Control / 20w / 21 / -0.79
Kingsley et al. (1977) / 90th percentile for wt. / 10-11 / 60 / 14 a / Mother/Youth / Control / 8w / 18 / 0.70
14 b / Youth Alone / Control / 8w / 18 / 0.70
14 c / Mother Alone / Control / 8w / 18 / 0.73
Manchester (1977) / Screened by researcher / 5-13 / 71 / 15 a / Behavior Modification / Control / 7w / 12 / 0.66
15 b / Rational Emotive / Control / 7w / 12 / 0.60
15 c / Gestalt / Control / 7w / 11 / 1.01
Weiss (1977) / 1-104% OW;
1-120 lbs. OW / 9-18 / 76 / 16 a / Diet +
Stimulus Control / Control / 12w / 17 / 0.27
16 b / Stimulus Control / Control / 12w / 21 / 0.23
16 c / Diet + Reward / Control / 12w / 17 / 0.52
16 d / Diet / Control / 12w / 19 / 0.25
Botvin et al. (1979) / 20% OW / 12-14 / 56 / 17 / Multi-Component / Control / 10w / 106 / 0.57*
Rotatori & Fox (1980) / 10% OW / M= 17 / 50 / 18 / Behavior Therapy / Control / 19w / 18 / 0.53
Geronilla (1981) / Weight at 2 SD for ht. / 6-16 / 63 / 19 a / Mother-Youth / Control / 15w / 43 / 0.79*
19 b / Mother Only / Control / 15w / 39 / 0.75*
Holt (1981) / 10% OW / 11-14 / 100 / 20 a / Education / Control / 48 / -2.48*
20 b / Jogging / Control / 48 / 1.11*
Brownell & Kaye (1982) / 10% OW / 5-12 / 52 / 21 / Multi-Component / Control / 10w / 77 / 1.50*
Clark (1983) / 14-85% OW / 5-11 / 22 / Behav. Modification / Control / 8w / 44 / 1.23*
Lansky et al. (1983) / 10% OW / 11-14 / 56 / 23 / Behavioral / Control / 12w / 55 / 0.48
Epstein et al. (1984) / 20-80% OW; 85th percentile for skinfold / 8-12 / 24 a / Exercise + Diet / Control / 30w / 32 / 0.95*
24 b / Diet / Control / 30w / 29 / 1.00*
Israel et al. (1984) / 20% OW / 8-12 / 73 / 25 a / Parent as Helper / Control / 9w / 29 / 0.12
25 b / Parent Own Weight Loss / Control / 9w / 44 / 0.06
Kirschenbaum et al. (1984) / 20% OW / 9-13 / 77 / 26 a / Parent/Youth / Control / 9w / 21 / -0.22
26 b / Youth Only / Control / 9w / 17 / 0.35
Foster et al. (1985) / M = 30% OW / 6-11 / 27 / Peer-Led Tx / Control / 12w / 84 / 0.65*
Page (1985) / 10-80% OW / 5-13 / 46 / 28 / Multi-Component / Control / 10w / 15 / 0.27
Senediak et al. (1985) / 20% OW / 6-12 / 33 / 29 a / Rapid Behavior
Modification / Control / 4w / 22 / 0.19
29 b / Gradual Behavior
Modification / Control / 8w / 22 / 0.35
29 c / Minimal Tx / Control / 4w / 21 / 0.01
Stolmaker (1986) / 15% OW / 7-12 / 30 a / Parent Training / Control / 11w / 21 / 0.66
30 b / Behav. Modification / Control / 11w / 21 / 0.55
Fillingim (1987) / 80th percentile for skinfold / 8-11 / 58 / 31 / Health Enhancemt. / Control / 12w / 85 / 0.25
Mellin et al. (1987) / 10-100% OW / 12-18 / 79 / 32 / SHAPEDOWN / Control / 14w / 63 / 0.44
Suttapreyasri et al. (1990) / 20% OW / 8-12 / 33 a / Problem-Solving / Control / 12w / 43 / 0.39
33 b / Lecture / Control / 12w / 41 / 0.53
33 c / Lecture/Reward / Control / 12w / 42 / 0.76*
33 d / Self-Learning / Control / 12w / 35 / 1.05*
Flodmark et al. (1993) / 85th percentile for
weight; 2.4 SD for BMI / 10-11 / 52 / 34 a / Family Therapy / Control / 64w / 70 / 0.77*
34 b / Diet / Control / 64w / 67 / 0.09
Mo-suwan et al. (1993) / 20% OW / 6-12 / 48 / 35 / Exercise / Control / 104w / 137 / 0.03
Figueroa-Colon et al. (1996) / 40% OW / 8-13 / 42 / 36 / Diet / Control / 26w / 19 / 0.74
Braet et al. (1997) / 20% OW / 7-17 / 62 / 37 a / Camp / Control / 24w / 109 / 0.00
37 b / Advice / Control / 24w / 102 / 0.00
Gutin et al. (1999) / 85th percentile for skinfold / 7-11 / 79 / 38 / Physical Training / Control / 16w / 79 / 0.00
Owens et al. (1999) / 85th percentile for skinfold / 7-11 / 60 / 39 / Physical Training / Control / 16w / 73 / 0.48*
Yoshinaga et al. (2004) / % relative body weight > 20 / 6-11 / 32 / 40 / Educational Counseling / Control / 56w / 280 / 0.94*
______
Note. OW = overweight. Tx = Treatment. * p < .05.
Table 2
Alternate Treatment Comparisons Related to Parent Involvement, with Weight-Related Effect Size d at End of Treatment
Study / Definition of OW / Age / % F / ID / Treatment / Comparison / Treat-mentLength / N for ES / Weight-Related ES
Gillick (1974) / 10% OW / 6-12 / 68 / 101 / Parent Training / Minimal Tx / 5w / 35 / 1.79*
Aragona et al. (1975) / Parent/
physician referral / 5-10 / 100 / 102 / Response-Cost + Reinforcement / Response-Cost Only / 12w / 7 / 0.04
Kingsley & Shapiro (1977) / 90th percentile for wt. / 10-11 / 60 / 103 a / Mother/ Youth / Youth / 8w / 18 / 0.03
103 b / Mother/Youth / Mother / 8w / 18 / 0.00
103 c / Youth Alone / Mother / 8w / 18 / 0.03
Bleidt (1978) / Self-referred / 8-11 / 68 / 104 / Parent Control / Self-Control / 11w / 21 / 0.22
Epstein et al. (1980) / 20% OW / 6-12 / 36 / 105 / Behavior Modification / Nutrition / 19w / 13 / 0.23
Rotatori et al. (1980) / 10% OW / M = 17 / 50 / 106 / Behavior Therapy / Social/Nutrition / 19w / 24 / 0.43
Epstein et al. (1981) / 15-80% OW, 95th percentile for skinfold / 6-12 / 70 / 107 a / Target Parent/ Youth Weight / Target Youth Weight / 32w / 36 / -0.16
107 b / Target Parent/ Youth Weight / Non-Specific Target / 32w / 39 / 0.06
107 c / Target Youth Weight / Non-Specific Target / 32w / 37 / 0.22
Coates et al. (1982) / 10% OW / 13-17 / 64 / 108 / Parent Participation / No Parent Participation / 15w / 30 / 0.14
Epstein et al. (1982) / 20-80% OW / 8-12 / 78 / 109 a / Diet/Lifestyle Exercise / Diet/Programmed Exercise / 24w / 18 / 0.06
109 b / Diet/Lifestyle Exercise / Lifestyle Exercise / 24w / 18 / 0.00
109 c / Diet/Lifestyle Exercise / Programmed Exercise / 24w / 21 / 0.26
109 d / Diet/Programmed Exercise / Lifestyle Exercise / 24w / 16 / -0.29
109 e / Diet/Programmed Exercise / Programmed Exercise / 24w / 19 / -0.01
109 f / Lifestyle Exercise / Programmed Exercise / 24w / 19 / 0.24
Brownell et al. (1983) / 20% OW / 12-16 / 79 / 110 a / Mother/Youth Together / Mother/Youth Separate / 16w / 26 / -0.13
110 b / Mother//Youth Together / Youth Alone / 16w / 25 / 0.05
110 c / Mother /Youth Separate / Youth Alone / 16w / 25 / 0.32
Epstein et al. (1984) / 20-80% OW, 85th percentile for skinfold / 8-12 / 111 / Exercise/ Diet / Diet / 30w / 31 / 0.00
Israel et al. (1984) / 20% OW / 8-12 / 73 / 112 / Parent as Helper / Parent Weight Loss / 61w / 38 / -0.15
Kirschenbaum et al. (1984) / 20% OW / 9-13 / 77 / 113 / Parent /Youth / Youth Only / 9w / 22 / -0.61
Epstein Wing, Penner & Kress (1985) / 20% OW / 8-12 / 100 / 114 / Exercise/Diet / Diet Only / 8w / 22 / 0.17
Epstein, Wing, Woodall et al. (1985) / M = 40% OW / 5-8 / 100 / 115 / Behavior Modification / Education / 41w / 19 / 0.72
Senediak et al. (1985) / 20% OW / 6-12 / 33 / 116 a / Rapid Behavior Modification / Gradual Behavior Modification / 4w, 8wt / 18 / -0.26
116 b / Rapid Behavior Modification / Non-Specific Treatment / 4wt / 18 / 0.46
116 c / Gradual Behavior Modification / Non-Specific Treatment / 8w, 4wt / 18 / 0.75
Stolmaker (1986) / 15% OW / 7-12 / 117 / Parent Involved / Behavior Modification / 25w / 10 / 1.25
Graves et al. (1988) / 20% OW / 6-12 / 118 a / Problem-Solving / Behavioral / 8w / 26 / 0.22
118 b / Problem-Solving / Instruction Only / 8w / 26 / 0.03
118 c / Behavioral / Instruction Only / 8w / 26 / -0.18
Hills & Parker (1988) / 95th percentile for weight, BMI > 25 / 119 / Diet/Exercise / Minimal Tx. / 16w / 20 / 0.74
Israel et al. (1990) / 20% OW / 9-13 / 120 a / Parent as Helper / Parent Weight Loss / 26w / 40 / 0.49
120 b / Overweight Parent as Helper / Parent Weight Loss / 26w / 22 / 0.00
120 c / Non-Overweight Parent as Helper / Parent Weight Loss / 26w / 24 / 0.00
Wadden et al. (1990) / 10 kg OW / 12-16 / 100 / 121 a / Mother/Youth Together / Mother /Youth Separately / 16w / 20 / 0.00
121 b / Mother/Youth Together / Youth Alone / 16w / 26 / 0.00
121 c / Mother/Youth Separately / Youth Alone / 16w / 26 / 0.00
Nuutinen & Knip (1992) / 20% OW / 6-16 / 27 / 122 / Intensive (Individual and Group) / School Nurse Counseling / 52w / 45 / 0.78*
Hammarlund (1992) / 20% OW, 85th percentile for weight / 7-12 / 53 / 123 / Multi-Component / Nutrition Counseling / 10w / 21 / -0.41
Flodmark et al. (1993) / 2.4 SD on BMI, 85th percentile for skinfold / 10-11 / 52 / 124 / Family Therapy / Diet / 64w / 41 / 0.38
Israel et al. (1994) / 20% OW / 8-13 / 125 / Enhanced Youth Involvement / Standard Treatment/ Parent Responsibility / 26w / 20 / 0.05
Johnson et al. (1997) / 20% OW / 8-17 / 72 / 126 a / Nutrition then Exercise / Exercise then Nutrition / 16w / 18 / 0.01
126 b / Nutrition then Exercise / Information / 16w / 18 / -0.09
126 c / Exercise then Nutrition / Information / 16w / 18 / -0.10
Sothern (1997) / 20% OW, BMI > 24 / 7-17 / 64 / 127 / Tailored Exercise / Regular Exercise / 10w / 45 / -0.23
Golan et al. (1998) / 20% OW / 6-11 / 50 / 128 / Parents Sole Agents of Change / Conventional, Nutrition / 52w / 50 / 0.75*
Sothern et al. (2000) / 120% of ideal weight / 7-12 / 129 / Diet/Resistance
Training / Diet/Walking / 10w / 32 / 0.39
Goldfield et al. (2001) / 20-100% OW / 8-12 / 71 / 130 / Group and Individual / Group Only / 24w / 24 / 0.00
Nova et al. (2001) / 20% OW / 3-12 / 44 / 131 / Information, Diet, Encourage Parent / Information / 52w / 130 / -0.11
Ball (2002) / 85th percentile skinfold / 6-10 / 132 / SHAPEDOWN / Vitality Group / 12w / 47 / 0.00
Eliakim et al. (2002) / 85th percentile BMI / 6-16 / 50 / 133 / Diet/Exercise / Minimal Tx / 12w / 202 / 0.02
Saelens et al. (2002) / 20-100% OW / 12-16 / 41 / 134 / Healthy Habits / Typical Care / 15w / 39 / 0.14
Eliakim et al. (2004) / Average BMI = 26 / 6-16 / 57 / 135 / Multi-Component / Minimal Treatment / 52w / 114 / 1.01*
Herrera et al. (2004) / 15% OW; 2/3 had BMI > 75th percentile / 6-18 / 65 / 136 a / Cognitive / Behavioral / 10w / 50 / -0.15
136 b / Cognitive / Tx as Usual / 10w / 50 / -0.19
136 c / Behavioral / Tx as Usual / 10w / 50 / -0.01
______
Note. OW = overweight. * p < .05. tAlthough treatment lengths varied, outcomes were assessed at the same time point (15 weeks after initiating treatment).
Lifestyle interventions 15
Table 3
Analyses Related to Treatment Effectiveness
______
Possible Moderator /Study Number in Table 1
Year of Publication All studies in Table 1 / r (66) = 0.09 / All comparisons in Table 1Randomization / Qb (1) = 2.17
Randomized (n = 27) / d = 0.54* / 2 5 6ab 7ab 9 10ab 11 12a 14abc 17 18 23 24ab 27 30ab 31 32 36 38 39
Non-randomized (n = 39) / d = 0.32* / 1 3 4ab 8ab 12b 13 15abc 16abcd 19ab 20ab 21 22 25ab 26ab 28 29abc 33abcd 34ab 35 37ab 40
Treatment Setting / Qb (2) = 0.33
Community/school (n = 21) / d = 0.38* / 1 2 3 9 11 13 15abc 17 20ab 21 23 27 31 33abcd 36
Medical (n = 9) / d = 0.36 / 4ab 16abcd 34ab 40
Physical training center (n = 1) / d = 0.00 / 38
Definition of Overweight / Qb (2) = 0.54
Physician/Self-labeled (n = 9) / d = 0.55* / 12ab 13 15abc 22 27 32
Objective cutoff (n = 57) / d = 0.39* / 1 2 3 4ab 5 6ab 7ab 8ab 9 10ab 11 14abc 16abcd 17 18 19ab 20ab 21 23 24ab 25ab 26ab 28 29abc 30ab 31 33abcd 34ab 35 36 37ab 38 39 40
Recruitment Methods / Qb (2) = 0.49
Community ads (n = 16) / d = 0.49* / 5 6ab 10ab 14abc 22 26ab 29abc 38 39
Large group screening (n = 24) / d = 0.35* / 1 2 4ab 9 13 15abc 17 20ab 21 23 31 33abcd 34ab 35 36 40
Physician referral (n = 2) / d = 0.57 / 12ab
Severely Overweight Participants / Qb (1) = 3.01
Ruled out (n = 4) / d = 0.92* / 22 24ab 28
Not ruled out (n = 62) / d = 0.38* / 1 2 3 4ab 5 6ab 7ab 8ab 9 10ab 11 12ab 13 14abc 15abc 16abcd 17 18 19ab 20ab 21 23 25ab 26ab 27 29abc 30ab 31 32 33abcd 34ab 35 36 37ab 38 39 40
Note. * = p < .05.
Table 4
Analyses Related to Parent Involvement in Treatment
______
Treatment-Control Comparisons / Study Number in Table 1