A Pilot Study to Assess the Compliance and Impact on Weight of Kurbo, a Pediatric Centered Weight Loss App (Preprint)

2019 ◽  
Author(s):  
Victoria Cobb ◽  
Alexander Knee ◽  
Cansu Tokat ◽  
Rushika Conroy
Keyword(s):  
Weight Loss ◽  
Pilot Study ◽  
Weight Management ◽  
Nutrition Education ◽  
Lifestyle Modification ◽  
Pediatric Population ◽  
Standard Of Care ◽  
Smart Device ◽  
Learning Coach ◽  
Reported Data

BACKGROUND The national prevalence of adolescent obesity has increased from 5% to 21% over the last five decades. Lifestyle modification continues to be the cornerstone of treatment for obesity and its comorbidities, and a number of digital tools have been developed as adjuncts to foster weight and BMI decrease. Apps targeting the pediatric population are few and none to date have been validated with scientific studies assessing their feasibility and outcomes. OBJECTIVE The purpose of this pilot study is to establish compliance and feasibility of Kurbo, a pediatric-centered weight loss app, as an adjunct to our pediatric weight management clinic. METHODS Kurbo utilizes games and activities to educate children about healthy eating and exercise. Kurbo also includes the option of personalized weekly feedback with a learning coach that covers basic nutrition education, behavior modification tools, and action plans to reach weekly food and exercise goals. Subjects were primarily English speaking, aged 10 through 17 years old, with regular access to a smart device, and who were seen at Baystate Children’s Hospital outpatient weight management clinic. Participants were randomized to receive the Kurbo app or Kurbo plus a learning coach in addition to standard of care. Subjects were seen monthly by the dietitian or physician, where BMI was determined, and questionnaires assessing use of the app were answered. RESULTS Twenty-seven subjects were enrolled; 13 in the Kurbo group and 14 in the Kurbo plus learning coach group. Compliance overall was poor, with only 15% of subjects completing the required follow-up visits and approximately 7% and 4% of subjects self-reporting > 75% compliance with food or exercise tracking, respectively. A small increase in compliance was noted in app collected versus self-reported data. CONCLUSIONS Future studies might look into enrolling more motivated patients who might utilize the app more and have better outcomes. CLINICALTRIAL ClinicalTrials.gov NCT02880254; https://clinicaltrials.gov/ct2/show/NCT02880254 (Archived by WebCite® at http://www.webcitation.org/74jU3ATSJ)

scholarly journals A pilot study of acceptance-based behavioural weight loss for adolescents with obesity

2019 ◽  
Vol 47 (6) ◽  
pp. 686-696 ◽  
Author(s):  
Jena Shaw Tronieri ◽  
Thomas A. Wadden ◽  
Sharon M. Leonard ◽  
Robert I. Berkowitz
Keyword(s):  
Physical Activity ◽  
Weight Loss ◽  
Pilot Study ◽  
Lifestyle Modification ◽  
Psychological Treatment ◽  
Psychosocial Outcomes ◽  
Cognitive Restraint ◽  
Acceptance And Commitment ◽  
Medium Increase

AbstractBackground:Acceptance and commitment therapy (ACT) is a psychological treatment that has been found to increase weight loss in adults when combined with lifestyle modification, compared with the latter treatment alone. However, an ACT-based treatment for weight loss has never been tested in adolescents.Methods:The present pilot study assessed the feasibility and acceptability of a 16-week, group ACT-based lifestyle modification treatment for adolescents and their parents/guardians. The co-primary outcomes were: (1) mean acceptability scores from up to 8 biweekly ratings; and (2) the percentage reduction in body mass index (BMI) from baseline to week 16. The effect size for changes in cardiometabolic and psychosocial outcomes from baseline to week 16 also was examined.Results:Seven families enrolled and six completed treatment (14.3% attrition). The mean acceptability score was 8.8 for adolescents and 9.0 for parents (on a 1–10 scale), indicating high acceptability. The six adolescents who completed treatment experienced a 1.3% reduction in BMI (SD = 2.3, d = 0.54). They reported a medium increase in cognitive restraint, a small reduction in hunger, and a small increase in physical activity. They experienced small improvements in most quality of life domains and a large reduction in depression.Conclusions:These preliminary findings indicate that ACT plus lifestyle modification was a highly acceptable treatment that improved weight, cognitive restraint, hunger, physical activity, and psychosocial outcomes in adolescents with obesity.

scholarly journals Retrospective analysis of a dedicated care pathway for nonalcoholic fatty liver disease in an integrated US healthcare system demonstrates support of weight management and improved ALT

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Heather Patton ◽  
Raoul Burchette ◽  
Stephanie Tovar ◽  
Jose Pio ◽  
Jiaxiao Shi ◽  
...  
Keyword(s):  
Weight Loss ◽  
Liver Disease ◽  
Weight Management ◽  
Weight Change ◽  
Fatty Liver Disease ◽  
Lifestyle Modification ◽  
Care Pathway ◽  
Liver Stiffness ◽  
Nonalcoholic Fatty Liver ◽  
Disease Staging

Abstract Background A care pathway for nonalcoholic fatty liver disease (NAFLD) in Kaiser Permanente San Diego, California was instituted in August 2017 to improve efficiency of disease staging and promote lifestyle modification. Methods The NAFLD Care Pathway includes: (1) patient education (2) vibration controlled transient elastography (VCTE) examination (3) hepatology consultation for VCTE ≥ 8 kPa and (4) referral to weight management (WM). Patients referred to the pathway during the first 6 months of its implementation were studied for adherence to its components and impact on weight change and ALT values in the 12 months following referral. Retrospective assessment of WM participation, change in weight, and change in ALT were evaluated in the 12-months following referral and compared to changes 12-months prior. Student’s t-test or Wilcoxon signed rank test were used as appropriate (p < 0.05). Results 632 patients were included. 575 (91.0%) completed VCTE examination with mean liver stiffness 8.5 kPa (SD 9.2). 52 patients had mean liver stiffness ≥ 15 kPa. 180/632 (28.5%) attended NAFLD education. 153/632 (24.2%) were offered hepatology clinic and 136/153 (88.9%) completed at least 1 appointment. Participation in WM was 24/632 (3.8%) prior to referral and 67/632 (10.6%) after referral and increased among patients who attended NAFLD education. Mean weight change following referral was − 0.69 kg (SD 6.58 kg) among patients without WM and − 7.78 kg (SD 13.43 kg) with WM. Overall, 44.2% of participants experienced weight gain after referral, 40.8% had weight loss < 5% and 15% had weight loss ≥ 5%. Variables associated with weight loss included WM (p < 0.0001) and higher liver stiffness (p = 0.0066). Mean ALT change was − 15.2 (SD 38.5) U/L without WM and − 28.8 (SD 29.6) U/L with WM. Conclusions A care pathway for NAFLD within a large, integrated healthcare system provides non-invasive disease staging and minimizes hepatology clinic utilization to those with more advanced disease. Referral was associated with increased enrollment in WM, weight loss, and decreased ALT. Given its impact on healthcare resources, strategies to improve NAFLD identification, staging, and promotion of lifestyle modification are imperative.

Erickson solution-focused coaching for weight management in obese patients with obstructive sleep apnoea: ECOHEALTH pilot study

2018 ◽  
Vol 25 (13-14) ◽  
pp. 2141-2150
Author(s):  
Ruzena Tkacova ◽  
Ivana Paranicova ◽  
Eva Timkova ◽  
Dagmar Vonkova ◽  
Pavol Joppa
Keyword(s):  
Weight Loss ◽  
Weight Management ◽  
Obstructive Sleep Apnoea ◽  
Lifestyle Modification ◽  
Healthy Lifestyle ◽  
Multiple Regression Model ◽  
Sleep Apnoea ◽  
Session Attendance ◽  
Obstructive Sleep ◽  
Solution Focused

Coaching as a lifestyle modification approach to weight management is insufficiently explored in obstructive sleep apnoea. We investigated anthropometry and body composition after 20 weeks of Erickson coaching in 26 obstructive sleep apnoea patients (19 males; 47.6 ± 2.4 years). Body weight, neck circumference, waist-to-hip ratio and %body fat significantly decreased after 20 weeks. The mean weight loss was 5.2 per cent ± 1.0 per cent; 20 (77%) participants achieved target reduction of >3 per cent. Coaching session attendance ( p = 0.006) and reaching personal goal related to physical performance ( p = 0.044) were independently associated with weight loss (multiple regression model R2 = 0.608, p < 0.001). Erickson solution-focused coaching supports adherence to healthy lifestyle and weight reduction in obstructive sleep apnoea.

scholarly journals Adolescents’ and Parents’ Perspectives of a Revised Protein-Sparing Modified Fast (rPSMF) for Severe Obesity

2019 ◽  
Vol 16 (18) ◽  
pp. 3385 ◽  
Author(s):  
Pratt ◽  
Cotto ◽  
Xu ◽  
Watowicz ◽  
Walston ◽  
...  
Keyword(s):  
Weight Loss ◽  
Pilot Study ◽  
Weight Management ◽  
Severe Obesity ◽  
Protein Sparing ◽  
Low Carbohydrate ◽  
Food Variety ◽  
Pediatric Weight Management ◽  
Over Time

The purpose of this pilot study was to assess the acceptability to adolescents (11–18 years old) and their parents using a revised protein-sparing modified fast (rPSMF) for 12 months as an intervention for severe obesity in a tertiary pediatric weight management clinic (PWMC). To assess acceptability (satisfaction, confidence) with the rPSMF protocol, surveys were completed by adolescents and parents at baseline, 1, 3, 6, and 12 months, with adolescent height and weight measured. Analyses were conducted to assess differences in satisfaction and confidence based on adolescent response (weight loss) and adherence to the rPSMF. Adolescents’ adherence with the rPSMF was close to 50% in the first 3 months, but dropped to 14.7% at 6 months. Adolescents were most confident with choosing low carbohydrate foods at baseline. Over 12 months, adolescents and parents reported weight loss as “the most liked” part of the rPSMF. Adolescents who were adherent were more satisfied with their weight loss than their non-adherent peers. Parents and adolescents reported lack of food variety and difficulty following the protocol as challenges with the rPSMF. Adolescents and their parents were able to follow the rPSMF protocol, with weight loss, but with decreased adherence over time.

scholarly journals Long-Term Weight-Loss Lifestyle Modification Programme in a Patient with Severe Lumbar Intervertebral Disc Degeneration and Obesity: A Case Report

Reports ◽  
2018 ◽  
Vol 1 (3) ◽  
pp. 21 ◽  
Author(s):  
Dana El Masri ◽  
Dima Kreidieh ◽  
Hana Tannir ◽  
Leila Itani ◽  
Marwan El Ghoch
Keyword(s):  
Weight Loss ◽  
Case Report ◽  
Weight Management ◽  
Disc Degeneration ◽  
Intervertebral Disc Degeneration ◽  
Lifestyle Modification ◽  
Weight Loss Maintenance ◽  
Lumbar Intervertebral Disc ◽  
Arabic Speaking

Obesity is a growing health problem worldwide, associated with serious medical and psychosocial comorbidities that increase the risk of mortality. Strong evidence confirms lifestyle modification programmes as the cornerstone of its treatment. However, the available long-term lifestyle modification programmes for weight management delivered in Arabic-speaking countries seem to be lacking in effectiveness in terms of weight-loss maintenance and do not conform to the standard for clinical significance. Factors such as methodological weaknesses in programme transcultural adaptation and the lack of expert clinical supervision before and during implementation seem to underlie this discrepancy. In this case report, we describe for the first time an Arabic-speaking patient with obesity and severe lumbar intervertebral disc degeneration, who successfully underwent weight management by means of a new, well-adapted and well-implemented personalized cognitive behavioural programme for obesity (CBT-OB). After eighteen months, the patient displayed significant weight-loss maintenance (~16% weight-loss), improvement in total and central body fat distribution, reduced pain from disc degeneration, and an increase in high-density lipoprotein (HDL). The CBT-OB programme may be a feasible approach to managing Arab patients with obesity, producing long-lasting weight-loss maintenance improvements in the obesity-related profile.

scholarly journals Impact of a Culinary Training Program on Medical Students’ Knowledge, Attitudes and Behaviors Relating to Nutrition and Weight Loss Counseling

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 477-477
Author(s):  
Megan Freiburger ◽  
Sarah Roger ◽  
Jessica Zaman
Keyword(s):  
Weight Loss ◽  
Medical Students ◽  
Training Program ◽  
Weight Management ◽  
Nutrition Education ◽  
Demographic Data ◽  
School Setting ◽  
Volunteer Program ◽  
Meal Preparation ◽  
Change In Mean

Abstract Objectives Nutrition education in the medical school setting has evolved over the past decade, but overall represents an area in need of further improvement. We propose that implementing an interdisciplinary culinary training program can effectively teach medical students the principles of nutrition and weight management. Methods Medical students enrolled in a volunteer program underwent an immersive culinary education program to acquire cooking skills and nutrition knowledge to provide live counselling for post-operative bariatric surgery patients in meal preparation. A total of 30 students were administered a survey prior to the training. The same survey was administered one month after undergoing training to assess the training program's impact on the students’ knowledge, attitudes, and behavior. All variables were assessed on a Likert Scale. The cohort of students were followed and their responses to the pre- and post-training surveys were matched via demographic data and analyzed via a paired t-test. Results A statistically significant change in mean survey response was seen for questions relating to nutrition principles (P = 0.001), obesity knowledge (P = 0.006), and weight loss counseling after the training program intervention (P = 0.045). Conclusions An interdisciplinary culinary training program can be an effective tool for medical students to obtain skills and knowledge needed to counsel patients on healthy cooking and weight management. Interdisciplinary programming may be a way to improve medical student knowledge and positively impact patient health. Funding Sources The Bariatric and Nutrition Clinic Teaching Kitchen was generously donated by Brown & Weinraub, PLLC and Earl B. Feiden, Inc. Funding for the training program itself was provided by the medical school's Dean's fund.

scholarly journals A Pilot Study of the Lifestyle Questionnaire for Weight Management Shows Scores Significantly Associate With Weight Trajectory

2016 ◽  
Vol 12 (6) ◽  
pp. 521-530
Author(s):  
Christopher D. Anderson ◽  
Ron Hammond
Keyword(s):  
Weight Loss ◽  
Pilot Study ◽  
Weight Management ◽  
Statistical Properties ◽  
Convenience Sample ◽  
Healthy Behaviors ◽  
Weight History ◽  
Effective Counseling ◽  
Lifestyle Questionnaire ◽  
Weight Trajectories

Context. An instrument is needed to facilitate a brief, but effective, counseling interaction between a patient and a provider. Such an instrument should raise patients’ awareness of their behavioral patterns and indicate their likelihood of weight loss statistically. Objective. To determine if the Lifestyle Questionnaire–Weight Management (LQ-WM) contains statistical properties that discriminate subjects’ weight trajectories. Design and Participants. A convenience sample of 269 college students at Utah Valley University in Orem, Utah, were administered the LQ-WM and a weight history questionnaire. Main Outcome Measure. A Lifestyle Score was created by subtracting the amount of self-reported unhealthy behaviors from the amount of healthy behaviors in the previous week. Results. The Lifestyle Score was significantly different among subjects who reported recently losing, maintaining, or gaining weight recently ( P < .001) and in the previous year ( P < .05). The Lifestyle Score was also significantly different among individuals losing weigh rapidly, moderately, and slowly ( P < .05). Conclusions. This pilot study of the statistical properties of the LQ-WM supports that higher Lifestyle Scores associate with weight loss cross-sectionally. Future studies should examine its statistical properties longitudinally and with diverse samples to assess its suitability for clinical practice.

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