Evaluation of Three New Strategies to Fight Obesity in Families
Evaluation of Three New Strategies to Fight Obesity in Families
Context: Endeavours to reduce overweight by calorie-restriction diets are often neither
 sufficient nor sustained. The growing obesity epidemic demands additional measures to enhance
 and sustain weight loss.

 Objective: To evaluate three alternative weight-loss measures on top of a calorie-restriction
 diet.

 Design, Setting, and Participants: Six-month randomized and controlled trial using a
 three-factorial design. The participants were 110 families with 142 obese parents and their
 119 obese children.
Intervention: All families kept to a calorie-restriction diet and were assigned at random to
 one or more of three additional weight-loss strategies: (1) a diet on top of
 calorie-restriction with preference for carbohydrates having a low glycemic index (dual
 diet), (2) financial incentive, and (3) continuous telemetric control of weight and physical
 activity (telemonitoring). The design made it possible to determine the effect of each single
 measure: financial incentive vs. no financial incentive (54 vs.56 families),
 calorie-restriction vs. dual diet (53 vs. 57 fami-lies) and telemonitoring vs. no
 telemonitoring (19 vs. 91 families). The design also allowed an assessment of the effects of
 combinations of the additional measures, each adapted for possible effects of the other
 factors.

 Main Outcome In the parents the outcome variable at 6 months was the relative weight loss. In
 children, be-cause of their body growth, the outcome variable was the age-adjusted BMI
 standard deviation score (BMI-SDS). Analysis was done by three-factorial ANOVA and by a
 one-factorial ANOVA with the included Dunnett test as a post-hoc comparison, to distinguish
 between the effects of the different combinations of the additional strategies.
Inclusion Criteria:

 -  BMI > 30 kg/m2

 Exclusion Criteria:

 -  disease of kidney or liver