Psychological Need-support Centered Lifestyle Program To Treat Pediatric Obesity: A Randomized Controlled Trial

Recently, the prevalence of obesity has increased, not only in racial-ethnic minorities but also in low-income families. According to the recent report, Mexican American and Hispanic children and adolescents (i.e., 2-19-year-olds) have the highest obesity rate (e.g., 26.9% and 25.6%) of all racial/ethnic groups. Despite lifestyle interventions targeted at Hispanic adolescents, few interventions have demonstrated long-term changes in children’s weight status or body composition. PURPOSE: This study examined the efficacy of the psychological need-support centered BRAVO! lifestyle program on the longer-term changes in participants’ body composition (body mass index [BMI], standardized BMI [BMIz], waist circumference [WC]) and health-related fitness (cardiovascular endurance and muscular strength/endurance). METHODS: This study was a randomized controlled trial with a sample of 40 pediatrician-referred overweight or obese adolescents (Mage = 13.20 ± 1.54) allocated to two parallel arms: 1) BRAVO! (n = 20) and 2) The “usual care” control group (n = 20). Experiment consisted 24 hrs of exercise, 6 hrs of family nutrition education, and self-determination centered behavior modification. RESULTS: Thirty-two subjects completed the 12-week intervention and a 6-week follow-up. BRAVO! was efficacious in generating positive changes in participants’ BMI (F[1, 31] = 23.83, p < 0.001, ηp2 = 0.45), BMz (F[1, 31] = 12.92, p < 0.001, ηp2 = 0.31), WC (F[1, 31] = 23.29, p < 0.001, ηp2 = 0.45), cardiovascular endurance (F[1, 31] = 8.18, p = 0.008, ηp2 = 0.23), upper body muscular strength/endurance (F[1, 31] = 28.33, p < 0.001, ηp2 = 0.50), and abdominal muscular strength/endurance (F[1, 31] = 28.34, p < 0.001, ηp2 = 0.45). The changes in cardiovascular endurance disappeared, but the changes in BMI, BMIz, WC, upper body muscular strength/endurance, and abdominal muscular strength/endurance remained for a longer, 6-week term. In addition, our analysis showed that BRAVO! impacted positively participants’ intrinsic motivation and extrinsic regulation. CONCLUSION: BRAVO!, a psychological need-support centered lifestyle program, was effective in improving at-risk Hispanic children’s body composition, muscular endurance and fitness as well as intrinsic motivation.