A New Approach for Obese Teens

TOPLINE:

Intermittent energy restriction (IER) and continuous energy restriction (CER) reduced body mass index (BMI) in adolescents with obesity after 52 weeks, with no major differences found in body composition or cardiometabolic outcomes.

METHODOLOGY:

• Researchers conducted a 52-week randomized clinical trial at two pediatric centers in Australia that involved 141 adolescents aged 13-17 years with obesity and at least one associated complication.
• Participants were divided into two groups: IER and CER, with three phases: Very low-energy diet (weeks 0-4), intensive intervention (weeks 5-16), and continued intervention/maintenance (weeks 17-52).
• Interventions included a very low-energy diet of 3350 kJ/d (800 kcal/d) for the first 4 weeks, followed by either IER intervention (2500-2950 kJ [600-700 kcal 3 days/wk]) or a daily CER intervention (6000-8000 kJ/d based on age; 1430-1670 kcal/d for teens aged 13-14 years and 1670-1900 kcal/d for teens aged 15-17 years).
• Participants were provided with multivitamins and met with dietitians regularly, with additional support via telephone, text message, or email.

TAKEAWAY:

• Teens in both the IER and CER groups showed a 0.28 reduction in BMI z-scores at 52 weeks with no significant differences between the two.
• The researchers observed no differences in body composition or cardiometabolic outcomes between the IER and CER groups.
• The occurrence of insulin resistance was reduced in both groups at week 16, but this effect was maintained only in the CER group at week 52.
• The study found no significant differences in the occurrence of dyslipidemia or impaired hepatic function between the IER and CER groups.

IN PRACTICE:

“These findings suggest that for adolescents with obesity-associated complications, IER can be incorporated into a behavioral weight management program, providing an option in addition to CER and offering participants more choice,” the authors of the study wrote.

SOURCE:

The study was led by Natalie B. Lister, PhD, of the University of Sydney, Sydney, and was published online on August 26 in JAMA Pediatrics.

LIMITATIONS:

The COVID-19 pandemic and subsequent lockdowns limited the sample size. Some dietician visits were conducted via telehealth.

DISCLOSURES:

Lister received grants from the National Health and Medical Research Council of Australia. Louise A. Baur, MBBS, PhD, received speakers’ fees from Novo Nordisk and served as a member of the Eli Lilly Advisory Committee.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.