Thursday, June 13, 2013

Think About Weight Loss Programs

Participants in this weight loss program attend a bootcamp for anywhere from one to eight weeks, depending upon weight loss and fitness goals. During their stay, participants eat meal proportions and food types custom-tailored to their needs, and also participate in six to eight hours of workout/exercise each day. Educators and medical professionals are on hand to supervise the process, educate clients, and monitor vital statistics. Clients have the opportunity to socialize with others in the evenings and form friendships that will serve as support groups throughout the process.

This program might be useful for children and parents because it involves parents and children together and has the potential to address issues and challenges within the parent/child relationship.

Bricker, Rajan, Zalewski, Anderson, Ramey and Peterson (2009) found parent-noncompliance had a strong negative influence on children's success. If parents become noncompliant, it is unlikely the children will maintain compliance. Perhaps ongoing parent support groups meeting once per month would help maintain inspiration that the parents will pass on to their children. Sharing parental experiences with the program may be beneficial to all. Since the parent-child relationship has a tremendous influence on children (Bricker, Rajan, Zalewski, Anderson, Ramey, & Peterson, 2009) this program may be valuable in teaching parents and children to work toward a goal together. This experience may have a positive effect on their ability to continue to work together to maintain compliance over the long-term.

Looking at the family context may be beneficial with weight loss programs. Identifying and understanding the family's narrative truth is central to addressing the complex issues of childhood obesity (Grønbæk, 2008). Because it is well-established that overweight and obesity is the result of unhealthy diet and insufficient exercise, these narratives are dubious and might benefit from being identified and modified (Grønbæk, 2008). The program was designed to include parents and children. This may help families correct their shared narrative of how overweight and obesity has become characteristic of one or more family members. Grønbæk (2008) explains when families believe they have control of making changes in family overweight and obesity, they are more likely to be successful in weight management over the long-term. It may be beneficial to guide families toward taking control and understanding their part in weight management.

Children need the full emotional support from parents (Grønbæk, 2008), and this program directly involves parents in becoming educated about overweight and obesity alongside their children. It would be important to address appropriate parent psychological support, and teach what works, and what does not, when trying to inspire children to maintain a weight loss program. The complexity of family relationships may be challenging, and it is important for parents to understand the ambiguity of messages they send to their children unknowingly, especially those messages that derive from established family narratives (Grønbæk, 2008).

Another challenge will be for children to maintain compliance over the long-term. According to the Theory of Triadic Influence, the influences of parents and friends on children are powerful (Bricker et al., 2009). After completing the program, the children will, at some point, be exposed to a social environment unfriendly to their goals. For example, when children visit a friend's home and the parent offers a sweet treat that does not comply with the child's eating plan, ordinarily, he or she will choose to eat the treat anyway, because the friend is eating it. Bricker et al., (2009) found teaching behavior regulating skills to adolescents at risk for noncompliance. To increase compliance with issues related to the negative influence of friends, children may benefit from learning skills that enable them to make decisions independent of their friend's choices (Bricker, Rajan, Zalewski, Anderson, Ramey, & Peterson, 2009).

For the children, it may be beneficial to add socialization programs that enable the children to build lasting supportive relationships that will provide a positive influence for decision-making related to food consumption choices, but it will also provide a peer support network. Peer influence weilds tremendous power on decision making, especially during adolescence, so emphasizing this type of relationship-building may help children succeed (Jaccard, Blanton, & Dodge, 2005; Thorlindsson & Bernburg, 2006).

In the management of chronic illness, more positive outcomes are likely when parents collaborate with children regarding decision making for their care, whether or not the children made the ultimate decision (Miller, 2009). Applying this concept to the weight loss program, children may be more likely to eventually make correct decisions about their exercise and food consumption habits if children become stakeholders and decision makers in matters relating to weight management. Considering this, the program could include educating the parents and children on collaborative decision making that includes practice scenarios in which they could become accustomed to sharing in this process. The process of shared decision making may combat rebelliousness that may at some point become a challenge to children's compliance.


Bricker, J. B., Rajan, K. B., Zalewski, M., Andersen, M. R., Ramey, M., & Peterson, A.V. (2009). Psychological and social risk factors in adolescent smoking transitions: A population-based longitudinal study. Health Psychology, 28(4), 439–447. doi:10.1037/a0014568

Grønbæk, H. N. (2008) "We’ve always eaten healthily": Family narratives about causes of their child’s obesity and the motivation for taking action. Nordic Psychology, 60(3), 183–208.

Jaccard, J., Blanton, H. & Dodge, T. (2005). Peer influences on risk behavior: An analysis of the effects of a close friend. Developmental Psychology, 41(1), 135–147.

Miller, V. A. (2009). Parent-child collaborative decision making for the management of chronic illness: A qualitative analysis. Families, Systems, & Health, 27(3), 249–266. doi: doi:10.1037/a0017308

Thorlindsson, T., & Bernburg, J. G. (2006). Peer groups and substance use: Examining the direct and interactive effect of leisure activity. Adolescence, 41(162), 321–339.

Wilson, D. K., Van Horn, M., Kitzman-Ulrich, H., Saunders, R., Pate, R., Lawman, H. G., ... Brown, P. V. (2011). Results of the "Active by Choice Today" (ACT) randomized trial for increasing physical activity in low-income and minority adolescents. Health Psychology, 30(4), 463–471.

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