Social support and weight loss among adolescent females Public Deposited

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  • March 21, 2019
Creator
  • Kulik, Noel
    • Affiliation: Gillings School of Global Public Health, Department of Health Behavior
Abstract
  • The growing rates of overweight and obesity among adolescents continue to pose significant health risks, yet this trend can be reversed with continued improvement of multicomponent interventions that not only help youth reduce body weight, but maintain weight loss and healthy diet and exercise habits well into adulthood. Peer support has been shown to impact diet and physical activity among adolescents, yet whether it impacts weight loss remains largely unexplored. The purpose of this research was 1) to examine the role of social support from family and friends for adolescents enrolled in a weight loss intervention, and 2) test the effects of peer support skills training in a randomized controlled 16-week weight loss intervention on feasibility, satisfaction, adherence, and perceived support among a group of overweight adolescent females randomly assigned to a cognitive-behavioral (CB) intervention or a cognitive-behavioral intervention enhanced with social and peer support strategies (CB+SS). Findings from Study 1 show that baseline friend encouragement for healthy eating was lower (8.5+/-3.9), compared with the amount of encouragement reported from family (16.3+/-5.1); however, results indicate that even when controlling for other predictors of weight loss (change in vigorous physical activity and program attendance), in a regression model (R2 = 38.1%, F (5, 43) = 5.285), p < .001), baseline friend encouragement for healthy eating ([beta] = .265, p = .036) and change in friend encouragement for healthy eating ([beta] = -.347, p = .014) remained significant predictors of weight loss at 12 months. In Study 2, groups differed on their perception of friend support for healthy eating (F(1,33) = 9.16, p = .005) and exercise (F(1,33) = 5.69, p =.023); however, groups did not differ on the percentage of participants who lost any weight, 3% or 5% of their initial body weight. Participants lost an average of 6.4 pounds (SD: 7.65) with a range from -30.0 to 7.2 pounds. Adherence to the enhanced peer support component outside of the group sessions was minimal, yet, participants in the highest tertile of adherence lost significantly more weight from Week 4 to Week 16 than the lower two tertiles (F(2,16) = 3.591, p = .051) even though they did not experience significantly higher rates of support. Taken together, the results of the two studies suggest peer support from participants' existing social network may be helpful for weight loss but support from other adolescents in a group based weight loss program does not increase weight loss or ensure a dose-response effect. Creating and building social support for healthy eating and exercise from friends can be a useful tool for maintaining weight loss, but future studies are needed to test the role of support. Further research can also distinguish those adolescents who may benefit most and least from increased support from peers in a weight loss intervention as well as how to best develop support and program components for adolescents that are engaging, lasting and fun.
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  • In Copyright
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  • "... in partial fulfillment of the requirements for the degree of Doctor of Philosophy in the Department of Health Behavior and Health Education."
Advisor
  • Tate, Deborah
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  • Chapel Hill, NC
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  • Open access
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