The children, plus at least one parent, participated in a weight-loss program for five months. Once their weight loss had been achieved, 150 children were randomized into one of three treatment groups for four months: no maintenance treatment, social facilitation maintenance (SFM) treatment, or behavioral skills maintenance (BSM) treatment.
SFM focuses on providing a positive social environment for the child. "It's based on the premise that people need a supportive environment for weight control," Wilfley explained. Parents were taught how to guide their children into getting in more physical activity, especially when having play dates. Parents were also taught ways to get kids to eat healthier foods when their peers were present. Wilfley said a lot of parents assumed that kids would balk if they weren't given pizza or burgers on a play date, and that those same parents were pleasantly surprised that kids were generally fine when they were given healthier options, such as fruit. Additionally, SFM helped children improve their body esteem and gave them skills to cope with teasing.
BSM focused on the specific behavior skills that children need to maintain their weight loss. Children were asked to monitor their weight and to immediately return to weight-loss strategies if they found their weight increasing. "It was really about teaching problem-solving skills for weight-loss management," Wilfley explained.
The study found that after two years of follow-up, children in maintenance treatment maintained about a one-quarter point drop in their body mass index (BMI) scores, while those receiving no maintenance treatment maintained an average of less than one-tenth of a point drop in BMI.
The author of an accompanying editorial, Dr. David Ludwig, director of the Optimal Weight for Life program at Children's Hospital Boston, said that while the effect of the maintenance program
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