***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND AND OBJECTIVE : Most clinic-based weight control treatments for youth have been design ed for preadolescent children by using family-based care . However , as adolescents become more autonomous and less motivated by parental influence , this strategy may be less appropriate . This study evaluated a primary care – based , multicomponent lifestyle intervention specifically tailored for overweight adolescent females . METHODS : Adolescent girls ( N = 208 ) 12 to 17 years of age ( mean ± SD : 14.1 ± 1.4 years ) , with a mean ± SD BMI percentile of 97.09 ± 2.27 , were assigned r and omly to the intervention or usual care control group . The gender and developmentally tailored intervention included a focus on adoptable healthy lifestyle behaviors and was reinforced by ongoing feedback from the teen ’s primary care physician . Of those r and omized , 195 ( 94 % ) completed the 6-month posttreatment assessment , and 173 ( 83 % ) completed the 12-month follow-up . The primary outcome was reduction in BMI z score . RESULTS : The decrease in BMI z score over time was significantly greater for intervention participants compared with usual care participants ( −0.15 in BMI z score among intervention participants compared with −0.08 among usual care participants ; P = .012 ) . The 2 groups did not differ in secondary metabolic or psychosocial outcomes . Compared with usual care , intervention participants reported less reduction in frequency of family meals and less fast-food intake . CONCLUSIONS : A 5-month , medium-intensity , primary care – based , multicomponent behavioral intervention was associated with significant and sustained decreases in BMI z scores  among obese adolescent girls compared with those receiving usual care BACKGROUND Cognitive behavioral therapy ( CBT ) teaches behavioral and cognitive strategies that focus on achieving and maintaining lifestyle changes . OBJECTIVE We examined the effectiveness of a CBT program ( CHOOSE HEALTH ) for improving body composition , diet , and physical activity in overweight and obese adolescents . DESIGN Adolescents [ 16 male , 31 female ; aged 14.5 + /- 1.6 y ; body mass index ( BMI ; in kg/m(2 ) ) 30.9 + /- 4.2 ] were block-matched into 2 groups by age , sex , Tanner stage , BMI , and hip and waist circumferences and were r and omly assigned to CBT or no treatment ( control ) . CBT consisted of 10 weekly sessions , followed by 5 fortnightly telephone sessions . RESULTS Compared with the control , over 20 wk , CBT improved ( significant group x time interactions ) BMI ( CBT , -1.3 + /- 0.4 ; control , 0.3 + /- 0.3 ; P = 0.007 ) , weight ( CBT , -1.9 + /- 1.0 kg ; control , 3.8 + /- 0.9 kg ; P = 0.001 ) , body fat ( CBT , -1.5 + /- 0.9 kg ; control , 2.3 + /- 1.0 kg ; P = 0.001 ) , and abdominal fat ( CBT , -124.0 + /- 46.9 g ; control , 50.1 + /- 53.5 g ; P = 0.008 ) . CBT showed a greater reduction in intake of sugared soft drinks as a percentage of total energy ( CBT , -4.0 + /- 0.9 % ; control , -0.3 + /- 0.9 % ; P = 0.005 for group x time interaction ) , which was related to reductions in weight ( r = 0.48 , P = 0.04 ) , BMI ( r = 0.53 , P = 0.02 ) , and waist circumference ( r = 0.54 , P = 0.02 ) . Physical activity did not change significantly . CONCLUSIONS A 10-wk CBT program followed by 10 wk of fortnightly phone contact improved body composition in overweight and obese adolescents . Changes in soft drink consumption may have contributed to this benefit OBJECTIVE A r and omized controlled trial tested the efficacy of an internet-based lifestyle behavior modification program for African-American girls over a 2-year period of intervention . RESEARCH METHODS AND PROCEDURES Fifty-seven overweight ( mean BMI percentile , 98.3 ) African-American girls ( mean age , 13.2 years ) were r and omly assigned to an interactive behavioral internet program or an internet health education program , the control condition .  Overweight parents were also participants in the study . Forty adolescent-parent dyads ( 70 % ) completed the 2-year trial . Outcome data including BMI , body weight , body composition , and weight loss behaviors were collected at baseline and at 6-month intervals . A computer server tracked use of the web sites . RESULTS An intention-to-treat statistical approach was used , with the last observation carried forward . In comparison with the control condition , adolescents in the behavioral program lost more mean body fat ( BF ) ( -1.12 + /- 0.47 % vs. 0.43 + /- 0.47 % BF , p < 0.05 ) , and parents in the behavioral program lost significantly more mean body weight ( -2.43 + /- 0.66 vs. -0.35 + /- 0.64 kg , p < 0.05 ) during the first 6 months . This weight loss was regained over the next 18 months . After 2 years , differences in fat for adolescents ( -0.08 + /- 0.71 % vs. 0.84 + /- 0.72 % BF ) and weight for parents ( -1.1 + /- 0.91 vs. -0.60 + /- 0.89 kg ) did not differ between the behavioral and control programs . DISCUSSION An internet-based weight management program for African-American adolescent girls and their parents result ed in weight loss during the first 6 months but did not yield long-term loss due to reduced use of the web site over time Lifestyle modification programs ( LMP ) for weight loss in adolescents with obesity are effective but not available . Primary care may be a setting for reaching more adolescents . Two models of LMP for use in primary care were examined . Adolescents and caregivers enrolled in a 1-year r and omized trial comparing Group LMP with Self-Guided LMP .  All participants ( N = 169 ) received the same treatment recommendations and met with a health coach six times in clinic . Group LMP participants had an additional 17 group sessions ; those in Self-Guided LMP followed the remainder of the program at home with parental support . The primary outcome was percentage change in initial body mass index . The mean ( SE ) 1.31 % ( 0.95 % ) reduction in Group LMP did not differ significantly from the 1.17 % ( 0.99 % ) decrease in the Self-Guided LMP ( p = 0.92 ) . Both treatments were significantly effective in reducing body mass index . Given its brevity , the Self-Guided LMP offers an innovative approach for primary care Using self-determination theory ( SDT ) as an explanatory framework , this r and omised-controlled study evaluates the effect of a motivational interviewing (MI)-based intervention as an addition to a st and ard weight loss programme ( SWLP ) on physical activity ( PA ) practice in obese adolescents over a six-month period . Fifty-four obese adolescents ( mean age = 13 years , mean BMI = 29.57 kg/m² ) were r and omly assigned to an  SWLP group ( n = 28 ) or SWLP + MI group ( n = 26 ) . Both groups received two SWLP sessions , supplemented for the SWLP + MI group , by six MI sessions . Perceived autonomy support , perceived competence , motivational regulations , PA and BMI were assessed at baseline , three and six months ( i.e. the end of the programme ) . MLM analyses revealed that compared to SWLP , the SWLP + MI group had a greater BMI decrease and a greater PA practice increase over time . Moreover , the SWLP + MI group reported greater autonomy support from medical staff at the end of the programme , greater increase in integrated and identified regulations and a stronger decrease in amotivation . MI appears as an efficient counselling method as an addition to an SWLP to promote PA in the context of pediatric obesity OBJECTIVE To evaluate the efficacy of Motivational Interviewing ( MI ) as an intervention for promoting self-efficacy and weight loss in a sample of overweight and obese youth . METHODS / Design 40 participants ( aged 10 - 18 years ) were r and omly assigned to control ( social skills training ) or treatment ( MI ) group . Both groups received individual therapy ( ~30 min/month ) in addition to usual care of diet/exercise counseling . Pre- and post- ( at 6 months follow-up ) variables included measures of self-efficacy and anthropometrics . RESULTS Although significant between-group differences were not found , individuals in the MI group attended more sessions . Overall , participants in both groups showed significant increases in self-efficacy and a trend of decreased body mass index z-scores . CONCLUSIONS Health benefits from participation in individual therapy may have been accrued ; however , specific benefits attributable to MI were limited . Findings suggest that more than one type of counseling intervention ( i.e. , MI and social skills training ) may be beneficial when providing integrative treatment for obese youth OBJECTIVE : This study examined the 24-month outcomes of a r and omized controlled trial of a group-based behavioral weight control ( BWC ) program combined with either activity-based peer intervention or aerobic exercise . METHODS : At baseline , 118 obese adolescents ( 68 % female ; BMI = 31.41 ± 3.33 ) ages 13 to 16 years ( mean = 14.33 ; SD = 1.02 ) were r and omized to receive 1 of 2 weight loss interventions . Both interventions received the same 16-week group-based cognitive-behavioral treatment , combined with either aerobic exercise or peer-based adventure therapy .  Eighty-nine adolescents ( 75 % of original sample ) completed the 24-month follow-up . Anthropometric and psychosocial measures were obtained at baseline , at the end of the 16-week intervention , and at 12 and 24 months following r and omization . RESULTS : An intent-to-treat mixed factor analysis of variance indicated a significant effect for time on both percent over 50th percentile BMI for age and gender and st and ardized BMI score , with no differences by intervention group . Post hoc comparisons showed a significant decrease in percent overweight at 4 months ( end of treatment ) , which was maintained at both 12- and 24-month follow-up visits . Significant improvements on several dimensions of self-concept were noted , with significant effects on physical appearance self-concept that were maintained through 24 months . CONCLUSIONS : Both BWC conditions were effective at maintaining reductions in adolescent obesity and improvements in physical appearance self-concept through 24-month follow-up . This study is one of the first to document long-term outcomes of BWC intervention among adolescents OBJECTIVE The aim was to evaluate the efficacy of a Family Weight School treatment based on family therapy in group meetings with adolescents with a high degree of obesity . METHODS Seventy-two obese adolescents aged 12 - 19 years old were referred to a childhood obesity center by pediatricians and school nurses and offered a Family Weight School therapy program in group meetings given by a multidisciplinary team . Intervention was compared with an untreated waiting list control group .  Body mass index ( BMI ) and BMI z-scores were calculated before and after intervention . RESULTS Ninety percent of the intervention group completed the program ( 34 boys , 31 girls ; baseline age = 14.8 + /- 1.8 years [ mean + /- st and ard deviation , SD ] , BMI = 34 + /- 4.0 , BMI z-score = 3.3 + /- 0.4 ) . In the control group 10 boys and 13 girls ( baseline age = 14.3 + /- 1.6 , BMI = 34.1 + /- 4.8 , BMI z-score = 3.2 + /- 0.4 ) participated in the 1-year follow-up . Adolescents in the intervention group with initial BMI z-score < 3.5 ( n = 49 out of 65 , baseline mean age = 14.8 , mean BMI = 33.0 , mean BMI z-score = 3.1 ) , showed a significant decrease in BMI z-scores in both genders ( -0.09 + /- 0.04 , p = 0.039 ) compared with those in the control group with initial BMI z-score < 3.5 ( n = 17 out of 23 , mean baseline age = 14.1 , mean baseline BMI = 31.6 , mean baseline BMI z-score = 3.01 ) . No difference was found in adolescents with BMI z-scores > 3.5 . CONCLUSIONS Family Weight School treatment model might be suitable for adolescents with BMI z-score < 3.5 treated with a few sessions in a multidisciplinary program AIM This study evaluates the efficacy of the Choose Health program , a family-based cognitive behavioural lifestyle program targeting improved eating and activity habits , in improving body composition , cardiovascular fit 
    Output:
    
There was considerable variability between the interventions , but they were all multifactorial , with components such as  nutritional education , physical activity , family support and psychological therapy .
The number of contacts with subjects during the course of the intervention was a predictor of treatment efficacy when the groups were compared .
Conclusions Multidisciplinary interventions including family support and guided behavior modification appear to be effective methods of reducing BMI in overweight and obese adolescents