***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 Despite the high prevalence and negative physical and psychosocial consequences of overweight and obesity in adolescents , very little research has evaluated treatment in this population . Consequently , clinicians working with overweight and obese adolescents have little empirical research on which to base their practise . Cognitive behavioural therapy has demonstrated efficacy in promoting behaviour change in many treatment resistant disorders . Motivational interviewing has been used to increase motivation for change and improve treatment outcomes . In this paper we describe the rationale and design of a r and omised controlled trial testing the efficacy of motivational interviewing and cognitive behaviour therapy in the treatment of overweight and obese adolescents . METHODS Participants took part in a  motivational interview or a st and ard semi-structured assessment interview and were then r and omly allocated to a cognitive behavioural intervention or a wait-list control condition . The cognitive behavioural intervention , the CHOOSE HEALTH Program , consisted of 13 individual treatment sessions ( 12 face-to-face , 1 phone call ) followed by 9 maintenance sessions ( 7 phone calls , 2 face-to-face ) . Assessment s were conducted prior to participation , after the treatment phase and after the maintenance phase of intervention . Improvement in body composition was the primary outcome ; secondary outcomes included improved cardiovascular fitness , eating and physical activity habits , family and psychosocial functioning . CONCLUSION Despite the demonstrated effectiveness of motivational interviewing and cognitive behavioural therapy in the long-term management of many treatment resistant disorders , these approaches have been under-utilised in adolescent overweight and obesity treatment . This study provides baseline data and a thorough review of the study design and treatment approach to allow for the assessment of the efficacy of motivational interviewing and cognitive behavioural therapy in the treatment of adolescent overweight and obesity . Data obtained in this study will also provide much needed information about the behavioural and psychosocial factors associated with adolescent overweight and obesity Background : The best outcomes for treating childhood obesity have come from comprehensive family-based programmes . However there are questions over their generalizability . Objective : To examine the acceptability and effectiveness of ‘ family-based behavioural treatment ’ ( FBBT ) for childhood obesity in an ethnically and socially diverse sample of families in a UK National Health Service ( NHS ) setting . Methods : In this parallel group , r and omized controlled trial , 72 obese children were r and omized to  FBBT  or a waiting-list control . Primary outcomes were body mass index ( BMI ) and BMI s.d . scores ( SDSs ) . Secondary outcomes were weight , weight SDSs , height , height SDSs , waist , waist SDSs , FM index , FFM index , blood pressure ( BP ) and psychosocial measures . The outcomes were assessed at baseline and after treatment , with analyses of 6-month data performed on an intent-to-treat ( ITT ) basis . Follow-up anthropometric data were collected at 12 months for the treatment group . Results : ITT analyses included all children with baseline data ( n=60 ) . There were significant BMI SDS changes ( P<0.01 ) for the treatment and control groups of −0.11 ( 0.16 ) and −0.10 ( 1.6 ) . The treatment group showed a significant reduction in systolic BP ( −0.24 ( 0.7 ) , P<0.05 ) and improvements in quality of life and eating attitudes ( P<0.05 ) , with no significant changes for the control group . However the between-group treatment effects for BMI , body composition , BP and psychosocial outcomes were not significant . There was no overall change in BMI or BMI SDSs from 0–12 months for the treatment group . No adverse effects were reported . Conclusions : Both treatment and control groups experienced significant reductions in the level of overweight , but with no significant difference between them . There were no significant group differences for any of the secondary outcomes . This trial was registered at http://www.controlled-trials.com/ under IS RCT N 51382628 Abstract Background The Loozit ® Study is a r and omised controlled trial investigating extended support in a 24 month community-based weight management program for overweight to moderately obese , but otherwise healthy , 13 to 16 year olds . Methods This pre-post study examines the two month outcomes of the initial Loozit ® group intervention received by both study arms . Adolescents ( n = 151 ; 48 % male ) and their parents separately attended seven weekly group sessions focused on lifestyle modification . At baseline and two months , adolescents ' anthropometry , blood pressure , and fasted blood sample were assessed . Primary outcomes were two month changes in body mass index ( BMI ) z-score and waist-to-height-ratio ( WHtR ) . Secondary outcomes included changes in metabolic profile , self-reported dietary intake/patterns , physical and sedentary activities , psychological characteristics and social status . Changes in outcome measures were assessed using paired sample s t-tests for continuous variables or McNemar 's test for dichotomous categorical variables . Results Of the 151 adolescents who enrolled , 130 ( 86 % ) completed the two month program . Among these 130 adolescents ( 47 % male ) , there was a statistically significant ( P < 0.01 ) reduction in mean [ 95 % CI ] BMI ( 0.27 kg/m2 [ 0.41 , 0.13 ] ) , BMI z-score ( 0.05 [ 0.06 , 0.03 ] ) , WHtR ( 0.02 [ 0.03 , 0.01 ] ) , total cholesterol ( 0.14 mmol/L [ 0.24 , 0.05 ] ) and low-density lipoprotein cholesterol ( 0.12 mmol/L [ 0.21 , 0.04 ] ) . There were improvements in all psychological measures , the majority of the dietary intake measures , and some physical activities ( P < 0.05 ) . Time spent watching TV and participating in non-screen sedentary activities decreased ( P < 0.05 ) . Conclusions The Loozit ® program may be a promising option for stabilizing overweight and improving various metabolic factors , psychological functioning and lifestyle behaviors in overweight adolescents in a community setting .Trial registration Australian New Zeal and Clinical Trials Registry OBJECTIVE We examined the effect of a 12-week family-based cognitive behavioural weight management programme developed for use in primary care setting s. METHODS The sample consisted of 49 children with obesity ( aged 7 - 13 years ; mean ± SD : 10.68 ± 1.24 ) . Families were r and omly assigned to immediate start-up of treatment or to a 12-week waiting list condition . Outcome measures were body mass index st and ard deviation score ( BMI SDS ) , self-esteem , symptoms of depression and blood parameters indicative of cardio-metabolic risk . Assessment s were conducted at baseline , post-treatment , post-waiting list and 12 months after treatment termination . RESULTS The mean reduction for the treatment group was -0.16 BMI SDS units compared with an increase of 0.04 units for the waiting list group ( p = .001 ) . For the entire sample , there was a significant post-treatment improvement on BMI SDS ( p = .001 ) , all self-esteem measures ( p = .001-.041 ) and symptoms of depression ( p = .004 ) . The mean BMI SDS reduction was -0.18 units post-treatment , and it was maintained at 12-month follow-up . Significant reductions were found in blood lipid levels of total cholesterol ( p = .03 ) , LDL-cholesterol ( p = .005 ) and HDL-cholesterol ( p = .01 ) at 12-month follow-up . The favourable effect on most of the psychological measures waned from post-treatment to follow-up , but not approaching baseline levels . Boys demonstrated significantly greater reductions in BMI SDS than girls ( p = .001 ) , while baseline psychiatric co-morbidity did not influence BMI SDS outcome . CONCLUSIONS The treatment shows significant and favourable effects on BMI SDS , self-esteem and symptoms of depression compared with a waiting list condition The aim of the study was to investigate prospect ively the direction of the relationship between adolescent girls ' body dissatisfaction and self-esteem .  Participants were 242 female high school students who completed question naires at two points in time , separated by 2 years . The question naire contained measures of weight ( BMI ) , body dissatisfaction ( perceived overweight , figure dissatisfaction , weight satisfaction ) and self-esteem . Initial body dissatisfaction predicted self-esteem at Time 1 and Time 2 , and initial self-esteem predicted body dissatisfaction at Time 1 and Time 2 . However , linear panel analysis ( regression analyses controlling for Time 1 variables ) found that aspects of Time 1 weight and body dissatisfaction predicted change in self-esteem , but not vice versa . It was concluded that young girls with heavier actual weight and perceptions of being overweight were particularly vulnerable to developing low self-esteem 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 fitness , eating and activity behaviours in overweight and obese adolescents . METHOD The sample comprised 29 male and 34 female overweight ( n = 15 ) or obese ( n = 48 ) adolescents aged 11.5 - 18.9 years ( M = 14.3 , SD = 1.9 ) . Participants were r and omly allocated to treatment or waitlist control conditions ; waitlist condition participants were offered treatment after 6 months .  DEXA-derived and anthropometric measures of body composition ; laboratory-based cycle ergometer and field-assessed cardiovascular fitness data ; objective and self-report physical activity measures ; and self-report measures of eating habits and 7-day weighed food diaries  were used to assess treatment outcome . Adherence to treatment protocol s was high . RESULTS Treatment result ed in significant ( p < .05 ) and sustained improvements in a range of body composition ( body fat , percent body fat , lean mass ) and anthropometric measures ( weight , BMI , BMI -for-age z-score and percentiles ) . Minimal improvements were seen in cardiovascular fitness . Similar results were obtained in completer and intention-to-treat analysis . Poor adherence to assessment protocol s limits conclusions that can be drawn from physical activity and dietary data . CONCLUSIONS Participation in the Choose Health program result ed in significant improvement in body composition . Longer-term follow up is required to determine the durability of intervention effects . Alternative approaches to the measurement of diet and physical activity may be required for adolescents Objective : Since peers have such an important influence on adolescents , we evaluated the efficacy of adding peer-based ‘ adventure therapy ’ to a st and ard cognitive-behavioral weight control program for overweight adolescents . Methods : Adolescents ( N=76 ) aged 13–16 years and 20 to 80 % overweight ( M=60.56 % , s.d.=15.17 % ) , were r and omly assigned to one of two treatment conditions : cognitive-behavioral group treatment with ‘ adventure therapy ’ similar to Outward Bound ® ( cognitive-behavioral treatment with peer-enhanced adventure therapy ( CBT+PEAT ) ) or cognitive-behavioral group treatment with aerobic exercise ( CBT+EXER ) . Anthropometric and psychosocial measures were obtained at baseline , at the end of the 16-week intervention , and at 10 months following r and omization . Results : Adolescents assigned to both treatment conditions demonstrated significant weight loss over time , F=29.06 , df=2 , 53 , P<0.01 . Average weight loss did not differ significantly between groups ( −5.31 
    Output:
    
Conclusion The lack of change in self-esteem suggests weight loss alone is insufficient to improve self-esteem .
Multicomponent weight management interventions require a specific focus on self-esteem to improve this outcome in overweight and obese adolescents