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A community-based motivational personalised lifestyle intervention to reduce BMI in obese adolescents: results from the Healthy Eating and Lifestyle Programme (HELP) randomised controlled trial
  1. Deborah Christie1,
  2. Lee Duncan Hudson2,
  3. Sanjay Kinra3,
  4. Ian Chi Kei Wong4,
  5. Irwin Nazareth5,
  6. Tim J Cole6,
  7. Ulla Sovio7,
  8. John Gregson8,
  9. Anthony S Kessel8,
  10. Anne Mathiot6,9,
  11. Stephen Morris9,
  12. Monica Panca9,
  13. Silvia Costa9,
  14. Rebecca Holt9,
  15. Russell M Viner6
  1. 1 University College London Hospitals and UCL Institute of Epidemiology and Health Care, London, UK
  2. 2 Great Ormond Street Hospital for Children, London, UK
  3. 3 Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
  4. 4 University College London School of Pharmacy, London, UK
  5. 5 Primary Care and Population Health, UCL Institute of Epidemiology & Health, London, UK
  6. 6 Population, Policy and Practice Programme, UCL Institute of Child Health, London, UK
  7. 7 Department of Obstetrics and Gynaecology, University of Cambridge, Cambridge, UK
  8. 8 London School of Hygiene and Tropical Medicine, London, UK
  9. 9 UCL Institute of Epidemiology & Health, London, UK
  1. Correspondence to Dr Deborah Christie, Child and Adolescent Psychological Services, 250 Euston Rd, London NW1 2PQ, UK; deborah.christie{at}uclh.nhs.uk

Abstract

Objective Approximately 7% of children and young people aged 5–15 years in the UK have obesity at a level likely to be associated with comorbidities. The majority of multicomponent lifestyle programmes have limited applicability and generalisability for British adolescents.

The Healthy Eating and Lifestyle Programme (HELP) was a specific adolescent-focused intervention, designed for obese 12 to 18-year-olds seeking help to manage their weight. Participants were randomised to the 12-session HELP intervention or standard care. The primary outcome was difference in mean body mass index (BMI) (kg/m2) between groups at week 26 adjusted for baseline BMI, age and sex.

Subjects 174 subjects were randomised (87 in each arm), of whom 145 (83%) provided primary outcome data at week 26.

Results At week 26 there were no significant effects of the intervention on BMI (mean change in BMI 0.18 kg/m2 for the intervention arm, 0.25 kg/m2 for the control arm; adjusted difference between groups: −0.11 kg/m2 (95% CI −0.62 to 0.40), p=0.7). At weeks 26 and 52 there were no significant differences between groups in any secondary outcomes.

Conclusion At minimum this study reinforces the need for higher level, structured interventions to tackle the growing public health burden of obesity in the UK and internationally.

The HELP intervention was no more effective than a single educational session for reducing BMI in a community sample of obese adolescents.

Further work is needed to understand how weight management programmes can be delivered effectively to young people from diverse and deprived backgrounds in which childhood obesity is common. The study has significant implications in terms of informing public health interventions to tackle childhood obesity.

Trial registration number ISRCTN: ISRCTN99840111.

  • adolescent health
  • obesity
  • lifestyle intervention
  • child psychology

This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/

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Footnotes

  • Contributors The trial was conceptualised by DC and RMV. The intervention was developed by DC with input from RMV. RMV and DC developed the trial design, with input from SK, ICKW, IN and TJC. TJC and US developed the statistical plan, with input from RMV and JG. ASK, AM and LDH contributed to trial design and writing of the protocol. SM and MP contributed to the trial design and undertook the economic analysis. RH supervised the providers and analysed the fidelity data and process evaluation. All authors read and approved the final manuscript.

  • Funding This paper presents independent research funded by the NIHR under its Programme Grants for Applied Research programme (Grant Reference Number RP-PG-0608-10035) – the Paediatric Research in Obesity Multi-model Intervention and Service Evaluation (PROMISE) programme). The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health. The HELP research team acknowledges the support of the NIHR, through the Primary Care Research Network. TJC was funded by MRC grant MR/M012069/1.

  • Competing interests ASK is director of International Public Health at Public Health England (PHE). The views represented in this paper are those of the author and do not necessarily represent those of PHE. All other authors declare no competing interests.

  • Ethics approval The study was approved by National Research Ethics Service, West London REC 3, on the 27 August 2010. Research Ethics Committee (REC) reference number 10/H0706/54.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Data are available upon request from the investigators RMV and DC.

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