Obesity prevention in defined (high school) populations

BACKGROUND: A challenge for the widespread dissemination of Internet-based programs designed to produce weightmaintenance/loss in defined (high school) populations is to adapt them to local needs and interests, whereas demonstratingeffectiveness and salience for both universal and targeted populations.OBJECTIVE: The objective of this study is to examine the feasibility of providing an inexpensive, Internet-based universal(healthy weight regulation) and targeted (weight maintenance/loss) health program to all ninth-grade students in a high schoolserving a lower socioecnomic status, diverse population.DESIGN: A total of 118 normal-weight and 64 overweight/obese students in the same ninth-grade class completed a baselinescreen and were allocated to a healthy weight regulation program or a weight-loss maintenance program. Both groupssimultaneously received a 10-week Internet-based intervention. Program implementation required minimal teacher time.Measurement included self-reported fruit, vegetable and high-fat/-calorie food consumption, self-reported change in bodymass index (BMI), weight and shape concerns, as well as program engagement.RESULTS: The program was successfully implemented in nine classes, with minimal help from the investigators. There wasa significant increase in self-reported consumption of fruits and vegetables (P¼0.001). There was a significant reduction inself-reported BMI in the overweight/obese group (P¼0.001). Students found the program helpful and engaging. There wasa significant reduction in weight and shape concerns in the high-risk female students, consistent with a reduced risk forthe development of an eating disorder. Providing a universal and targeted online healthy weight regulation program toninth-grade students is feasible and inexpensive. The results suggest the program can serve as ‘core’ for future studiesusing adaptive, continuous quality-improvement designs.