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Randomized Controlled Trial
. 2021 Sep;148(3):e2021050261.
doi: 10.1542/peds.2021-050261. Epub 2021 Aug 19.

Weight Loss Interventions for Adolescents With Intellectual Disabilities: An RCT

Lauren T Ptomey  1 , Richard A Washburn  2 , Jeannine R Goetz  3 , Debra K Sullivan  3 , Cheryl A Gibson  2 , Matthew S Mayo  4 , Ron Krebill  4 , Anna M Gorczyca  2 , Robert N Montgomery  4 , Jeffery J Honas  2 , Brian C Helsel  2 , Joseph E Donnelly  2
Affiliations
Randomized Controlled Trial

Weight Loss Interventions for Adolescents With Intellectual Disabilities: An RCT

Lauren T Ptomey et al. Pediatrics. 2021 Sep.

Abstract

Objectives: In this randomized trial, we compared the effectiveness of 2 diets (enhanced stop light diet [eSLD] versus conventional meal plan diet [CD]) and 2 delivery strategies (face-to-face [FTF] versus remote delivery [RD]) on weight loss across 6 months in adolescents with intellectual and developmental disabilities who were overweight or obese.

Methods: Participants were randomly assigned to 1 of 3 arms (FTF/CD, RD/CD, or RD/eSLD) and asked to attend one-on-one sessions with a health educator every 2 weeks to aid in maintaining compliance with recommendations for a reduced-energy diet and increased physical activity. The CD followed the US dietary guidelines. The eSLD used the stop light guide and was enhanced with portion-controlled meals. The FTF arm was delivered during in-person home visits. The RD arms were delivered by using video conferencing.

Results: A total of 110 adolescents with intellectual and developmental disabilities (aged ∼16 years, 53% female, BMI 33) were randomly assigned to the FTF/CD (n = 36), RD/CD (n = 39), or RD/eSLD (n = 35) group. Body weight at 6 months was obtained from 97%, 100%, and 86% of participants in the FTF/CD, RD/CD, and RD/eSLD arms, respectively. The eSLD elicited significantly greater weight loss than the CD: RD/eSLD (-5.0 ± 5.9 kg; -6.4%) versus RD/CD (-1.8 ± 4.0 kg; -2.4%) (P = .01). However, weight loss did not differ by delivery strategy: FTF/CD (-0.3 ± 5.0 kg; -0.2%) versus RD/CD (-1.8 ± 4.0 kg; -2.4%) (P = .20).

Conclusions: The eSLD elicited significantly greater 6-month weight loss compared with a CD when both interventions were delivered remotely. Minimal 6-month weight loss, which did not differ significantly between FTF delivery and RD, was observed with a CD.

Trial registration: ClinicalTrials.gov NCT02561754.

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Conflict of interest statement

POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.

Figures

Figure 1.
Figure 1.
Consort Diagram. FTF/CD=Face-to-face delivery/Conventional Diet, RD/CD = Remote delivery/Conventional Diet, RD/eSLD= Remote Delivery/Enhanced Stop Light Diet
Figure 2.
Figure 2.
Individual variations of percent change in weight in adolescents with intellectual and developmental disabilities across 6 months. FTF/CD=Face-to-face delivery/Conventional Diet, RD/CD = Remote delivery/Conventional Diet, RD/eSLD= Remote Delivery/Enhanced Stop Light Diet.
Figure 3.
Figure 3.
Individual variations of percent change in BMI in adolescents with intellectual and developmental disabilities across 6 months. FTF/CD=Face-to-face delivery/Conventional Diet, RD/CD = Remote delivery/Conventional Diet, RD/eSLD= Remote Delivery/Enhanced Stop Light Diet.
See this image and copyright information in PMC

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