Thread by @MichelleCardel

New pub alert: our qualitative paper identifying perceived barriers & facilitators to a healthy lifestyle & weight loss among a diverse group of teens with overweight & #obesity has been published.

A thread of our findings & lessons learned 👇🏾.
onlinelibrary.wiley.com/doi/full/10.10…

We conducted 10 focus groups with teens medically classified as having overweight or obesity (OW/OB).

Demographics:
41 teens
68% female
53.5% identify as Black, African American, Hispanic/LatinX, multiple races
Socioeconomically Diverse
All w BMI over 85th percentile for sex/age

We found that teen girls and teen boys described their lived experience with overweight/obesity (OW/OB) differently.

Girls shared that healthcare providers, family, & friends discussed weight w them & they felt weight loss was needed to meet societal and/or medical standards.

Boys reported they did not experience weight-based struggles. Only boys with severe obesity (data not shown) described desires to lose weight. When describing body size or weight modifications, boys expressed desires to build muscle or get bigger for sports (e.g., football).

Barriers to weight loss or healthy lifestyle across both sexes:
-Wanting/liking "tempting" or "unhealthy" food
-Parents purchasing "unhealthy food"
-Emotional eating
-Lack of motivation and excess school demands as barrier to physical activity

Barriers to weight loss or healthy lifestyle for girls only:
-Lack of knowledge of exercise equipment use & fear of embarrassment if use equipment wrong
-Social engagements w friends centering around food
-Comments about food/weight from family inducing feelings of guilt/shame

Barriers to weight loss or healthy lifestyle for girls only:
-Being too busy to engage in healthy behaviors
-Hormonal fluctuations and periods leading to cravings/excess eating
-Medical diagnoses (e.g., PCOS)
-Medications (e.g., anti-psychotics or steroids)

Facilitators to weight loss & healthy lifestyles for boys & girls:
-Engaging in physical activity
-Healthy eating & ⬇️ portion sizes
-Encouragement
-Internal motivation
-Stable home environment
-Family support
-Parental & Peer modeling of healthy behaviors
-Organized sports

Though parents were reported as generally well‐intentioned, teens perceived parents as playing a role in both helping (by providing support and encouragement) and hindering weight loss and a healthy lifestyle (by making negative comments or buying "unhealthy" foods for home.

Take home messages:
-Boy & girl teens have a different lived experience w medically classified OW/OB
-Significant gender differences in goals related to body weight:

Boys report desire to⬆️muscle & get bigger

Girls report wanting wt loss to meet medical or societal standards

Takeaways for scientists & providers
-Data from this study can inform the design of weight management or healthy lifestyle interventions tailored to needs of teens

-Consider tailoring interventions by sex/gender given significant differences in facilitators/barriers by sex

Takeaways for parents:
-Don't make comments about your child's (or anyone else's including your own) body size, shape, weight, or what they eat

-Create a supportive & stable home environment

-Model healthy behaviors you want kids to engage in

-Limit "unhealthy" food purchases

Papers currently under review are our:

Qualitative paper reporting on teen's preferences on what they want/don't want in a healthy lifestyle intervention

Protocol paper describing the adolescent-engaged approach we took to develop an acceptance-based therapy teen intervention

Many thanks to our incredible study team who made this happen: @sarahszurek @JacksonRDillard @abhaya_ @DarciMPH @lindsay_lathom @AlexLee_AML

and @NIH @nih_nhlbi for my K01 award that provided the funds to conduct this formative work for our teen healthy lifestyle intervention.