Background and rationale
obesity, ’ behavior, Weight Loss, overweight, weight loss
OBESITY
More than one-fifth of U.S. adolescents (age 12-19 years) have obesity (body mass index [BMI]≥95Involving parents in family-based obesity treatment can be particularly challenging during adolescence, given normative developmental factors, such as opposition to authority, role transformations, and increasing personal responsibility [A specific focus on parents is a vital component of pediatric obesity treatment for several reasons. Specifically, parental obesity is associated with overweight in children [Parent weight change during adolescent BWL treatment is an important predictor of adolescent outcomes. For example, change in parent BMI during adolescent BWL treatment was associated with change in adolescent BMI [Previous adolescent obesity treatments involving parents [More specifically, in the TEENS+ pilot, we randomized parents to PAC (Parents as Coaches; parent skills training based on authoritative parenting) or PWL (Parent Weight Loss; parents engaged in their own BWL), and found significant reductions in adolescent BMI in both groups [Previous trials have identified parent variables that might serve as mechanisms influencing adolescent weight loss. Specifically, authoritative parenting, characterized as being both responsive (attuned and supportive to foster autonomy) and demanding (providing structure to cultivate responsibility), is associated with healthy weight outcomes in adolescents (although conclusions are limited by a lack of longitudinal research) [In summary, these studies support use of a parent skills training intervention within adolescent obesity treatment, and identify authoritative parenting as a potential mechanism through which parents’ behavior influences adolescent weight loss maintenance. However, other than our pilot, no studies have directly compared parent skills training with alternative, empirically-supported parent approaches and examined their impact on adolescent outcomes. The current fully-powered trial, guided by an empirically and theoretically-supported conceptual model (Fig. Conceptual model for parent influence on adolescent weight loss and maintenance within obesity treatment