Objectives
TEENS+PWL, weight loss
SECONDARY
The primary objective of this trial is to evaluate the efficacy of TEENS+PAC and TEENS+PWL on adolescent weight loss maintenance. We hypothesize that adolescents in TEENS+PAC will manifest better weight loss maintenance at 12 months (BMI change [Δ] from 4-12 months) compared with adolescents in TEENS+PWL. We also hypothesize that baseline BE/LOC will moderate the impact of treatment on adolescent weight loss maintenance: in PAC, those without BE/LOC will have better weight loss maintenance than those with BE/LOC; in PWL, there will be no difference in maintenance between those with or without BE/LOC.A secondary aim is to evaluate mediators of the PAC and PWL treatments on adolescent weight loss maintenance. We hypothesize that parents in both groups will make significant improvements to the home food environment during the 4-month treatment. However, parents in PWL will manifest greater reductions in weight at 4 months (% weight loss) and improvements in weight management behaviors (dietary intake, physical activity, and self-monitoring) than parents in PAC. The PAC intervention will have a greater impact on parenting variables (e.g., authoritative parenting and feeding) during the 4-month treatment compared with PWL.We further hypothesize that increases in authoritative parenting (from 0 to 4 months) will mediate the differential impact of PAC vs PWL on adolescent weight loss maintenance at 12 months (ΔBMI from 4-12 months), with baseline BE/LOC as a moderator. Specifically, increases in authoritative parenting will negatively impact weight loss maintenance among adolescents with BE/LOC and positively impact weight loss maintenance among adolescents without BE/LOC.In addition to these primary aims, we will evaluate the efficacy of TEENS+PAC and TEENS+PWL on adolescent diet and physical activity. We hypothesize that adolescents in TEENS+PAC will achieve greater improvements in dietary intake and physical activity at 12 months compared with adolescents in TEENS+PWL.Finally, we will explore how parent and adolescent concordance of sex, weight loss, behavioral changes (self-monitoring, dietary intake, physical activity), and perceived parenting style impacts adolescent weight loss maintenance. We will also assess how adolescents’ perceptions of their non-participating parents’ parenting style (and its concordance with their participating parent) impacts adolescent weight loss maintenance.