SCIENTIFIC FOUNDATIONS FOR
WEIGHT LOSS PROGRAM FOR TEENS
Obesity Research – A Note from Dr. Daniel S. Kirschenbaum, Clinical Director of Wellspring
In 1958, my friend and colleague Albert Stunkard summarized the results of the previous 30 years of research in the area of obesity: “Most obese persons will not stay in treatment for obesity. Of those who stay in treatment, most will not lose weight, and of those who do lose weight, most will regain it.”
Fortunately, more modern methods using cognitive-behavioral therapy, very low-fat diets, pedometers to promote increased activity and related techniques produce much better outcomes. So while in the review from 1958 reported by Stunkard, only 1% of people treated for weight problems lost 40 pounds or more, recent reviews show that approximately 90% of people treated using the best of the current techniques lose at least 20 pounds and 50% lose 40 pounds or more.
Consequently, Wellspring’s approach to changing the behavior and lifestyles of students has a long and solid scientific basis. The highlights of this scientific foundation – outlined below – illustrate some of the key developments in the history of the treatment of weight problems among children, teenagers, and adults. This scientific foundation has allowed Wellspring to incorporate every major approach demonstrated by research to be effective in treating excess weight in adolescents and its complications.
- Ferster and associates (1962). Ferster and colleagues showed how principles of learning established in laboratory and field studies could be applied to treating problems such as obesity. They showed that weight problems can be viewed as a function of learned behavior (learned problems in eating) that could be unlearned and replaced by new habits. More specifically, they showed how principles such as stimulus control, shaping, chaining and reinforcement could help people learn new, more effective ways of eating and exercising.
- Stuart (1967). Stuart showed through a series of case studies that the principles of learning when applied to changing eating habits could lead to very successful outcomes: averages of more than 30 pounds of weight loss in overweight adults.
- Brownell* and associates (1978). Brownell and colleagues demonstrated that rallying the support of interested spouses can lead to better long-term weight loss than treatments that do not target family members.
- Self-regulatory (self-control) theories of Bandura (1968,1977), Kanfer & Karoly (1972), Carver & Scheier (1981,1990), Kirschenbaum (1987)**, Mischel (1968, 1973,2004) . These researchers showed how principles associated with goal-setting and the notion of a “feedback loop” can apply to changing self-regulated habits. Their research and formulations demonstrated, for example, that the process of self-monitoring (systematic observation and gathering of information about targeted behaviors) is necessary for successful weight control.
- Wadden and associates (1985-2004). Wadden and colleagues showed that the use of a very low-calorie diet (VLCD) can accelerate weight loss for many people.
- Epstein (1990). Epstein and associates showed that children treated with a cognitive-behavioral and family-based approach maintained substantial improvements in weight over a ten year follow-up period compared to comparison and control conditions.
- Perri (1992). Harvey-Berino (2004). Perri and colleagues demonstrated that longer treatments produce better outcomes and that the content of the treatment matters less than expected. As long as the treatment promotes focusing on the problem (and self-monitoring), weight controllers often benefit from frequent contact with therapists and others who help them concentrate on this aspect of life. Harvey-Berino and associates showed that maintaining contact with therapists via the Internet helped “participants sustain comparable weight loss over 18 months compared to individuals who continued to meet face-to-face.”
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* Healthy Living Academies Advisory Board Member
** Healthy Living Academies Clinical Director
Data Monitoring and Tracking
In this same spirit, Healthy Living Academies evaluates the effectiveness of Wellspring Academies (formerly Academy of the Sierras) every year. Students and parents complete standardized questionnaires that assess such factors as mood, self-esteem and satisfaction/dissatisfaction with weight. We also collect data about height and weight throughout a student’s time at School, and at follow-up periods of three months, six months, and one year after School. Other measures will be taken during school to evaluate the process of change, such as consistency of self-monitoring (record keeping pertaining to eating and physical activity).
