The careful development and implementation of the effective intervention for weight control, loss, and management in obese adolescents need to be emphasized. This is because of the challenging psychodynamics of the adolescents. The careful analysis of the available researches, studies, and literature help in analyzing the effectiveness of the chosen intervention and approach (Chen et al., 2014). To develop an effective intervention, it is important to analyze the factors and variables that help in developing a self-impression and weight perception amongst the adolescents.
For this purpose, the study conducted by Pich et al., (2015) used the Regulatory Focused Theory for conducting a population-based cross-sectional survey on the oversized multiple-step, simple random sampling (N= 1961; 12–17 years old; 2007–2008) to analyze the body composition, Self-reported body weight, Body image perception, Attitudes, and Behaviors of the sample population. In their study, the researchers developed and analyzed the relationships between the status of the body weight, self-body image, the concern of weight gain, the actual effort for weight loss by restraining from eating and exercising more. Moreover, Pich et al. (2015) used the Regulatory Focused Theory, and the statistical results were analyzed and evaluated that highlighted the “The relationships between the status of the body weight, self-body image, the concern of weight gain, the actual effort for weight loss by restraining from eating and increasing exercising”(p.1). The authors concluded that “the actively implementing of social values of men and women bodily image (strong verse pretty), with existing of social habituation to overweight were recommended” (Pich et al., 2015, p.6). Respective research will be significantly important for the evaluation and identification of the factors that affect the weight loss management and perception amongst the adolescents. Based on these factors, more effective plans and programs can be developed
Extending the same idea, Cunningham et al. (2014) gathered the relevant data for the standard thresholds from the Centers for Disease Control and Prevention that was evaluated using the variance estimates for the analysis of multistage probability sampling for the data of 7738 participants that were obtained from the statistical population of Early Childhood Longitudinal Study, Kindergarten Class of 1998-1999. The authors analyzed the relationship between the childhood obesity while considering the BMI of children from the sample in this quantitative study. According to the study, the elevated rate of prevalence of childhood obesity in the United Stated of America is a reflection of the correlation between sex, socioeconomic status, ethnicity, weight at birth and weight at kindergarten (Cunningham et al., 2014).
Furthermore, the authors stated that the” incidence of obesity between the age 5 and 14 high, and that the probability that it occurred at a younger age is higher, this was primarily associated with children who started kindergarten overweight” (Cunningham et al., 2014). This shows that to develop an effective intervention, the stated psycho-social dynamics and factors have to be considered. This research will be particularly important in understanding the factors that actually lead to obesity and weight gain in younger individuals and children. The development of the weight loss programs need to be in accordance to the psychology of this younger generation.
Furthermore, there has been a recent trend in increased use of commercial weight loss products and programs by the adolescents as a quick way out. It is important to analyze the effectiveness of these programs as well. For this purpose, the study conducted by Finkelstein et al. (2015) is very effective. Finkelstein et al. (2015) conducted a meta-analysis using the CONQUER randomized controlled trial for analyzing the subject. Furthermore, the Incremental Cost-Effectiveness (ICER) Ratios and sensitivity analysis were used for the study of the cost effectiveness of Qsymia (Finkelstein et al. 2015). For this purpose, the sample of the study was collected from “56-week, multicenter, placebo-controlled, phase 3 clinical trial undertaken in 93 health centers in the US. Participants (3500 participants) were overweight and obese adults (aged 18–70 years) with a body-mass index of 27–45 kg/m2 and two or more comorbidities” (Finkelstein et al., 2015, p. 1). Therefore, the authors have managed to conclude that the cost of drugs like Qsymia directly impacts the self-determination of the subjects to lose weight which shows that there is a direct relation between the cost and the weight loss (Finkelstein et al., 2015).
In a previous study conducted by Finkelstein (2014), they evaluated another dimension of the commercial weightless interventions. In the meta – analysis conducted by Finkelstein et al. (2014) a systematic literature review was conducted to identify randomized controlled trials of commercially available weight loss studies of at least one year in duration. For each of the commercial programs, minimum of 3 studies were reviewed. The following were the programs under analysis: two lifestyle programs (Weight Watchers and Vtrim), one meal replacement program (Jenny Craig), and three pharmaceutical products (Qsymia, Lorcaserin, and Orlistat), Weight loss, commercial diet cost. Evaluating the positives and negatives of these programs, and measuring the correlation between the cost of commercial weight loss programs and actual weight loss, the authors deduced that there appears to be a direct correlation between the variables. Therefore, they further concluded that the cost of commercial diet plans and strategies have a direct impact on the weight loss adherence and management. The combination of these two studies is specifically important in analyzing how the adolescents become attracted towards commercial weightless plans for easier way out and shortcut to weight loss. Here the socio-psychology of the adolescents can be analyzed to develop more intriguing weightless programs.
Considering and evaluating the advantages, disadvantages, and limitations of the currently available commercial weight loss programs, and the psycho-dynamics of obese adolescents, there is a need for developing an effective intervention and approach.
The project will include emphasis on analyzing and illustrating self- managing programs for obese or overweight patients by applying the Bandura’s self-efficacy theory (Bandura, 1982) through promoting weight loss awareness, eating healthy, health education that will impact our communities by preventing chronic diseases such as type 2 diabetes, high blood pressure, and some cancers. Self-efficacy must not be missed, when motivating the individuals to change their lifestyles including behavioral changes such as habits, cultures and much more (Fineout-Overholt et al., 2010). This will go far to improve the patients’ understanding and health awareness which will reduce the risk of contracting chronic disease based on excessive weight gain right from childhood.
A good attitude or habit approach towards weight loss is important for reduction and management of obesity related to life threatening diseases (Fineout-Overholt et al., 2010). It is expected that this project will be a venture for all family nurse practitioners (FNP’s) for promoting weight loss. These recommendations are especially for adolescents who are obese through healthy lifestyle modifications, good nutrition and physical activities, self-efficacy and self-motivations. Currently, the majority of Americans are facing overweight/obesity crisis. Therefore, the finding from the study will be helpful to society to effectively address to obesity (Fineout-Overholt et al., 2010). Therefore, the outcome will result in weight loss in a vast number of people that will encourage a large number of people to participate in weight loss programs. Collectively, this research will help in understanding how the psychology of obese people can be controlled to attract them towards a healthier lifestyle.
Synthesis Table
| 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 | |
| Level I: Systematic review or meta-analysis | A2 | A3 | ||||||||||
| Level II: Randomized controlled trial | A2 | A3 | ||||||||||
| Level III: Controlled trial without randomization | ||||||||||||
| Level IV: Case-control or cohort study | A1 | |||||||||||
| Level V: Systematic review of qualitative or
descriptive studies |
A3 | A4 | ||||||||||
| Level VI: Qualitative or descriptive study
(includes evidence implementation projects) |
A3 | A4 | ||||||||||
| Level VII: Expert opinion or consensus | A1 |
| Studies | ||||||||||||
| 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 | |
| Interventions | ||||||||||||
| 1 Commercial Weightless Program | A3 | A4 | ||||||||||
| 2 Psychological Interventions | A1 | A2 | ||||||||||
| 3 Social Factors | A1 | A2 | ||||||||||
| Studies | Design | Sample | Outcome |
| 1. Pitch (2015) A1 | Randomized controlled trial | simple random sampling 1961 (N= 12–17 years
old; 2007–2008) |
“the actively implementing of social values of men and women bodily image (strong verse pretty), with existing of social habituation to overweight were recommended” |
| 2. Cunningham (2014) A2 | Randomized trial of 7738 participants | 7738 participants | “incidence of obesity between the age 5 and 14 high, and that the probability that it occurred at a younger age is higher, this was primarily associated with children who started kindergarten overweight” |
| 3. Finkelstein (2015) A3 | CONQUER randomized controlled trial | 3 clinical trials of 3500 participants from 93 US Health centers | direct relation between the cost and the weight loss. |
| 4. Finkelstein (2014) A4 | Systematic Review | Analysis of 3 commercial weightless programs | The cost of commercial diet plans and strategies have a direct impact on the weight loss adherence and management |
A1- Article One
A2- Article Two
A3- Article Three
A4- Article Four
References
Chen, J. L., & Wilkosz, M. E. (2014). Efficacy of technology-based interventions for obesity
prevention in adolescents: a systematic review. Adolescent health, medicine, and therapeutics, 5, 159.
Cunningham, S. A., Kramer, M. R., & Narayan, K. V. (2014). The incidence of childhood obesity in the United States. New England Journal of Medicine, 370(5), 403-411.
Fineout-Overholt, E., Melnyk, B. M., Stillwell, S. B., & Williamson, K. M. (2010). Critical appraisal of the evidence: Part III. American Journal of Nursing, 110(11), 43-51.
Finkelstein, E. A., & Kruger, E. (2014). Meta‐and cost‐effectiveness analysis of commercial
weight loss strategies. Obesity, 22(9), 1942-1951.
Finkelstein, E. A., Kruger, E., & Karnawat, S. (2015). Cost-effectiveness analysis of Qsymia for
weight loss. PharmacoEconomics, 33(7), 699-706.
Pich, J., del Mar Bibiloni, M., Pons, A., & Tur, J. A. (2015). Weight self-regulation process in adolescence: the relationship between control weight attitudes, behaviors, and body weight status. Frontiers in Nutrition, 14, 2-8.
Bandura, A. (1982). Self-efficacy mechanism in human agency. American psychologist, 37(2), 122.
