A randomized trial comparing diet and delivery strategies for weight management in adolescents with intellectual disabilities

Abstract

Background: The literature evaluating multi-component interventions for long-term weight loss in adolescents with intellectual disabilities (ID) is extremely limited. Objectives: To compare the effectiveness of two delivery strategies, face-to-face (FTF) or remote delivery (RD), and two diets, enhanced Stop Light diet (eSLD) or conventional diet (CD) on weight change across 12 and 18 months. in response to an 18 months. weight management intervention (6 months Weight loss/12 months. Weight maintenance) in adolescents with ID.Methods: Adolescents with ID were randomized to one of three arms: FTF /CD, RD/CD, RD/eSLD and asked to attend individual education sessions with a health educator which were delivered during FTF home visits or remotely using video conferencing. The CD followed the US dietary guidelines. The eSLD utilized the Stop Light guide and was enhanced with portion-controlled meals. Participants were also asked to increase their physical activity (PA) and to self-monitor diet, PA and body weight across the 18-month. intervention.Results: Weight was obtained from 92(84%) and 89(81%) randomized adolescents at 12 and 18 months, respectively. Weight change across 12 months. Differed significantly by diet (RD/eSLD: À7.0% vs. RD/CD: À1.1%, p = 0.002) but not by delivery strategy (FTF/CD: +1.1% vs. RD/CD: À1.1%, p = 0.21). Weight change across

Interviews with parents of adolescents with intellectual and developmental disabilities in a weight management study

“…Overall, when examining weight loss at 6 months, the eSLD group had significantly greater weight loss compared with the CD group when both interventions were delivered remotely; RD/eSLD (−5.0 ± 5.9 kg; −6.4%) versus RD/CD (−1.8 ± 4.0 kg; −2.4%). For the CD group, there was minimal 6‐month weight loss, which did not differ significantly between mode of delivery [FTF/CD (−0.3 ± 5.0 kg; −0.2%) versus RD/CD (−1.8 ± 4.0 kg; −2.4%) ( p = .20)] (Ptomey et al, 2022). Across study groups, however, most parents shared how they liked the prescribed diets.…”

“…This qualitative research study was nested within a three‐arm study examining weight loss among obese adolescents and young adults (ages 13–21 years) with mild to moderate intellectual and developmental disabilities (IQ 40–74) (Ptomey et al, 2022). Study methods, intervention components and main outcomes have been described previously (Donnelly et al, 2016; Ptomey et al, 2022).…”

“…This qualitative research study was nested within a three‐arm study examining weight loss among obese adolescents and young adults (ages 13–21 years) with mild to moderate intellectual and developmental disabilities (IQ 40–74) (Ptomey et al, 2022). Study methods, intervention components and main outcomes have been described previously (Donnelly et al, 2016; Ptomey et al, 2022). Briefly, the trial included 110 overweight and obese adolescents and young adults who were randomised into one of three groups for a 6‐month weight‐loss trial, followed by 12 months of weight maintenance.…”

Weight loss in adolescents with down syndrome compared to adolescents with other intellectual disabilities enrolled in an 18-month randomized weight management trial

“…weight maintenance) designed to compare diet [conventional meal plan diet (CD) vs. enhanced Stop Light diet(eSLD)] and delivery strategy [individual face-to-face home visit (FTF) vs. individual remote via FaceTime TM (RD)] in 110 adolescents and young adults with ID randomized to one of three intervention arms: FTF/CD, RD/CD, RD/eSLD. A detailed description of the rationale, design, and methods for this trial ( 21 ) and the results for our primary outcomes, weight change at 6 and 18 months, have been published previously ( 22 , 23 ). Weight loss at 6 months was clinically relevant and significantly greater in the eSLD compared with the CD arms when both interventions were delivered remotely: RD/eSLD (−6.4%) vs. RD/CD (−2.4%, p = .01).…”