William H. Dietz, MD, PhD
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John D. Rowlett
Eastern Kentucky University
August 17, 2006
The measure of our success
It is always enlightening to read the accumulated wisdom of Dr. Dietz. His commentary on two recent Annals articles is no exception. While I agree completely with his analysis of these articles, I hasten to point out that the traditional measured endpoints for treatment of obesity in adolescents (weight loss, change in BMI, lipid profiles) are only part of the story.
It is my opinion that the more substantial benefits of behavioral modification programs for weight reduction are in unmeasured, maybe unmeasurable, areas. Strategies to reduce and prevent childhood and adolescent obesity include increasing physical activity and decreasing television viewing. Secondary benefits of these activities are difficult to quantitate and infrequently measured. But if, as studies have well- documented, increased television is associated with increased health-risk behaviors (alcohol intake, sexual activity, smoking, decreased academic performance), it stands to reason that decreasing this exposure will have positive benefits. Other benefits are even more difficult to measure. A child who helps prepare dinner or takes a walk with a parent may not lose weight, but hopefully has spent "quality" time with a parent or loved one and had the opportunity, all too often absent, to share thoughts. In a time-pressured society, this is of great value.
Dietz WH. What Constitutes Successful Weight Management in Adolescents?. Ann Intern Med. 2006;145:145–146. doi: 10.7326/0003-4819-145-2-200607180-00014
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Published: Ann Intern Med. 2006;145(2):145-146.
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