DENVER – When 45 families in Brooklyn, N.Y., got weekly reminders to keep to their diets – delivered by e-mail, text message, or voice mail – they stuck with their weight-loss programs longer, according to a study at Brooklyn’s Maimonides Infants and Children’s Hospital.
The messages came once a week on Thursday afternoon, when most parents did their grocery shopping. "They wanted the reminder [then] so that when they reached for [fattening] food, they saw the message and said ‘okay, let’s keep our family on track,’ " lead investigator Rachel Friedman, Ph.D., said at the annual meeting of the Pediatric Academic Societies.
The program, Kids Weight Down, focuses on children aged 2-18 years, but also helps their families. The messages went to parents, and supplemented weekly parenting and exercise classes during the program’s maintenance phase.
Of the 45 families who got them, 37 (83%) remained in the program after 3 months, and 31 (68%) remained in the program at 1 year. Among the 45 families in the program who did not get the messages, only half remained at 3 months, and fewer than 10 were left at 1 year.
The families were demographically similar and equally motivated; Dr. Friedman and her colleagues think the messages made the difference. Families want to be healthy and want to stay in the program, but "just need an extra push. That’s what the technology is doing," she said.
They wanted to get the messages, too. "Without hesitation, they provided cell phone numbers, e-mail addresses, home phone numbers. There wasn’t one who requested to not be part of this study." Plus, "it cost us nothing; it cost them nothing," Dr. Friedman said.
She and her colleagues came up with the idea after hearing how text messages from doctors help people quit smoking and take better care of their diabetes. Kids Weight Down had a problem with attrition during the maintenance phase, so they decided to give electronic messaging a try.
The program consists of 3 months of cognitive-behavioral obesity treatment, followed by the year-long maintenance phase with weekly classes plus individualized quarterly meetings with families.
Children and their families work with psychologists, nutritionists, exercise physiologists, and endocrinologists on nutritional education, awareness of binge triggers, increases in activity, self-esteem, and other issues.
Across both groups of 45 families, children had body mass indexes above the 95th percentile for age and sex; 65% were female, and 77% were of Hispanic ethnicity. They were 8 years old on average.
Messages were short and helpful. One said, "Remember your 543210 goal this week. Memorial Day is a great time for family fun. Turn off the TV, and plan a family activity outdoors."
The numbers 543210 stand for five daily servings of fruits and vegetables; no more than 4 hours without a healthy meal or snack; three meals every day; less than 2 hours of screen time every day; 1 hour or more of exercise; and zero sugary drinks.
Dr. Friedman and her colleagues are following the families to see if their persistence translates to better lipid profiles, weight management, and other outcomes. In the meantime, messaging has been extended to additional families.
Dr. Friedman said she had no relevant financial disclosures.