E-Health and Social Media Studies in the News This Week

We’ve discussed before how e-health and telehealth can be effectively used to combat childhood obesity in conjunction with other interventions. This week, in the news, there were two studies that seemed of interest. One was an Australian study involving kids ages 7-13 and dealt with e-health (electronic health) intervention, and another looked at the connection between social media use and binge eating behaviors in adolescents.

The purpose of the e-health study

E-health interventions have the potential to enhance the effectiveness of traditional, in-person treatments for childhood obesity. This study assessed the impact of a 10-week, web-based healthy lifestyle program designed for school-aged children with overweight or obesity. The results were published in BMC Public Health this week.

Methods of the study

This randomized controlled trial (RCT) involved families with children aged 7–13 years, living in Victoria, Australia, who had a body mass index (BMI) at or above the 85th percentile (indicating overweight or obesity). Families were randomly assigned to either the intervention group or a waitlist control group and participated in the 10-week web-based program. The primary outcome was the change in the children’s BMI scores over the 10 weeks. Secondary outcomes included changes in waist circumference, dietary habits, physical activity, and quality of life over the same period.

In the intervention group, families accessed weekly modules on a secure website, covering topics such as healthy eating, physical activity, and family-centered behavior changes. Each week, families had phone sessions with a health professional coach (e.g., dietitians, nutritionists, or exercise physiologists), during which they discussed the week’s content and confirmed the completion of activities. The program also included interactive elements like online quizzes and goal-setting exercises to help families implement lifestyle changes.

The study results

Out of 148 children (125 families) recruited, 102 children (85 families) completed the trial. The intervention group showed a significant reduction in BMI scores compared to the control group after 10 weeks. The web-based program also led to improvements in children’s quality of life and lifestyle behaviors. In the intervention group, there were significant improvements in quality of life scores, overall diet quality, and daily physical activity levels compared to the control group.

Why it matters

A web-based healthy lifestyle program was effective in improving short-term health outcomes for children with overweight or obesity. Future research should focus on identifying factors that contribute to the program’s effectiveness, assessing its long-term impact, and ensuring the program is adapted to meet the needs of diverse populations.

Social media’s impact on binge eating, a study

Dr. Susan Carnell, an associate professor in the Division of Child and Adolescent Psychiatry at Johns Hopkins University School of Medicine, recently spoke about her research on the connection between social media use and binge eating behaviors in adolescents. Carnell is a co-author of the study, “Concurrent and prospective associations of social media usage with binge eating symptoms in early adolescence,” published in Obesity and highlighted this week in Contemporary Pediatrics. The article included an interview with Dr. Carnell conducted by the article’s author, Joshua Fitch, Senior Editor of Contemporary Pediatrics.

Dr. Carnell and her team wanted to investigate how social media might influence eating disorders, particularly by examining the role of social comparison and certain content that could lead to body dissatisfaction. The study used data from the Adolescent Brain Cognitive Development (ABCD) study, a large, ongoing project that tracks children across 21 sites in the U.S.

Dr. Carnell said:

The study began by recruiting children around 9 to 10 years old, and we’ve been following them ever since… This allowed us to analyze the relationship between social media use, how much time kids spent on it, and whether they exhibited addictive behaviors related to social media.

Carnell observed that social media use increased with age:

At ages 11 to 12, kids spent an average of about an hour per day on social media, and by adolescence, that rose to over two hours… For those who developed persistent binge eating, however, social media use went up to more than three hours a day.

Interestingly, the study found a key difference. To quote Dr. Carnell one more time,

We didn’t find that simply spending more time on social media was linked to binge eating. However, adolescents who showed high levels of addictive behaviors around social media at the start of the study were about 3.5 times more likely to develop binge eating by ages 14 to 15.

Carnell’s research underscores the importance of addressing addictive social media behaviors to help reduce the risk of eating disorders in adolescents. While the amount of time spent on social media isn’t inherently harmful, compulsive and addictive patterns of use can increase the likelihood of disordered eating behaviors.

Your responses and feedback are welcome!

Source: “The effectiveness of a 10-week family-focused e-Health healthy lifestyle program for school-aged children with overweight or obesity: a randomised control trial,” BMC Public Health, 1/7/25
Source: “Social media use and binge eating in early adolescence,” Contemporary Pediatrics, 1/6/25
Image by Polina Tankilevitch/Pexels

December Holidays Generate Half the Yearly Weight Gain

With the holiday season in full swing, let’s bring our attention to a study that specifically addresses how to handle the issue of overeating during the festive season that’s typically laden with rich foods, food-centric gatherings, tempting sugar bombs, and not necessarily focusing on healthy eating.

A recent systematic review and meta-analysis published in Obesity Reviews, highlighted and analyzed in a recent Medscape article, suggests that interventions during holidays and school breaks could help prevent weight gain in both children and adults. Research indicates that certain times of the year, including Christmas and summer vacations, are particularly linked to weight gain. For adults, nearly 50% of their annual weight gain happens during December.

Study overview

The study was led by Dr. Michelle Maree Haby de Sosa, an epidemiologist at the University of Sonora, Mexico. She explained that the research team first conducted a narrative review of weight gain during the holiday season. They found that the six-week period between December and mid-January is a critical time when people gain up to half of their annual weight. This finding emphasizes the importance of addressing obesity and overweight through lifestyle changes and prevention efforts.

The research team then performed a systematic review of global interventions aimed at preventing weight gain during these periods. They searched multiple databases, including Medline, EMBASE, and Cochrane, and focused on randomized controlled trials. Additional data were also gathered from gray literature and studies not included in the original search.

Key findings

The review covered studies from the United States (10), the United Kingdom (1), and Chile (1). The studies varied in their risk of bias, with two showing low risk, two moderate, seven high, and one critical. Most interventions targeted children and adults, and interventions for adolescents were particularly challenging due to the difficulty in changing behaviors at this age.

In children, interventions implemented during summer vacations (lasting 6-8 weeks) included physical activities, nutrition classes, and the provision of healthy meals. These programs resulted in slightly less weight gain compared to control groups. One meta-analysis of four studies found a small but significant reduction in body mass index (BMI) z-scores in the intervention group.

Among adults, interventions also showed positive effects, though results varied based on how the programs were carried out. A meta-analysis of five studies involving 462 participants indicated a slight reduction in body weight, although the result was not statistically significant.

Three main intervention areas were identified: nutrition, physical activity, and psychological support, including behavioral and cognitive strategies. Rather than strict diets, participants were encouraged to reduce their intake of high-calorie foods and sugary drinks and to increase vegetable consumption.

Promising interventions

The study highlighted effective interventions for both children and adults:

• For children, 6- to 8-week summer camps with daily physical activities and nutritious meals proved effective.
• For adults, daily weight monitoring, along with nutrition counseling based on social cognitive theory, also showed promise, especially during the critical holiday period between mid-November and early January.

Expert recommendations

Dr. Carlos Cristi-Montero, a researcher at Pontificia Universidad Católica de Valparaíso in Chile, emphasized the importance of portion control for children, particularly during the holidays when families often serve calorie-dense foods. He also recommended using tools like dual-energy X-ray absorptiometry to assess not just weight, but also fat and muscle mass.

Cristi-Montero also stressed the importance of physical activity and the need for education on healthy eating and weight management. Both he and Dr. Haby de Sosa agreed that teachers, parents, and primary care professionals have a crucial role in reinforcing healthy behaviors and driving effective interventions.

Future research

The University of Sonora team is currently conducting a controlled trial in Hermosillo, Mexico, focusing on adult participants. Early results highlight the effectiveness of strategies such as nutrition education, physical activity, regular weight goals, and psychological support in promoting long-term behavior changes.

The study’s authors concluded that interventions to prevent weight gain during the holidays and school breaks are crucial, and they call for more research to assess their effectiveness in different regions.

Your responses and feedback are welcome!

Source: “Strategies to Manage Metabolic Health During the Holidays,” Medscape, 12/19/24
Source: “Interventions for the prevention of weight gain during festive and holiday periods in children and adults: A systematic review,” Wiley Online Library, 9/14/24
Image by Adrian Vieriu/Pexels

Are GLP-1 Receptor Agonists Safe for Children?

Weight loss medications like Ozempic and Wegovy are becoming increasingly popular, especially as alternatives to the traditional and often ineffective advice of “eat less and exercise more.” These drugs, known as GLP-1 receptor agonists, have gained favor among adults but are also becoming more widely used by children and teenagers (here’s a good rundown on their types, benefits and side effects).

Adolescent use of GLP-1 medications surges

A recent article published on the MedicalXPress website cites a CDC statistic that roughly one in five children in the U.S. is affected by obesity. And, according to a University of [BLOCKQUOTE] study,  the use of GLP-1 medications among adolescents has surged, with over 30,000 young people aged 12 to 17 taking the drugs in 2023.

Are weight loss drugs safe for children under 12?

Doctors generally agree that addressing obesity early can prevent future health problems, but prescribing weight loss drugs to children brings its own set of challenges. Dr. Chris Straughn, a pediatrician in Dallas, explains that while research indicates that GLP-1 medications can be effective and safe for children and teens, the available studies only track their effects over a few years. As these drugs are relatively new, more time is needed to fully understand their long-term impact.

Wegovy, a version of Ozempic, is FDA-approved for children as young as 12, though it has not been approved for those younger than 12. There are ongoing studies on its use in younger children, and some research on Saxenda (a precursor to Wegovy) shows it can be effective for kids aged 6 to 12. This kind of research is promising for the potential use of GLP-1s in younger patients.

The study, which included 82 participants, found that when children discontinued Saxenda, their BMI began to increase once more. This suggests that to maintain the weight-related benefits as they grow, children may need to stay on the medication. The findings were presented Tuesday at the annual meeting of the European Association for the Study of Diabetes in Madrid and were also published in the New England Journal of Medicine.

Dr. Dan Cooper, a pediatric researcher at UC Irvine, agrees that GLP-1 medications can be useful in certain cases, such as when a child is already developing or has developed diabetes. However, he cautions that the risk-benefit balance is less clear in other children, especially since there is limited research on the long-term effects of GLP-1 use in growing bodies. Puberty is a critical period for bone, muscle, and brain development, and Cooper warns that altering a child’s energy balance during this time could have lasting consequences.

Dr. Cooper reminds parents not to feel ashamed if their child struggles with obesity or weight-related issues. He says,

No one should feel ashamed… Obesity is often driven by biology, and it’s not something to blame yourself or your child for.

The need for alternative solutions

As obesity rates continue to rise, many people are turning to prescription medications like Ozempic for weight loss. However, these drugs come with significant side effects, accessibility challenges, and high costs, highlighting the need for alternative solutions. We’ve discussed them before, including berberine and natural supplements.

A new natural treatment emerges

Researchers at the University of South Australia have developed a new, natural, food-grade treatment for obesity that not only helps reduce weight and improve metabolic health but allegedly does so without the negative side effects commonly associated with other medications.

The new treatment, called InuMCT microcapsules, is made from a combination of plant fiber (inulin) and MCT oils derived from coconut and palm kernel oils. This formulation helps reduce inflammation and improve key metabolic markers, such as blood glucose levels.

In a 21-day study, the InuMCT microcapsules demonstrated several significant benefits:

• Weight reduction: The microcapsules led to a substantial decrease in weight gain caused by a typical western diet, which is high in fats and linked to obesity.
• Blood sugar control: Blood sugar levels were reduced by 15%, an important factor in managing both obesity and diabetes.
• Reduced inflammation: Inflammatory markers dropped by 78%, which is crucial, as inflammation is a major contributor to obesity and related diseases.
• Liver health: Liver enzyme levels decreased by up to 47%, as high liver enzymes are often associated with poor diet and obesity.
• Gut health: The microcapsules improved protective gut bacteria by 8.3-fold, supporting the gut lining and helping prevent conditions like “leaky gut syndrome.”

Amin Ariaee, a Ph.D. researcher at UniSA, explains that InuMCT offers a natural solution for obesity and related metabolic conditions:

Obesity is a global epidemic with many complex health issues beyond just weight gain… It’s a state of systemic inflammation driven by complex biochemical processes, rather than just excess calories. Unfortunately, current treatments often overlook the role of the gut microbiome, focusing instead on symptoms like weight and high blood sugar. Additionally, anti-obesity drugs can harm the gut microbiome, leading to unpleasant side effects like nausea, stomach pain, and diarrhea, and potentially making long-term inflammation and weight gain worse.”

Our research is different. The InuMCT microcapsules are made from natural, food-grade ingredients that support a healthy gut microbiome, reduce inflammation, and effectively address excess weight. The results have been very promising, both in terms of weight reduction and overall metabolic health.

Your responses and feedback are welcome!

Source: “Are weight loss drugs like Ozempic, Wegovy safe for kids?,” MedicalXPress, 12/9/24
Source: “Obesity drug worked in children ages 6 to 12, study says, raising hopes and concerns,” StatNews.com, 9/10/24
Source: “New food-grade natural solution created for tackling obesity,” News-Meidcal.net, 12/2/24
Image by Mika Baumeister on Unsplash

What Doctors Say About Prescribing GLP-1 Receptor Agonists to Kids

Yesterday, MedPage Today published another part of its series called “Ozempic: Weighing the Risks and Benefits.” In the piece, Enterprise & Investigative Writer Sophie Putka examines how often doctors prescribe new weight loss drugs to kids and interviews a few professionals about their thinking process, reservations, and concerns.

As enthusiasm for GLP-1 receptor agonists as a weight-loss solution has grown, their use in children has also increased. Currently, liraglutide and semaglutide are the only GLP-1 drugs approved by the FDA for treating obesity in children aged 12 and older.

Between October 2022 and September 2024, prescriptions for these two medications by pediatric and adolescent medicine specialists surged from 3,448 to 24,435 — a sevenfold increase in just two years, according to a MedPage Today analysis of Symphony Health data. During this time, total prescriptions for all GLP-1 drugs written by these specialists more than doubled, rising from 59,868 to 125,538. These figures include prescriptions for 11 GLP-1 brands, many of which are approved for type 2 diabetes, but exclude those written by primary care or family medicine physicians and compounding pharmacies.

Many specialists feel cautiously comfortable prescribing GLP-1 medications to children when other options have been exhausted, provided that families are engaged in lifestyle interventions. However, concerns remain about long-term effects, particularly on bone density, and some experts remain uneasy about the rapid adoption of these drugs in pediatric care.

The jury is still deliberating

According to a recent article in Scientific American, written by Lauren J. Young, an associate editor for health and medicine, experts express concerns about potential impacts on bone health, growth, puberty, and restrictive eating habits, emphasizing the need for long-term studies like this JAMA study. These medications, considered lifelong treatments, pose unique challenges for teenagers compared to adults. Here at Childhood Obesity News, we also covered all kinds of questions and concerns regarding the potential risks of pediatric, adolescent, and adult use of GLP-1 drugs.

Still,

Clinical trials in younger age groups have shown significant weight and BMI reductions compared to lifestyle changes like diet and exercise, leading to FDA approvals of liraglutide (Saxenda) in 2020 and semaglutide (Wegovy) in 2022 for children 12 and older. A recent study reported a nearly 600% increase in GLP-1 prescriptions for adolescents and young adults between 2020 and 2023, largely driven by Wegovy’s approval for weight management in late 2022.

Proceeding with care

Last year, the American Academy of Pediatrics (AAP) issued an updated Clinical Practice Guideline for recommending the use of pharmacotherapy for adolescents 12 and up, including GLP-1 agonists.

Sarah Hampl, M.D., of the University of Missouri-Kansas City School of Medicine and lead author of the AAP guidelines, emphasized the role of other interventions that accompany medication. She said:

It was recommended, not in isolation or not as a monotherapy, but as adjunct or addition to intensive health behavior and lifestyle treatment… [AAP] needed to comment on [pharmacotherapy], because it can be a very effective form of treatment — again, as an adjunct and these kids, especially with severe obesity, they have some really serious and real comorbidities right here and now, in their childhood.

On the other hand, Dr. Fatima Cody Stanford, a pediatric obesity specialist at the Massachusetts General Hospital in Boston, avoids prescribing GLP-1 drugs to children under 12.

She said:

I would still probably use my other drugs where we do have some data, like a topiramate or metformin, or if they have very severe obesity, I would wonder if they had something else,” such as proopiomelanocortin (POMC) deficiency or leptin receptor deficiency.

Dr. Stanford ensures her adolescent patients receive comprehensive care, including dietitian support and psychological counseling, while closely monitoring bone health given the lack of long-term data on GLP-1 use.

It looks like family medicine doctors tend to use weight-loss drugs as a last resort. Dr. Tochi Iroku-Malize, former board chair of the American Academy of Family Physicians, noted that while medications might be necessary for some children with severe obesity, their long-term effects on developing bodies remain unclear.

She said:

When we’re starting with children, they have a longer way to go than adults when it comes to using these medications… [W]e don’t yet know what the long-term effects of taking the weight-loss medications are, and whether the young patients would have to continue taking them indefinitely to maintain their weight.

Despite these challenges, experts agree on the importance of combining medication with healthy lifestyle habits, stressing that the long-term success of any treatment relies on addressing the broader environmental and behavioral factors contributing to childhood obesity.

Your responses and feedback are welcome!

Source: “How Often Do Doctors Use New Weight-Loss Drugs in Kids?,” MedPage Today, 11/18/24
Source: “Teenagers Are Taking New Weight-Loss Drugs, but the Science Is Far from Settled,” Scientific American, 10/25/24
Image by Ben Wicks on Unsplash

Digital Technology Can Help Reduce Obesity

We continue looking at the role of digital technology in improving pediatric care. Two recent studies, both published in JAMA, found that adding a digital component to health counseling — even something as simple as a text message — may help reduce childhood obesity.

One study, funded by the Patient-Centered Outcomes Research Institute, used REDCap data tools hosted by Vanderbilt University Medical Center, with support from the National Institutes of Health. It was co-led by Dr. Eliana Perrin, a Bloomberg Distinguished Professor of Primary Care at Johns Hopkins University.

Text messages as a tool against obesity in infants

Dr. Perrin and her team developed the Greenlight Program, an initiative designed to educate parents about promoting healthy growth in infants. With most parents owning smartphones, this digital program is easily accessible.

The researchers recruited nearly 900 parent-infant pairs from hospitals and pediatric clinics at six different medical institutions. All participating infants were 21 days old or younger, born after 34 weeks of pregnancy, at a healthy weight, and without chronic conditions affecting weight gain.

Participants were divided into two groups. Both groups received Greenlight Program materials, which included counseling on nutrition and healthy habits, as well as age-appropriate booklets with goal-setting advice. However, only half of the group received interactive, personalized text messages from an automated system. These texts offered immediate feedback, tips for addressing challenges, and words of encouragement as they made progress.

The impact of text messages

The study tracked the outcomes of the text messages on childhood obesity until the children reached two years old. Researchers measured various health metrics, including weight and growth, to evaluate the program’s success. Through regular followups and digital monitoring, they could capture a comprehensive view of each child’s development.

Results showed a marked improvement in maintaining healthy growth patterns in children whose parents received the personalized texts. Between the two groups, children of parents who received digital support had healthier growth trajectories over their first two years compared to those who received only counseling.

The digital program led to a 45% relative reduction in obesity. Researchers found that the benefits of the digital intervention began as early as four months and continued over the two-year period, marking this study as one of the first large-scale efforts to prevent early childhood obesity.

Dr. Perrin said:

If we can prevent obesity in these children at the highest risk, we can also work toward greater health equity.

Implications for broader applications

The success of this study suggests that similar text-based interventions could be adapted to address other age groups or health issues. Digital technology offers a scalable way to deliver health education tailored to individual needs and support in real-time. The duration and size of this groundbreaking study adds confidence that the outcomes are not a coincidence.

Another study focuses on diversity

A recent study published in JAMA focused on infants coming from diverse racial and ethnic backgrounds. Called Greenlight Plus, the trial randomized 449 parent-child pairs to the digital intervention group and 451 to the counseling-only group. The study included 45% Hispanic children, 20.6% non-Hispanic White, 15.9% non-Hispanic Black, and 18.3% identifying as other or mixed races. Among parents, 65.2% preferred English and 34.8% preferred Spanish; 15.6% reported food insecurity, and 55.6% had limited health literacy.

Results showed a lower mean weight-for-length in the digital intervention group compared to the counseling-only group. Although the proportion of children classified as overweight was similar between groups, the digital intervention group had a significantly lower obesity rate (7.4% vs. 12.7%).

The authors noted that some population groups were not well represented in the study and that only English and Spanish speakers were included. Nonetheless, they highlighted the potential for a meaningful population-level impact if the intervention is scaled up, suggesting further studies on broader implementation.

Finally, a quick reminder about Dr. Pretlow’s app and an upcoming study geared at teens. The ability to rechannel displacement into less harmless activities rather than succumbing to urges is behind the behavior modification app, BrainWeighve, currently ramping up for a trial through the University of California Los Angeles (UCLA). The trial focuses on weight loss for obese teens using a self-directed, physician-supervised program withdrawing from one problem food at a time.

Your responses and feedback are welcome!

Source: “Digital Intervention Reduces Early Childhood Obesity Risk in Diverse Populations,” American Journal of Managed Care, 11/4/24
Source: “Simple text messages could help tackle childhood obesity,” Earth.com, 11/4/24
Image by Eyestetix Studio on Unsplash