Partnering with Adolescents, Parents, Researchers, and Family Medicine Clinics to Address Adolescent Weight and Weight-Related Behaviors

  • Jerica M. Berge
  • Katharine Didericksen
  • Michaela Bucchianeri
  • Shailendra Prasad
  • Dianne Neumark-Sztainer


Given the prevalence of adolescent overweight/obesity and disordered eating behaviors and the negative consequences associated with these conditions, it is important to develop interventions to reduce the risk of overweight/obesity and disordered eating behaviors in adolescents. Previous interventions targeting adolescent obesity and/or disordered eating behaviors have had limited success. There is a need to intervene with adolescents in a new way to address obesity and disordered eating behaviors simultaneously and in partnership with adolescents, parents, researchers, and family medicine clinics. An adolescent obesity and disordered eating prevention intervention was developed using focus groups with community members to guide the development of the intervention that simultaneously targeted the reduction of weight and harmful weight-related behaviors (e.g., fasting, binging, purging). A group-based and family-level intervention was ultimately designed which incorporated individual support from peers at a group level carried out at a family medicine “medical home” clinic, family-level support delivered through in-home visits, and social support via social media (i.e., Google+). Feasibility of carrying out the UMatter intervention was assessed and process evaluations were conducted with adolescents, parents, and staff who carried out the intervention.


Adolescents Parents Overweight/obesity Disordered eating behaviors Community-based participatory research 


  1. Austin, S., Spadano-Gasbarro, J., Greaney, M., Richmond, T., Feldman, H., Osganian, S., … Peterson, K. (2011). Disordered weight control behaviors in early adolescent boys and girls of color: An under-recognized factor in the epidemic of childhood overweight. Journal of Adolescent Health, 48(1), 109–112.Google Scholar
  2. Bandura, A. (1977). Social learning theory. Englewood Cliffs, NJ: Prentice Hall.Google Scholar
  3. Bandura, A. (1986). Social foundations of thought and action: A social cognitive theory. Englewood Cliffs, NJ: Prentice-Hall.Google Scholar
  4. Berge, J. M. (2009). A review of familial correlates of child and adolescent obesity: What has the 21st century taught us so far? International Journal of Adolescent Medicine and Health, 21(4), 457–483.CrossRefPubMedPubMedCentralGoogle Scholar
  5. Berge, J. M., & Everts, J. (2011). Family-based interventions targeting childhood obesity: A meta-analysis. Childhood Obesity, 7(2), 110–121.CrossRefPubMedPubMedCentralGoogle Scholar
  6. Berge, J., Jin, S., Hanson, C., Doty, J., Jagaraj, K., Braaten, K., … Doherty, W. J. (2016). Play it forward: A community-based participatory research approach to childhood obesity prevention. Families, Systems and Health, 34(1), 15–30.Google Scholar
  7. Berge, J. M., Maclehose, R., Loth, K. A., Eisenberg, M., Bucchianeri, M. M., & Neumark-Sztainer, D. (2013). Parent conversations about healthful eating and weight: Associations with adolescent disordered eating behaviors. JAMA Pediatrics, 167(8), 746–753. doi:10.1001/jamapediatrics.2013.78.CrossRefPubMedPubMedCentralGoogle Scholar
  8. Berge, J. M., Mendenhall, T. J., & Doherty, W. J. (2009). Using community-based participatory research (CBPR) to target health disparities in families. Family Relations, 58(4), 475–488. doi:10.1111/j.1741-3729.2009.00567.x.CrossRefPubMedPubMedCentralGoogle Scholar
  9. Bethell, C., Simpson, L., Stumbo, S., Carle, A. C., & Gombojav, N. (2010). National, state and local disparities in childhood obesity. Health Affairs, 29(3), 347–356.CrossRefPubMedGoogle Scholar
  10. Caballero, B., Clay, T., Davis, S. M., Ethelbah, B., Rock, B. H., Lohman, T., … Stevens, J. (2003). Pathways: A school-based, randomized controlled trial for the prevention of obesity in American Indian schoolchildren. American Journal of Clinical Nutrition, 78(5), 1030–1038.Google Scholar
  11. Ciao, A., Loth, K., & Neumark-Sztainer, D. (2014). Preventing eating disorder pathology: Common and unique features of successful eating disorders prevention programs. Current Psychiatry Reports, 16(7), 453. doi:10.1007/s11920-014-0453-02.CrossRefPubMedPubMedCentralGoogle Scholar
  12. Crow, S. J., Eisenberg, M. E., Story, M., & Neumark-Sztainer, D. (2008). Are body dissatisfaction, eating disturbances, and body mass index predictors of suicidal behavior in adolescents? A longitudinal study. Journal of Consulting and Clinical Psychology, 76, 887–892.CrossRefPubMedPubMedCentralGoogle Scholar
  13. Daniels, S. R. (2006). The consequences of childhood overweight and obesity. Future of Children, 16(1), 47–67.CrossRefPubMedGoogle Scholar
  14. Davison, K. K., & Birch, L. L. (2001). Childhood overweight: A contextual model and recommendations for future research. Obesity Reviews, 2, 159–171.CrossRefPubMedPubMedCentralGoogle Scholar
  15. Davison, K. K., Jurkowski, J. M., Li, K., Kranz, S., & Lawson, H. A. (2013). A childhood obesity intervention developed by families for families: Results from a pilot study. International Journal of Behavioral Nutrition and Physical Activity, 10, 3. doi:10.1186/1479-5868-10-3.CrossRefPubMedPubMedCentralGoogle Scholar
  16. Doherty, W. J., Mendenhall, T. J., & Berge, J. M. (2010). The families and democracy and citizen health care project. Journal of Marital and Family Therapy, 36(4), 389–402. doi:10.1111/j.1752-0606.2009.00142.x.CrossRefPubMedGoogle Scholar
  17. Doran, G. (1981). There’s a S.M.A.R.T. way to write management’s goals and objectives. Management Review, 70(11), 36–36.Google Scholar
  18. Ebbeling, C. B., Pawlak, D. B., & Ludwig, D. S. (2002). Childhood obesity: Public-health crisis, common sense cure. Lancet, 360, 473–482.CrossRefPubMedGoogle Scholar
  19. Emmons, K. M., & Rollnick, S. (2001). Motivational interviewing in health care settings. Opportunities and limitations. American Journal of Preventive Medicine, 20(1), 68–74.CrossRefPubMedGoogle Scholar
  20. Expert Committee Recommendations on the Assessment, Prevention, and Treatment of Child and Adolescent Overweight and Obesity. (2007). Retrieved August 27, 2007, from
  21. Gance-Cleveland, B., & Oetzel, K. B. (2010). Motivational interviewing for families with an overweight child. Childhood Obesity, 6(4), 198–200.CrossRefGoogle Scholar
  22. Gordon-Larsen, P., The, N. S., & Adair, L. S. (2009). Longitudinal trends in obesity in the United States from adolescence to the third decade of life. Obesity, 18(9), 1801–1804.CrossRefPubMedPubMedCentralGoogle Scholar
  23. Israel, B. A., Eng, E., Schulz, A. J., & Parker, E. A. (2005). Methods in community-based participatory research for health. San Francisco: Wiley.Google Scholar
  24. Israel, B., Schultz, A. J., Parker, E. A., Becker, A. B., Allen, A. J., & Guzman, J. R. (2003). Critical issues in developing and following community based participatory research principals. In M. Minkler & N. Wallerstein (Eds.), Community-based participatory research for health (pp. 53–76). San Francisco: Jossey-Bass.Google Scholar
  25. Katzman, D. K. (2005). Medical complications in adolescents with anorexia nervosa: A review of the literature. International Journal of Eating Disorders, 37(Suppl), S52–S59.CrossRefPubMedGoogle Scholar
  26. Keel, P. K., Fulkerson, J. A., & Leon, G. R. (1997). Disordered eating precursors in pre- and early adolescent girls and boys. Journal of Youth and Adolescence, 26, 203–206.CrossRefGoogle Scholar
  27. Lindsay, A. C., Sussner, K. M., Kim, J., & Gortmaker, S. (2006). The role of parents in preventing childhood obesity. Future of Children, 16(1), 169–186.CrossRefPubMedGoogle Scholar
  28. Livingstone, M. B., McCaffrey, T. A., & Rennie, K. L. (2006). Childhood obesity prevention studies: Lessons learned and to be learned. Public Health Nutrition, 9(8A), 1121–1129.CrossRefPubMedGoogle Scholar
  29. Mendenhall, T. J., Berge, J. M., Harper, P., GreenCrow, B., LittleWalker, N., WhiteEagle, S., & BrownOwl, S. (2010). The Family Education Diabetes Series (FEDS): Community-based participatory research with a midwestern American Indian community. Nursing Inquiry, 17(4), 359–372. doi:10.1111/j.1440-1800.2010.00508.x.
  30. Merten, M. J. (2010). Weight status continuity and change from adolescence to young adulthood: Examining disease and health risk conditions. Obesity (Silver Spring), 18(7), 1423–1428. doi:10.1038/oby.2009.365. oby2009365 [pii].CrossRefGoogle Scholar
  31. Miller, W. R., & Rollnick, S. (2002). Motivational interviewing: Preparing people for change (2nd ed.). New York: Guilford Press.Google Scholar
  32. Minkler, M., & Wallerstein, N. (2003). Community-based participatory research for health. San Francisco: Jossey-Bass.Google Scholar
  33. Minnesota Department of Health. (2014). Health care homes. Retrieved from
  34. Neumark-Sztainer, D. (2004). New moves: Obesity prevention among adolescent girls: Grant proposal. Bethesda, MD: National Institutes of Health.Google Scholar
  35. Neumark-Sztainer, D. (2005a). Can we simultaneously work toward the prevention of obesity and eating disorders in children and adolescents. International Journal of Eating Disorders, 38, 220–227. doi:10.1002/eat.20181.CrossRefPubMedGoogle Scholar
  36. Neumark-Sztainer, D. (2005b). Preventing the broad spectrum of weight-related problems: Working with parents to help teens achieve a healthy weight and a positive body image. Journal of Nutrition Education and Behavior, 37(Suppl 2), S133–S140.CrossRefPubMedGoogle Scholar
  37. Neumark-Sztainer, D. (2009a). Preventing obesity and eating disorders in adolescents: What can health care providers do? Journal of Adolescent Health, 44(3), 206–213.Google Scholar
  38. Neumark-Sztainer, D. (2009b). New moves online. Retrieved January 26, 2010, from
  39. Neumark-Sztainer, D., Flattum, C. F., Story, M., Feldman, S., & Petrich, C. A. (2008). Dietary approaches to healthy weight management for adolescents: The new moves model. Adolescent Medicine: State of the Art Reviews, 19(3), 421–430.PubMedCentralGoogle Scholar
  40. Neumark-Sztainer, D., Friend, S. E., Flattum, C. F., Hannan, P. J., Story, M., Bauer, K. W., … Petrich, C. A. (2010). New moves-preventing weight-related problems in adolescent girls: A group-randomized study. American Journal of Preventive Medicine, 39(5), 421–432.Google Scholar
  41. Neumark-Sztainer, D., & Hannan, P. J. (2000). Weight-related behaviors among adolescent girls and boys: Results from a national survey. Archives of Pediatrics and Adolescent Medicine, 154(6), 569–577.CrossRefPubMedGoogle Scholar
  42. Neumark-Sztainer, D., Levine, M. P., Paxton, S. J., Smolak, L., Piran, N., & Wertheim, E. H. (2006). Prevention of body dissatisfaction and disordered eating: What next? Eating Disorders, 14(4), 265–285.CrossRefPubMedGoogle Scholar
  43. Neumark-Sztainer, D., Maclehose, R., Loth, K., Fulkerson, J. A., Eisenberg, M. E., & Berge, J. (2012). What’s for dinner? Types of food served at family dinner differ across parent and family characteristics. Public Health Nutrition, 17, 145–155. doi:10.1017/s1368980012004594.CrossRefPubMedPubMedCentralGoogle Scholar
  44. Neumark-Sztainer, D., Paxton, S. J., Hannan, P. J., Haines, J., & Story, M. (2006). Does body satisfaction matter? Five-year longitudinal associations between body satisfaction and health behaviors in adolescent females and males. Journal of Adolescent Health, 39, 244–251.CrossRefPubMedGoogle Scholar
  45. Neumark-Sztainer, D., Wall, M., Eisenberg, M. E., Story, M., & Hannan, P. J. (2006). Overweight status and weight control behaviors in adolescents: Longitudinal and secular trends from 1999–2004. Preventive Medicine, 43(1), 52–59.CrossRefPubMedGoogle Scholar
  46. Neumark-Sztainer, D., Wall, M., Guo, J., Story, M., Haines, J., & Eisenberg, M. (2006). Obesity, disordered eating, and eating disorders in a longitudinal study of adolescents: How do dieters fare five years later? Journal of the American Dietetic Association, 106, 559–568.CrossRefPubMedGoogle Scholar
  47. Neumark-Sztainer, D., Wall, M., Haines, J., Story, M., Sherwood, N., & van den Berg, P. (2007). Shared risk and protective factors for overweight and disordered eating in adolescents. American Journal of Preventive Medicine, 33, 359–369.CrossRefPubMedGoogle Scholar
  48. Neumark-Sztainer, D., Wall, M., Larson, N. I., Eisenberg, M. E., & Loth, K. (2011). Dieting and disordered eating behaviors from adolescence to young adulthood: Findings from a 10-year longitudinal study. Journal of the American Dietetic Association, 111(7), 1004–1011. doi:10.1016/j.jada.2011.04.012. S0002-8223(11)00425-1 [pii].CrossRefPubMedPubMedCentralGoogle Scholar
  49. NIH. (2007). Reducing health disparities among children: Strategies and programs for health plans. Washington, DC: NIHCM.Google Scholar
  50. Ogden, C., Carroll, M., Curtin, L., Lamb, M., & Flegal, K. (2010). Prevalence of high body mass index in US children and adolescents, 2007–2008. Journal of the American Medical Association, 303(3), 8.Google Scholar
  51. Ogden, C. L., Carroll, M. D., Curtin, L. R., McDowell, M. A., Tabak, C. J., & Flegal, K. M. (2006). Prevalence of overweight and obesity in the United States, 1999–2004. JAMA, 295(13), 1549–1555.CrossRefPubMedGoogle Scholar
  52. Ogden, C., Carroll, M. D., Kit, B. K., & Flegal, K. M. (2012). Prevalence of obesity and trends in body mass index among US children and adolescents, 1999–2010. Journal of the American Medical Association, 307(5), 483–490. doi:10.1001/jama.2012.40.CrossRefPubMedGoogle Scholar
  53. Ogden, C., Lamb, M., Carroll, M., & Flegal, K. (2010). Obesity and Socioeconomic status in children and adolescents: United Stated, 2005–2008. NCHS Data Brief, 51, 1–8.PubMedGoogle Scholar
  54. Patient Centered Medical Homes. Retrieved from
  55. Patton, G. C., Selzer, R., Coffey, C., Carlin, J. B., & Wolfe, R. (1999). Onset of adolescent eating disorders: Population based cohort study over 3 years. BMJ, 318(7186), 765–768.CrossRefPubMedPubMedCentralGoogle Scholar
  56. Peterson, J. C., & Gubrium, A. (2011). Old wine in new bottles? The positioning of participation in 17 NIH-funded CBPR projects. Health Communication, 26(8), 724–734. doi:10.1080/10410236.2011.566828.CrossRefPubMedGoogle Scholar
  57. Pi-Sunyer, F. X. (2002). The obesity epidemic: Pathophysiology and consequences of obesity. Obesity Research, 10(Suppl 2), 97S–104S.CrossRefPubMedGoogle Scholar
  58. Popkin, B. M. (2007). Understanding global nutrition dynamics as a step towards controlling cancer incidence. Nature Reviews Cancer, 7, 61–67.CrossRefPubMedGoogle Scholar
  59. Rao, G. (2008). Childhood obesity: Highlights of AMA expert committee recommendations. American Family Physician, 78(1), 56–63.PubMedGoogle Scholar
  60. Resnicow, K., Davis, R., & Rollnick, S. (2006). Motivational interviewing for pediatric obesity: Conceptual issues and evidence review. Journal of the American Dietetic Association, 106(12), 2024–2033.CrossRefPubMedGoogle Scholar
  61. Resnicow, K., DiIorio, C., Soet, J. E., Ernst, D., Borrelli, B., & Hecht, J. (2002). Motivational interviewing in health promotion: It sounds like something is changing. Health Psychology, 21(5), 444–451.CrossRefPubMedGoogle Scholar
  62. Rhee, K. E., De Lago, C. W., Arscott-Mills, T., Mehta, S. D., & Davis, R. K. (2005). Factors associated with parental readiness to make changes for overweight children. Pediatrics, 116(1), e94–e101.CrossRefPubMedGoogle Scholar
  63. Rittenhouse, D. R., Casalino, L. P., Gillies, R. R., Shortell, S. M., & Lau, B. (2008). Measuring the medical home infrastructure in large medical groups. Health Affairs, 27(5), 1246–1258.CrossRefPubMedGoogle Scholar
  64. Stice, E., Becker, C., & Yokum, S. (2013). Eating disorder prevention: Current evidence-base and further directions. International Journal of Eating Disorders, 46(5), 478–485.CrossRefPubMedPubMedCentralGoogle Scholar
  65. Stice, E., Hayward, C., Cameron, R. P., Killen, J. D., & Taylor, C. B. (2000). Body-image and eating disturbances predict onset of depression among female adolescents: A longitudinal study. Journal of Abnormal Psychology, 109(3), 438–444.CrossRefPubMedGoogle Scholar
  66. Stice, E., Shaw, H., & Marti, C. N. (2007). A meta-analytic review of eating disorder prevention programs: Encouraging findings. Annual Review of Clinical Psychology, 3, 207–231. doi:10.1146/annurev.clinpsy.3.022806.091447.CrossRefPubMedGoogle Scholar
  67. Story, M., Sherwood, N. E., Himes, J. H., Davis, M., Jacobs, D. R., Jr., Cartwright, Y., … Rochon, J. (2003). An after-school obesity prevention program for African-American girls: The Minnesota GEMS pilot study. Ethnicity & Disease, 13(Suppl 1), S54–S64.Google Scholar
  68. Stovitz, S., Hannan, P., Lytle, L., Demerath, E., Pereira, M., & Himes, J. (2010). Child height and the risk of young-adult obesity. American Journal of Preventive Medicine, 38(1), 74–77.CrossRefPubMedPubMedCentralGoogle Scholar
  69. Wang, C., & Burris, M. (1994). Empowerment through Photo Novella: Portraits of participants. Health Education and Behavior, 21(2), 171–186.CrossRefGoogle Scholar
  70. Whitaker, R. C., Wright, J. A., Pepe, M. S., Seidel, K. D., & Dietz, W. H. (1997). Predicting obesity in young adulthood from childhood and parental obesity. New England Journal of Medicine, 25(337), 869–873.CrossRefGoogle Scholar
  71. Wilson, D. K. (2009). New perspectives on health disparities and obesity interventions in youth. Journal of Pediatric Psychology, 34(3), 231–244.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Jerica M. Berge
    • 1
  • Katharine Didericksen
    • 2
  • Michaela Bucchianeri
    • 3
  • Shailendra Prasad
    • 1
  • Dianne Neumark-Sztainer
    • 3
  1. 1.Department of Family Medicine and Community HealthUniversity of Minnesota Medical SchoolMinneapolisUSA
  2. 2.Child Development and Family RelationsEast Cardina UniversityGrennvilleUSA
  3. 3.Division of Epidemiology and Community HealthSchool of Public Health, University of MinnesotaMinneapolisUSA

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