Girls Benefit from Obesity Program

Harvard researchers reported last week that an obesity prevention program tested in Massachusetts middle schools may be preventing more than just obesity—the curriculum appears to be stopping nascent eating disorders as well, at least among girls.

Compared to girls in middle schools without obesity prevention programs, the study found a two-thirds decrease in self-induced vomiting and the abuse of diet pills and laxatives among girls at schools that implemented a two-year health program called “5-2-1-Go!”

“The protective effect we found for girls was very strong,” said lead author S. Bryn Austin, an assistant professor at both Harvard Medical School and the Harvard School of Public Health (HSPH). “It cut the risk for girls by two-thirds, that’s really quite large.”

Yet boys in the health program did not demonstrate any measurable reduction in the unhealthy weight control behaviors—a result that surprised the authors of the study.

“We don’t know the answer to that, and that’s definitely one of the top areas that we want to go in our research,” Austin said. “What we need to be able to do is to extend the protective effect to boys as well.”

Approximately 4 percent of both girls and boys in the control group reported taking up unhealthy weight control behavior during the two-year study.

Though such behaviors do not necessarily indicate that a child has an eating disorder, they often presage full-blown eating disorders.

The researchers measured the incidence of unhealthy weight control behavior by analyzing questionnaires completed by the middle school students in the study, which raises the possibility of students not providing fully accurate information.

“As researchers, we’re always concerned about [reporting bias],” Austin said. “But because it was a randomized controlled trial—six [schools] received the intervention and seven got the usual education—we’d expect that would help make them very similar.”

According to Maria F. Bettencourt, who directs the Nutrition and Physical Activity Unit at the Massachusetts Department of Public Health, the state is expanding similar obesity prevention programs in its public schools.

“114 schools across the state in different communities have implemented Healthy Choices, which is a version of 5-2-1-Go!” Bettencourt said. “It’s been expanded, so we now strongly recommend the 5-2-1 message.”

The program’s name, 5-2-1-Go!, stands for the goals of five fruits and vegetables, no more than two hours of TV, and one hour of physical activity every day. The curriculum incorporates separate programs from HSPH and the Centers for Disease Control.

—Staff writer Clifford M. Marks can be reached at cmarks@fas.harvard.edu.