The Impact of Exercise Consultation on Activity Levels and Metabolic Markers in Obese Adolescents: A Pilot Study

Obesity rates in Canadian children have tripled over the past three decades [1]. This trend is concerning, given that obese children tend to become obese adults [2–7], putting them at risk for coronary artery disease, type 2 diabetes mellitus, and other chronic conditions [3–8]. Physical activity represents an essential element in energy balance through enhanced energy expenditure. Behavioral lifestyle modification programs have been promising in terms of weight reduction in obese youth [9, 10]. Previous studies have considered the use of physical activity counseling interventions as an effective and inexpensive method of enhancing physical activity with long-term benefits [11–13].Exercise consultation is a structured form of physical activity counseling based on the transtheoretical model [14–17], combining both motivational interviewing and cognitive behavioral approaches to promote activity [18]. In a randomized controlled trial involving adults with type 2 diabetes, exercise consultation was associated with a sevenfold increase in activity levels from baseline over a 6-month period [19]. To our knowledge, no study has evaluated this approach in an adolescent population. The purpose of this pilot study was to assess whether exercise consultation would increase physical activity levels, lead to a progression in stage of readiness to change in exercise behavior, as well as improve anthropometric measures and metabolic markers in obese adolescents over a 3-month period.Obese adolescents aged 14 to 18 years were recruited over a 9-month period (July 2005 to March 2006) from 4 outpatient clinics at CHU (Centre Hospitalier Universitaire) Ste-Justine (Montreal, Canada), including the endocrinology, diabetes, nutrition, and lipid clinics. For the purpose of this study, obesity was defined as a BMI greater than or equal to the 95th percentile for age (2000 CDC growth charts). Written informed consent was obtained from all participants and their parents. This study receive