Research published today on bmj.com reports that a new computerized device that can track portion size and how fast people eat, is more successful in helping obese children and adolescents lose weight than standard treatments.

Developed at the Karolinska Institute in Stockholm, the Mandometer device is a portable computerized weighing scale. It is used to retrain individuals to eat less and more slowly by providing real-time feedback during meal times. A graph is plotted by the device showing the rate at which food actually disappears from the plate. It is compared to the ideal graph programmed in by a food therapist.

Childhood obesity is an increasing global problem. Furthermore, there is little evidence to support one particular treatment program. In this study the patients ate large portions very rapidly. However, it is unclear whether specific eating patterns are common in all obese people.

Professor Julian Hamilton-Shield led researchers at Bristol Royal Hospital for Children and the University of Bristol. The team carried out a randomized controlled trial. A total of 106 obese patients participated. They were aged between 9 to 17 years.

They were divided in two groups. One group of participants received Mandometer therapy to lose weight. The other group was provided with standard care. Both groups were encouraged to increase their levels of physical activity to 60 minutes of exercise a day. They were motivated to eat a balanced diet based on the Food Standards Agency “eatwell plate.”

After 12 months participants were assessed. There was a follow-up evaluation at 18 months. During the research period they were also monitored on a regular basis. They were also offered telephone support and encouragement.

After one year, results showed that the Mandometer group had a significantly lower average body mass index and body fat score than the standard care group. In addition, their portion size was smaller and their speed of eating was reduced by 11 percent compared with a gain of 4 percent in the other group. Levels of ‘good cholesterol‘ were also significantly superior in the Mandometer group.

Six months after the end of treatment, the improvement in body mass index was maintained. The authors remark that this suggested an element of longer term behavioral change.

The researchers say: “Mandometer therapy, focusing on eating speed and meal size, seems to be a useful addition to the rather sparse options available for treating adolescent obesity effectively without recourse to pharmacotherapy.”

They grant that the Mandometer requires additional evaluation in other settings and with different groups of patients, but they say in closing: “Retraining eating behavior and reinforcing feelings of satiety, however, does seem to improve weight loss in obese adolescents.”

“Treatment of childhood obesity by retraining eating behaviour: randomised controlled trial”
Anna L Ford, research nurse, Cecilia Bergh, CEO of Mando Group AB, Per So¨dersten, professor, Matthew A Sabin, RCH Foundation clinical research fellow, Sandra Hollinghurst, senior lecturer, Linda P Hunt, senior lecturer, Julian P H Shield, professor
BMJ 2010; 340:b5388
doi:10.1136/bmj.b5388
bmj.com

Written by Stephanie Brunner (B.A.)