The Houston Texans TwEAT Healthy program : using professional athletes as role models to prevent adolescent obesity

The objective of this study was to examine the effects of using professional athletes or registered dietitians (RD) as role models to modify diet/exercise behaviors and weight status in overweight/obese adolescents. The overall hypothesis of this study was that professional athletes could more effectively change diet/exercise behaviors in overweight/obese adolescents due to their representation of a physically active lifestyle, high adolescent identification, ability to popularize ideals, broadly distribute information and influence social norms. The Houston Texans TwEAT Healthy program was a 12-week social media delivered program where adolescents received text messages (3x/wk) and video messages (2x/wk) from either a professional athlete (n=16) or registered dietitian (n=14). They were assessed for anthropometrics (height, weight, waist circumference), percent body fat, diet/exercise behaviors, weight status and psychological mediators of behavioral change pre- and post- intervention to determine changes. Adolescents, parents and athletes were interviewed post-intervention to examine feasibility/acceptability of the program. Subjects (n=30) paired with a professional athlete were significantly more likely to report something positive about their mentor than those paired with an RD (80% vs. 7%, p<0.001). Participants paired with an athlete were significantly more likely to decrease consumption of sugar sweetened beverages (SSB) t(27)=1.82, p=0.08, but the registered dietitian group was significantly more likely to decrease BMI z-score t(28)=-2.99, p=0.006. Additionally, registered dietitians were more effective at increasing stages of change for physical activity than athletes t(28) = 2.12, p < .05. Both RD’s and athletes were effective at significantly increasing motivation to be healthy, t(13) =2.56, p < .05; t(15) = 2.03, p < .10. While professional athletes may improve acceptability of a social media delivered weight loss program, they do not appear to be more effective than RD’s at influencing psychosocial mediators of behavioral change and weight status. Although both groups increased motivation to be healthy, only RD’s were able to influence weight status. Behaviorally based interventions should include a longer intervention time frame and larger sample size to allow for more robust changes. Utilizing role models who may be perceived as experts in the field of healthy eating and weight loss appear to be more effective mentors than utilizing public figures that solely represent that lifestyle.