Behavioural treatments of childhood obesity

A meta-analysis of family-behavioral weight-loss treatments for children

Childhood obesity is a major concern in the United States. Because children's diets can be significantly influenced by parental behavior (e.g., food purchases, meal preparation), researchers have included family intervention components in some childhood weight-loss programs. The relative benefits of adding the family component have not been well-established. This meta-analysis compared the mean effect sizes of family-behavioral, other treatment, and control weight-loss groups for children. A comprehensive literature review identified 16 studies with a total of 44 treatment groups. Results indicated that interventions containing a family-behavioral component produced larger effect sizes than the alternative treatment groups. This demonstrates that the inclusion of a family component may be advantageous to a child's weight-loss treatment.

The effectiveness of cognitive self-management as an adjunct to a behavioural intervention for childhood obesity: a research note

This study investigated the effectiveness of cognitive self-management training as an adjunct to the behavioural management of childhood obesity. Twenty-seven overweight children aged 7-13 years were randomly assigned to either behavioural management plus relaxation placebo or a combined behavioural-cognitive self-management approach. Evaluations following the eight treatment sessions revealed a significant reduction in percentage overweight for children in both experimental groups and improvements were maintained at 3- and 6-month follow-ups. Both conditions were also effective in reducing the number of high-risk foods consumed. No difference in outcome was found between treatments at the post-treatment assessment or 3- and 6-month follow-ups. Although a reduction in percentage overweight of around 9% was found for both procedures, subjects in general remained considerably overweight.

Behavioural treatment of somatic disorders in children and adolescents

During the past decade the field of behavioural medicine has developed rapidly and several somatic disorders in adults have been successfully treated. By contrast, the effects of behavioural interventions of somatic disorders in paediatric populations have been examined less extensively in controlled outcome research. The present review concerns the promising development and application of behavioural methods in the treatment of various somatic disorders in children and adolescents. The studies reviewed were required to be conducted on an individual or group basis and, in addition, to employ quasi-experimental or experimental designs. It is concluded that of psychological treatments, primarily behavioural approaches have proven to be effective for childhood disorders such as obesity, nocturnal enuresis and recurrent headaches. Further, in the treatment of recurrent abdominal pain and asthma in children, behavioural approaches have shown promising outcomes. This progress should alert the clinician and personnel in health care facilities to the contributions of behavioural paediatrics so that behavioural treatment methods may be utilized where appropriate.

Behavior therapy with children and adolescents: a twenty-year overview

A twenty-year overview of behavior therapy with children and adolescents is presented. The various techniques and their application to relevant major DSM-III-R categories are critically discussed. It is concluded that behavior therapy has made great progress and has proven applications in child and adolescent disorders but that its precise roles, comparative efficacy, and complementarity to other forms of psychotherapy and other treatments remain to be demonstrated. Much uncertainty stems from the relatively poor state of research in other forms of psychotherapy.

Emotional health of families and their members where a child is obese

A controlled study of families with an obese child showed a small but significantly greater impairment in family functioning when this was elicited and rated using clinical methods. However no significant impairment was found when functioning was elicited with standardized objective methods. Mothers of obese children rated their families as more dysfunctional than mothers of control children. Although the emotional health of individual members in obese families was not worse than in control families, significant differences in the family patterning of emotional health were found. The more overweight the obese child, the healthier the mother rated the family, and the better her own mental health as assessed by a self-report method; and in families of obese girls, the greater the degree of overweight, the worse the rated family functioning. The findings are integrated with the literature and a theoretical explanation in which obesity is seen as an identity disturbance is offered.