Importance of Age for 3-Year Continuous Behavioral Obesity Treatment Success and Dropout Rate
Division of Pediatrics, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden. Obesity Facts
(Impact Factor: 2.25).
03/2012; 5(1):34-44. DOI: 10.1159/000336060
To assess whether first year weight loss, age, and socioeconomic background correlate with the success rate of continuous long-term behavioral obesity treatment.
In a 3-year longitudinal study, obese children (n = 684) were divided into three groups based on age at the start of treatment, age 6-9 years, 10-13 years, and 14-16 years. RESULTs: The mean BMI standard deviation score (BMI-SDS) decline was age-dependent (p = 0.001), independently of adjustment for missing data: -1.8 BMI-SDS units in the youngest, -1.3 in the middle age group, and -0.5 in the oldest age group. SES and parental BMI status did not affect the results. 30% of the adolescents remained in treatment at year 3. There was only a weak correlation between BMI-SDS change after 1 and 3 years: r = 0.51 (p < 0.001). Among children with no BMI-SDS reduction during year 1 (n = 46), 40% had a clinically significantly reduced BMI-SDS after year 3.
Behavioral treatment should be initiated at an early age to increase the chance for good results. Childhood obesity treatment should be continued for at least 3 years, regardless of the initial change in BMI-SDS.
Available from: Paulina Nowicka
- "With infants and toddlers, parents can make all feeding decisions and respond to the child with a simple yes or no; responding to a preschooler's food demands, however , is more complex. The preschool age is therefore a crucial time in which parents develop communication about food with their children; indeed, previous studies have shown that obesity interventions may be most effective in the preschool age range[14,15]. The preschool age is a time when distinct eating behaviors are formed. "
[Show abstract] [Hide abstract]
ABSTRACT: Insight into parents’ perceptions of their children’s eating behaviors is crucial for the development of successful childhood obesity programs. However, links between children’s eating behaviors and parental feeding practices and concerns have yet to be established. This study aims to examine associations between parental perceptions of preschoolers’ eating behaviors and parental feeding practices. First, it tests the original 8-factor structure of the Child Eating Behavior Questionnaire (CEBQ). Second, it examines the associations with parental feeding practices, measured with the Child Feeding Questionnaire (CFQ).
Available from: Mark J Van Ryzin
- "From a clinical perspective, our results suggest that family-centered interventions such as the FCU can have a positive impact on family processes, which may in turn impact adolescent health in a manner that is carried forward into adulthood, even if the program does not include components related to nutrition or physical activity. This is especially promising as targeting obesity in adolescents through traditional means (focusing on obesity-related behaviors) continues to produce very modest results (Danielsson et al., 2012). As noted by Gerards and colleagues (2011), few obesity prevention and intervention programs address broader aspects of parenting, and our findings can spur the development of new programs by suggesting specific mechanisms by which the family can influence adolescent and early-adult health. "
[Show abstract] [Hide abstract]
ABSTRACT: We explored family processes in adolescence that may influence the likelihood of obesity in early adulthood using a randomized trial of a family-based intervention (the Family Check-Up, or FCU). The FCU has been shown to reduce escalations in antisocial behavior and depression in adolescence by supporting positive family management practices, but no research has examined the mechanisms by which the FCU could influence health-related attitudes and behaviors linked to obesity. Participants were 998 adolescents (n = 526 male; n = 423 European American; M age 12.21 years) and their families, recruited in 6th grade from 3 middle schools in the Pacific Northwest. We used structural equation modeling (SEM) and an Intent-To-Treat (ITT) design to evaluate the direct and indirect effects of the FCU on parent-youth relationship quality (ages 12-15), healthy lifestyle behaviors, eating attitudes, depressive symptoms (all measured at age 17), and obesity (age 22). We found that the FCU led to greater parent-youth relationship quality, which predicted enhanced health-related behaviors, reduced maladaptive eating attitudes, and reduced depression. In turn, reduced maladaptive eating attitudes predicted reduced odds of obesity. The indirect effect of the FCU on obesity by way of parent-youth relationship quality and eating attitudes was significant. Our findings illustrate how family processes may influence adolescent health and suggest that family functioning may be an additional factor to consider when developing intervention programs for obesity. (PsycINFO Database Record (c) 2013 APA, all rights reserved).
Available from: Eva Gronowitz
Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's impact factor and does not reflect the actual current impact factor. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.