Evidence-Based Behavioral Treatment of Obesity in Children and Adolescents

The Children's Weight Clinic PO Box 28533, Edinburgh EH4 2WW, Scotland, UK.
Child and adolescent psychiatric clinics of North America (Impact Factor: 2.88). 02/2009; 18(1):189-98. DOI: 10.1016/j.chc.2008.07.014
Source: PubMed


Obesity is the most common childhood disease and is widely acknowledged as having become a global epidemic. Well-recognized health consequences of childhood obesity exist, both during childhood and adulthood, affecting health and psychological and economic welfare. The importance of finding effective strategies for the management of childhood obesity has international significance with the publication of various expert reports and evidence-based guidelines in recent years.

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    • "Obesity is recognized as a worldwide heath problem that is on the rise in both adults and children (Ogden et al., 2006; Stewart, Reilly, & Hughes, 2009). Such problem has been associated with a range of physical and psychological symptoms, therefore many obesity treatment guidelines have been considered (Clapham, Arch, & Tadayyon, 2001; Ogden & Flanagan, 2008). "
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    ABSTRACT: The ability of chitosan to entrap large amounts of water when dispersed in an oily phase was utilized to formulate a novel meal replacement functional food. Furthermore, the proposed preparation can be fortified with nutrients. The purpose of this formulation was to produce an edible low calorie pseudo-fatty rich meal that can enhance the feeling of satiety when ingested. Different concentrations of chitosan and pectin were tested to find out a stable preparation with acceptable physical characteristics. It was found that a preparation containing 1% chitosan and 6% pectin is suitable to be consumed as a meal replacement diet. The safety of such preparation was assessed by repeated dose administration to rats. A set of other in vivo experiments was performed to assess the ability of this preparation to enhance satiety. The ingestion of chitosan preparation resulted in reduced body weight, food and water intake, and reduced faecal excretion in the emulsion administered rats (p < 0.05). Furthermore, serum lipids of tested rats were not essentially changed. Accordingly, the investigated chitosan emulsion could be introduced as a low calorie, relatively stable and a safe functional food preparation for enhancing satiety when ingested as a meal replacement diet.
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    • "The parental readiness to change may be classified as pre-contemplation (no intention to change), contemplation (considering to make the change, but not yet committed), preparation (intention to change), action (modifying behavior), and maintenance (maintaining the behavior change). Only the children of parents willing to change should be enrolled into BT programs.[31] "
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    ABSTRACT: Obesity is a major public health problem and is implicated in the rising prevalence of cardiac disease and type 2 diabetes mellitus in India. Management of an obese patient includes therapeutic lifestyle changes of increasing physical activity and reducing calorie intake. This combination can result in about a 10% loss of initial body weight. To reinforce this intervention, behavioral therapy needs to be incorporated into the overall intervention under the belief that obesity is a result of maladaptive eating behaviors and exercise patterns. This review explains the principles of behavioral therapy, including the underlying assumptions and characteristics. The common components of behavioral therapy for obesity are explained. The different settings where behavioral therapy can be administered are mentioned. The review focuses on how behavioral therapy can be incorporated in the routine clinical management of obesity by primary and secondary care physicians who encounter obese patients.
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    ABSTRACT: The prevalent surge in childhood and adolescent obesity within the past 3 decades poses a significant challenge for many pediatric clinicians who are charged with treating this condition. Comprehensive, research-based pediatric obesity treatment programs are essential to addressing this problem and preventing the transition of obesity and its many comorbidities into adulthood. This paper will identify dietary, physical activity, and behavioral approaches to lifestyle change and describe how they are incorporated as part of multidisciplinary treatment interventions in youth. Specific tailoring of treatment programs to address age and varying degrees of overweight and obesity will also be presented along with recommendations for future research.
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