ABSTRACT
OBJECTIVE: To evaluate the effects of behavioral, family-based treatment on disordered eating and child behavior problems for obese 8- to 12-year-old children. STUDY DESIGN: We examined disordered eating in children and parents using the Kids' Eating Disorder Survey (KEDS) and the Binge Eating Scale, respectively; and psychologic problems in children and their parents using the Child Behavior Checklist and Symptom Checklist-90, respectively, in 47 families who participated in a family-based obesity treatment program. RESULTS: Obese children showed significant decreases (-12.5 +/- 13.5) in percent overweight, internalizing problems (-7.0 +/- 7.3), and total behavior problems (-4.8 +/- 6.6) and increases in behavioral competence (3.7 +/- 5.0) over 2 years of measurement; and their parents showed significant decreases in weight (-5.0 +/- 8.3 kg) and reductions in parental distress (-2.3 +/- 7.6) and in disturbed eating and weight-related cognition (-3.2 +/- 5.3). No significant changes were observed in total KEDS (-0.2 +/- 1.9), weight dissatisfaction (-0.3 +/- 1.7), or purging/restricting (0.2 +/- 0.6) scores. Decreases in total KEDS were related to decreases in total behavior problems and externalizing behavior problems. CONCLUSIONS: These results document improvements in child behavior problems and competence and no change in symptoms of disordered eating in a standardized behavioral weight control program.
Subject(s)
Feeding Behavior , Feeding and Eating Disorders/psychology , Obesity/psychology , Obesity/therapy , Body Mass Index , Child , Child Behavior Disorders/diagnosis , Feeding and Eating Disorders/diagnosis , Female , Humans , Male , Multivariate Analysis , Problem Solving , Surveys and QuestionnairesABSTRACT
OBJECTIVE: The present study investigated whether making access to sedentary activities contingent on physical activity would increase physical activity. DESIGN: Experimental. PARTICIPANTS: Thirty-four obese children aged 8-12 y were randomized to one of three groups in which children had to accumulate 750 or 1500 pedometer counts to earn 10 min of access to video games or movies, or to a control group in which access to sedentary behaviors was provided noncontingently. MEASUREMENTS: Physical activity in the 20 min experimental session was measured by electronic pedometer and triaxial accelerometer (ie TriTrac(R)). Activity liking was measured by visual analog scales. Anthropometric and demographic characteristics were also assessed. RESULTS: Children in the 750 and 1500 count contingency groups engaged in significantly more physical activity and spent more time in moderate intensity activity or higher compared with controls. Children in the Contingent 1500 group engaged in more activity and spent more time in moderate or greater intensity activity compared to children in the Contingent 750 group. CONCLUSION: Findings suggest that contingent access to sedentary activities can reinforce physical activity in obese children, and changes in physical activity level depend in part on the targeted physical activity goal.
Subject(s)
Child Behavior/psychology , Exercise/psychology , Feedback , Obesity/therapy , Reinforcement, Psychology , Child , Female , Humans , Male , Obesity/prevention & control , Obesity/psychologyABSTRACT
This study randomized obese children from 67 families to groups that received a 6-month family-based behavioral weight-control program plus parent and child problem solving, child problem solving, or standard treatment with no additional problem solving. The standard group showed larger body mass index (BMI) decreases than the parent + child group through 2 years, with significant differences in the percentage of children who showed large BMI changes. Significant statistical and clinical improvements were observed over time in child behavior problems and parental distress. Parent problem solving increased in the parent + child condition relative to the other conditions, whereas child problem solving increased equally in all conditions. The bulk of evidence suggests that problem solving did not add to treatment effectiveness beyond the standard family-based treatment.
Subject(s)
Behavior Therapy/methods , Family Therapy/methods , Obesity/therapy , Problem Solving , Weight Loss , Adult , Body Mass Index , Child , Female , Humans , Male , Obesity/psychology , Parent-Child Relations , Treatment OutcomeABSTRACT
BACKGROUND: The relationship between maternal feeding practices and weight status of 7-12 year-old obese and nonobese siblings was evaluated in 18 families using a discordant sibling design. METHOD: Mothers completed measures of concern and perception of children's weight and eating behavior, their control over child feeding, and maternal eating behavior. RESULTS: Intraclass correlations suggested similarity between obese and nonobese siblings in maternal control over feeding. Mothers perceived differences between their obese and nonobese children's eating regulation. Mothers' weight status was positively associated with disinhibition of their own eating as well as concern about both their obese and nonobese children's weight and health. DISCUSSION: These findings fail to support the hypothesis that maternal control over child feeding is related to childhood obesity, but highlight the impact of maternal weight history and eating habits on her impression of children's future weight and health independent of the child's weight status.
