Effects of a dialectical behavior therapy-based skills group intervention for obese individuals: a Brazilian pilot study.

PURPOSE: This pilot study aimed to analyze the effects of an adapted dialectical behavior therapy (DBT) skills training group on problematic and adaptive eating behaviors in Brazilian obese individuals. METHODS: Thirty-one obese individuals were randomly assigned to 10 sessions of adapted DBT skills training (n = 14) or two months of a waiting list comparison condition (n = 17). RESULTS: Attrition rates were similar to what's been found in comparable studies, with most dropouts happening at the beginning of the treatment. Results showed improvements in binge eating severity (d = 0.80) and depression (d = 0.82) compared to no treatment condition. After the intervention, adaptive eating and distress outcomes showed an improvement trend, reaching nonclinical levels for most participants in the intervention group. Large to moderate between-group effect sizes were observed, but none of those were statistically significant. Large within-group effect sizes were observed in the intervention group in binge eating severity (d = 1.34), intuitive eating (d = 1.33) and depression (d = 1.12). Medium effect sizes were observed in emotional eating (d = 0.73) and in emotion regulation (d = 0.72). Despite positive outcomes in other variables, mindful eating worsened after the intervention (d = 0.66). CONCLUSIONS: These results are preliminary and require further replications with larger samples, yet they suggest that the intervention may be useful to improve distress outcomes and adaptive eating among obese people. Implications for clinical practice and recommendations for future research are discussed. LEVEL OF EVIDENCE: Level I, randomized controlled trial.

Weight loss interventions for overweight and obese adolescents: a systematic review.

PURPOSE: To determine what factors contribute to the efficacy of non-drug treatments designed to promote weight loss in overweight and obese adolescents. METHODS: Data sources Medline/PubMed; Psychinfo; EMBASE; Web of Science (ISI); and Cochrane Central Register of Controlled Trials. Study selection Randomized clinical trials of treatments for obesity and overweight in adolescents aged 10-19 years with a minimum duration of 2 months. Data extraction 115 of the 12,948 publications retrieved met eligibility criteria and 26 were included in the final sample. Period of extraction January 2004 to November 2014. RESULTS: The Delphi list was used to evaluate the methodological quality of the studies (M = 5.58, SD = 1.027). There was considerable variability between the interventions, but they were all multifactorial, with components such as nutritional education, physical activity, family support and psychological therapy. The number of contacts with subjects during the course of the intervention was a predictor of treatment efficacy when the groups were compared. Limitations This systematic review was limited to trials reported in English and by the lack of methodological rigor and shortcomings in reporting in the studies reviewed. CONCLUSIONS: Multidisciplinary interventions including family support and guided behavior modification appear to be effective methods of reducing BMI in overweight and obese adolescents.