Obesity is an important risk factor for cardiovascular diseases and non-insulin-dependent diabetes, which are chronic diseases that afflict American Indians and Alaska Natives today. Because American Indians are not represented in most national health and nutrition surveys, there is a paucity of data on actual prevalence of obesity in American Indians. We estimated prevalence of overweight and obesity for American Indian adults, school-age children, and preschool children from existing data. The prevalence of obesity in adults was estimated from self-reported weights and heights obtained from a special survey of American Indians performed as part of the 1987 National Medical Expenditure Survey. Prevalence of obesity in American Indians was 13.7% for men and 16.5% for women, which was higher than the US rates of 9.1% and 8.2%, respectively. Obesity rates in American Indian adolescents and preschool children were higher than the respective rates for US all-races combined.

Purpose of the Review: Children with obesity experience disordered eating attitudes and behaviors at high rates, which increases their risk for adult obesity and eating disorder development. As such, it is imperative to screen for disordered eating symptoms and identify appropriate treatments. Recent findings: Family-based multicomponent behavioral weight loss treatment (FBT) is effective at treating childhood obesity and demonstrates positive outcomes on psychosocial outcomes, including disordered eating. FBT utilizes a socio-ecological treatment approach that focuses on the development of individual and family healthy energy balance behaviors as well as positive self- and body-esteem, supportive family relationships, richer social networks, and the creation of a broader environment and community that facilitates overall physical and mental health. Summary: Existing literature suggests FBT is an effective treatment option for disordered eating and obesity in children. Future work is needed to confirm this conclusion and to examine the progression and interaction of obesity and disordered eating across development to understand the time for optimal intervention.

Sleep patterns and quality are associated with severity of overweight/obesity and various weight-related behaviors. Promoting a consistent sleep schedule throughout the week may be a worthwhile treatment target to optimize behavioral and weight outcomes in adolescent obesity treatment.

Obesity in adults has nearly doubled in the past 30 years and has risen similarly in children and adolescents. Obesity affects all systems of the body and the serious health consequences of obesity include an increased risk for cardiovascular disease, such as type 2 diabetes or high blood pressure, which are occurring at ever younger ages. The present article provides an introduction to traditional, behavioral weight loss strategies designed to change energy-balance behaviors (i.e., dietary and physical activity behaviors) and the contexts within which these interventions have typically been delivered. The applicability of findings from behavioral economics, cognitive processing, and clinical research which may lead to more potent weight loss and weight loss maintenance interventions are also considered. Given the pervasiveness of obesity, this paper concludes with a discussion of efforts towards wider-scale dissemination and implementation of behavioral treatments designed to address obesity and to reduce the risk of cardiovascular disease.

Objective Children with overweight/obesity have elevated eating disorder (ED) pathology, which may increase their risk for clinical EDs. The current study identified patterns of ED pathology in children with overweight/obesity entering family-based behavioral weight loss treatment (FBT), and examined whether children with distinct patterns differed in their ED pathology and zBMI change across FBT. Methods Before participating in 16-session FBT, children (N=241) completed surveys/interviews assessing ED pathology [emotional eating, shape/weight/eating concerns, restraint, and loss of control (LOC)]. Shape/weight concerns and LOC were also assessed post-treatment. Child height/weight were measured at baseline and post-treatment. Latent class analysis identified patterns of ED pathology. Repeated-measures ANOVA examined changes in zBMI and ED pathology. Results Four patterns of ED pathology were identified: Low ED Pathology, Shape and Weight Concerns, Only Loss of Control, and High ED Pathology. Shape/weight concerns decreased across treatment, with highest decreases in patterns characterized by high shape and weight concerns. All groups experienced significant decreases in zBMI; however, children with the highest ED pathology did not achieve clinically significant weight loss. Conclusions ED pathology decreased after FBT, decreasing ED risk. While all children achieved zBMI reductions, further research is needed to enhance outcomes for children with high ED pathology.