Is family‐based behavioral weight control appropriate for severe pediatric obesity?

Levine, Michele D.; Ringham, Rebecca; Kalarchian, Melissa A.; Wiśniewski, L; Marcus, Marsha D.

doi:10.1002/eat.1091

Cited by 185 publications

(160 citation statements)

References 25 publications

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“…This goes along with the habit, picked up by families and health professionals involved, to refer to the programme as the 'Traffic Light Diet'. Importantly, and in line with previous research (Epstein et al, 2001;Levine et al, 2001), there was no change in items assessing eating pathology and therefore no indication that the programme increased risk of eating disorders.…”

Section: Discussionsupporting

confidence: 83%

Family-based behavioural treatment of obesity: acceptability and effectiveness in the UK

et al. 2005

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Objective: To assess the acceptability and impact of family-based behavioural treatment (FBBT) for childhood obesity in a clinical setting in the UK. Design: Pre-and post-treatment assessment for four consecutive treatment groups. Setting: Treatment groups took place at Great Ormond Street Hospital, London. Patients: Participants were 33 families with obese (BMI X98th centile for age and sex) children aged 8-13 years. Intervention: FBBT was delivered over 12 sessions. Main outcome measures: Overweight (percentage BMI), self-esteem, mood and eating attitudes were assessed before and after treatment; overweight was re-assessed at 3-month follow-up for those who completed treatment. Results: The FBBT programme materials translated easily to the UK setting and the programme was well-liked by participants. Twenty-seven out of 33 families (82%) completed the sessions. Children lost 8.4% BMI over the time of treatment, and this was maintained at 3-month follow-up. Self-esteem and depression improved significantly and there was no change in food preoccupation, anorexia or bulimia on the ChEAT. Conclusions: These results establish that FBBT is feasible and acceptable in a clinical setting in Britain. They indicate that significant loss of overweight can be achieved using the programme without adverse psychological consequences.

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Section: Discussionsupporting

confidence: 83%

Family-based behavioural treatment of obesity: acceptability and effectiveness in the UK

et al. 2005

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“…Children and adolescents who are severely obese (BMI > 97th percentile) may show poorer treatment outcomes than moderately obese or overweight youth (Danielsson et al, 2012;Levine, Ringham, Kalarchian, Wisniewski, & Marcus, 2001;Nemet, Ben-Haim, Pantanowits, & Eliakim, 2013). Research has thus begun to examine the effectiveness of interventions in severely obese populations.…”

Section: Treatment Of Severe Obesitymentioning

confidence: 99%

Evidence Update on the Treatment of Overweight and Obesity in Children and Adolescents

Altman

Wilfley²

2014

Journal of Clinical Child & Adolescent Psychology

140

149

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Childhood obesity is associated with increased medical and psychosocial consequences and mortality and effective interventions are urgently needed. Effective interventions are urgently needed. This article reviews the evidence for psychological treatments of overweight and obesity in child and adolescent populations. Studies were identified through searches of online databases and reference sections of relevant review articles and metaanalyses. Treatment efficacy was assessed using established criteria, and treatments were categorized as well-established, probably efficacious, possibly efficacious, experimental, or of questionable efficacy. Well-established treatments included family-based behavioral treatment (FBT) and Parent-Only Behavioral Treatment for children. Possibly efficacious treatments include Parent-Only Behavioral Treatment for adolescents, FBT-Guided SelfHelp for children, and Behavioral Weight Loss treatment with family involvement for toddlers, children, and adolescents. Appetite awareness training and regulation of cues treatments are considered experimental. No treatments are considered probably efficacious, or of questionable efficacy. All treatments considered efficacious are multicomponent interventions that include dietary and physical activity modifications and utilize behavioral strategies. Treatment is optimized if family members are specifically targeted in treatment. Research supports the use of multicomponent lifestyle interventions, with FBT and Parent-Only Behavioral Treatment being the most widely supported treatment types. Additional research is needed to test a stepped care model for treatment and to establish the ideal dosage (i.e., number and length of sessions), duration, and intensity of treatments for long-term sustainability of healthy weight management. To improve access to care, the optimal methods to enhance the scalability and implementability of treatments into community and clinical settings need to be established.

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“…32,33 Short-term weight loss has been achieved in randomized, controlled trials involving various strategies including diet, control, and exercise. 32,34,35 These strategies include calorie and fat reduction, low carbohydrate diet, reduction of sedentary behaviors, and participation in structured, vigorous physical activity.…”

Section: Relative Effectivenessmentioning

confidence: 99%

Treatment of adolescents with morbid obesity with bariatric procedures and anti-obesity pharmacological agents

Um¹,

Slusser²,

DeUgarte

2011

OAS

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Adolescent obesity is a growing health concern that can have immense physical and psychological impact. Treatment of morbidly obese adolescents should include a multidisciplinary team to address medical comorbidities, diet, physical activity, mental health, and behavior modification. Anti-obesity pharmacologic agents have a limited role in the treatment of adolescents because of concerns with side effects, safety, and efficacy. Orlistat (GlaxoSmithKline, Moon Township, PA) is the only approved medication for weight-loss in adolescents. However, it is associated with gastrointestinal side effects and its long-term efficacy is unknown. Bariatric surgery is the most effective therapy to treat morbid obesity. However, adolescents must meet rigorous criteria and have appropriate cognitive, psychological, and social clearance before being considered for surgical intervention. Gastric bypass remains the gold standard bariatric operation. The adjustable gastric band is not FDA-approved for use in patients under 18 years of age. Sleeve gastrectomy is a promising procedure for adolescents because it avoids an intestinal bypass and the implantation of a foreign body. Prospective longitudinal assessment of bariatric surgery procedures is required to determine long-term outcomes. In this manuscript, we review the treatment options, efficacy, and impact on quality of life for morbidly obese adolescents.

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Is family‐based behavioral weight control appropriate for severe pediatric obesity?

Cited by 185 publications

References 25 publications

Family-based behavioural treatment of obesity: acceptability and effectiveness in the UK

Family-based behavioural treatment of obesity: acceptability and effectiveness in the UK

Evidence Update on the Treatment of Overweight and Obesity in Children and Adolescents

Treatment of adolescents with morbid obesity with bariatric procedures and anti-obesity pharmacological agents

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