The influence of preschoolers' emotional and behavioural problems on obesity treatment outcomes: Secondary findings from a randomized controlled trial

Abstract

Summary Background Few studies have explored the influence of preschoolers' behavioural problems on obesity treatment. Objectives To assess emotional and behavioural problems before and after an obesity intervention and examine relationships between changes in child behaviour and changes in weight status. Method The study included 77 children (4‐6 years old, 53% girls, mean body mass index [BMI] z‐score of 3.0 [SD 0.6]) who participated in the More and Less Study, a randomized controlled trial. Families were randomized to a parenting program or to standard treatment. The children's heights and weights (BMI z‐score, primary outcome) were measured at baseline and 12 months post baseline. Parents rated their children's behaviours (secondary outcome) on the Child Behavior Checklist (CBCL) for ages 1.5 to 5 years, a questionnaire that measures psychosocial health and functioning, encompassing emotional and behavioural problems. Changes in child behaviour during treatment were examined through paired samples t tests; the influence of child behaviour on treatment effects was examined through linear regressions. Results Child emotional and behavioural problems significantly improved after obesity treatment. Lower scores were found for Emotional Reactivity, Sleep Problems, Affective Problems, Aggressive Behaviour, Externalizing Behaviours, Oppositional Defiant Problems, and Total Problems. Child behaviour significantly affected obesity treatment results: Attention Problems and attention deficit hyperactivity disorder (ADHD) at baseline contributed to increasing BMI z‐scores, whereas Oppositional Defiant Problems, Externalizing Behaviours, and a higher number of behavioural problems predicted decreasing BMI z‐scores. Conclusions Child behaviours at baseline influenced treatment results. Child emotional and behavioural problems improved post treatment. The results suggest that obesity treatment may help in reducing emotional distress among preschoolers.

Psychological predictors of family-based behavioral treatment response in a diverse sample of youth with obesity.

“…The lack of impact of attention concerns on FBBT treatment response was surprising given the impact of ADHD on the planning and organizational skills that are advantageous for health behavior change (Eiffener et al, 2019). Notably, a relatively small proportion (i.e., 5%) of youth in this study had elevated parent-reported attention concerns compared to the prevalence of ADHD in pediatric obesity populations (i.e., 8.3–23.6%; Cortese & Tessari, 2017).…”

Repercussões clínicas, endócrinas e psicológicas da obesidade infantil: uma revisão de literatura / Clinical, endocrine and psychological repercussions of childhood obesity: an literature review

“…Para intervenção correta e efetiva é importante detectar precocemente o ganho excessivo de peso na infância, pois o comportamento alimentar inicia-se na fase préescolar e influenciará os hábitos alimentares na adolescência e na vida adulta (MELO KM, et al, 2017). A família constitui o espaço mais íntimo de vivências, principalmente na faixa etária infantil, sendo o pilar para o desenvolvimento da criança e do futuro adulto, tendo papel fundamental na identificação e auxílio no tratamento dos distúrbios psicossociais (EIFFENER E, et al, 2019). A influência dos pais no comportamento infantil é essencial, pois as crianças tendem a se espelharem nos seus genitores, por isso, práticas alimentares saudáveis e a inserção de atividade física diária, já são consideradas um bom início para a prevenção da obesidade (SILVA GAP, et al, 2016).…”

Psychotherapie bei juveniler Adipositas: gerechtfertigt und sinnvoll?

“…Erste Studien haben gezeigt, dass sich psychische Probleme auf den Erfolg von Gewichtsreduktionsprogrammen bei Kindern und Jugendlichen auswirken, wenn auch die Befundlage aufgrund der unterschiedlichen Interventionen und Designs heterogen ist (Zusatzmaterial online). Harcourt et al (2019) berichteten, dass verstärkte Verhaltensprobleme sowie Hyperaktivität einen geringeren Gewichtsverlust während eines einjährigen ambulanten Gewichtsreduktionsprogramms prädizieren, während nach vergleichsweise kürzeren ambulanten Programmen (8 bis 10 Wochen) externalisierende Verhaltensprobleme mit einem höheren Gewichtsverlust direkt zu Interventionsende (Blomquist et al 2018) oder zur Jahreskatamnese (Eiffener et al 2019) einhergingen. Andere Autoren fanden keine Effekte initialer psychischer Probleme auf den Gewichtsverlauf zur Ein-bzw.…”

“…B. vermittelt über emotionales Essverhalten) und auch der Impulskontrolle betonen (Warschburger und Petermann 2008). Zum Einfluss der Veränderung psychischer Probleme auf den Gewichtsverlauf liegt gemäß dem Wissen der Autoren des vorliegenden Beitrags nur eine weitere Studie (Eiffener et al 2019) vor. Diese fand, dass sich eine Reduktion von Ängsten und Depressivität ungüns-tig auf die zeitgleiche Gewichtsreduktion auswirkt.…”