An inpatient cognitive-behavioral nondiet approach is a promising treatment option for childhood obesity, with lasting effects throughout the 14-month posttreatment.

Differences in eating styles between overweight and normal-weight youngsters were investigated with a child version of the Dutch Eating Behavior Questionnaire (DEBQ). Subjects were children (n=1458; M: 10.1; SD=1.3) and adolescents (n=1016; M: 14.9; SD=1.5). Overweight adolescent girls scored high on emotional eating while overweight adolescent boys displayed more external eating. In overweight children, already 10.5 per cent displayed emotional eating and 38.4 per cent reported external eating. All overweight youngsters reported restrained attitudes. Eating styles were positively associated with indicators of eating pathology. The results suggest the use of appropriate norms that take into account the child's age, gender and overweight status.

Self-reports and observations provide complementary information on how parents interact with their overweight children. Family-based treatment programs should include discussions on the adequate amount of parental control and support.

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Familial factors have moderate ability to predict children's weight status. There is a need to identify other familial mechanisms taking into account developmental and temporal evolutions over the past decade.

Objective This study presents an 8-year outcome of overweight children who were treated in an outpatient program and aims to identify child and familial variables associated with longterm weight regulation. Methods A total of 90 children participated with a mean age of 10.1 years ± 2.6 at baseline and a mean adjusted BMI (actual BMI/50 th percentile of BMI for age and gender x 100) of 153.1 ± 20.7% at baseline participated in the 8-year follow-up (retrieval rate 71%; response rate 89%). Children's and parental factors, administered at baseline and at follow-up were related to the success of the treatment. Results The children obtained a mean reduction of 8% in adjusted BMI at the 8-year follow-up. A total of 59 children (66%) were successful in obtaining weight control (i.e. maintaining their original % adjusted BMI); 40% even decreased their adjusted BMI by 10% or more. Analyses revealed that the child's age, the degree of overweight at baseline and the child's global self-worth were positive predictors of long-term weight loss 8 years after treatment, whereas psychopathology in the mother was a negative predictor. The total explained variance was R² = 35%. Discussion Treatment of childhood obesity by means of a multidisciplinary cognitive behavioural program enables the majority of children to control their weight in the long term. In order to predict the success of the treatment, it is recommended to take into account the child's age, its degree of overweight, its global self-worth and the occurrence of maternal psychopathology.

The findings highlight the importance of assessing the emotional bond between mother and child and the emotion regulation of the youngster in the treatment of pediatric obesity.