A Cognitive Behavioural Intervention for Overweight and Obese Adolescents Illustrated by Four Case Studies

Abstract

This article reports four case studies illustrating the implementation of the ChooseHealthProgram, a cognitive behavioural lifestyle intervention for overweight and obese adolescents. Participants were an overweight (12 years) and obese (15 years) female, and an overweight (14 years) and obese (12 years) male. The program was delivered by provisional psychologists with program specific training and supervision. All participants demonstrated improvements in body composition, and maintained or improved dietary quality and psychosocial wellbeing. The program had variable effects on physical activity and minimal effect on cardiovascular fitness for three of the four participants. While parents and adolescents required considerable assistance to develop and monitor long term program goals, these goals were a useful clinical tool to support the adolescent and parent to recognise the improvements they had made. Identification and monitoring of specific, measurable, and realistic behaviour change strategies was particularly important in assisting adolescents and their parents to translate session information into improved health behaviours. Results indicate that an adolescent overweight and obesity treatment program that promotes adolescent responsibility and autonomy, and emphasises the importance of parent support and family change is both effective and highly acceptable to both adolescents and parents.

Physical Activity and Obesity Research in the Asia-Pacific

“…There were no studies from the Pacific Islands. We found that 5 studies concentrated on children, 8,14-17 3 on youth, 18-20 6 on adults, 21-26 and 2 on older adults. 13,27 In 3 of these studies, all the participants were female, 23,25,27 whereas in the other studies participants represented both genders.…”

“…Some studies that examined the impact of PA (38%) also assessed body composition. 13,17,18,21,26,27 Blood pressure was measured in 6 studies (38%). 13,20,21,23,24,26 PA was either measured directly using accelerometers 8,18 or indirectly through questionnaires.…”

“…Only a few studies examined psychological measures. The study by Brennan et al 18 included the largest number of psychological variables—anxiety, stress, depression, and self-esteem. Other studies only included 1 psychosocial measure.…”

“…Studies examining ways to increase PA in Asia-Pacific populations included 1 study with children 28 and 2 with adults. 29,30 Sample size in the impact studies varied from 4 in the case study of Brennan et al 18 to 5126 in the school-based intervention undertaken by Sirikulchayanonta et al 16 The participants in several studies on children and youth also included parents: for example, studies by Brennan et al 18 and O'Connor et al 20 on the impact of PA and by Chotibang et al, 28 which also included teachers, school administrators, cafeteria staff, and vendors in their intervention to increase PA. The participants in some studies on adults had health conditions in addition to obesity, including schizophrenia, 22 osteoarthritis, 25 and insulin resistance.…”

“…13,17,18,21,26,27 Blood pressure was measured in 6 studies (38%). 13,20,21,23,24,26 PA was either measured directly using accelerometers 8,18 or indirectly through questionnaires. 16,20 A number of studies included blood biochemistry measurements, including cholesterol, glucose, and insulin (38%).…”