Effectiveness of cognitive-behavioral therapy on nutrition improvement and weight of overweight and obese adolescents: A randomized controlled trial

Abstract

To assess the effectiveness of a cognitive-behavioral treatment (CBT) program on weight reduction among Iranian adolescents who are overweight. MethodsUsing a randomized controlled trial design, 55 adolescents who were overweight (mean [SD] age=14.64 [1.69] years; zBMI=2.18 [0.65]) were recruited in the CBT program and 55 in the treatment as usual (TAU; mean age=14.88 [1.50]; zBMI=2.09 [0.57]) group. All the participants completed several questionnaires (Child Dietary Self-Efficacy Scale; Weight Efficacy Lifestyle questionnaire; Physical Exercise Self-Efficacy Scale; Pediatric Quality of Life Inventory; and self-reported physical activity and diet) and had their anthropometrics measured (height, weight, waist and hip circumferences, and body fat). ResultsThe CBT group consumed significantly more fruits and juice, vegetables, and dairy in the 6month follow-up as compared with the TAU group (p-values <0.001). The CBT group consumed significantly less sweet snacks, salty snacks, sweet drinks, sausages/processed meat, and oils in the six-month follow-up compared with the TAU group (p-values<0.001).Additionally, the waist circumference, BMI, waist-hip ratio, and fat mass were significantly decreased in the CBT group in the six-month follow-up compared with the TAU group (p-values<0.005). The CBT group significantly improved their psychosocial health, physical activity, and health-related quality of life (p-values<0.001). ConclusionThe CBT program showed its effectiveness in reducing weight among Iranian adolescents who were overweight. Healthcare providers may want to adopt this program to treat excess weight problems for adolescents. 24 to estimate the duration of mild activities. The duration of each activity was summed up to calculate a weekly amount. The time elapsed during sleep and for each activity is multiplied by a constant number, which was 1 for sleep, 1.5 for light activity, 4 for moderate activity, 6 for hard activity, and 10 for very hard activity. To estimate adolescents' energy expenditure (in kilocalories), the scores are summed. To estimate the average amount of consumed energy on a day from the past week, the score was divided by 7. This questionnaire has been translated into Persian and was found as a useful tool for assessing the level of physical activity (47). Anthropometric measurements and body compositionAll body measurements were performed at the beginning of the study and after six months of the intervention. The weight of each adolescent was recorded using the SECA scale (SECA, Hamburg, Germany) with the least clothes and no shoes (100g accuracy). Height was recorded using a portable 217 SECA (SECA GmbH, Hamburg, Germany) with a precision of 0.1cm, when the heel was against the wall and the face was towards the researcher. The body mass index (BMI) was calculated with weight divided by the height in square meters. The anthropometric index of Z-scores for height-for-age, weight-for-age, and BMI-for-age were calculated as indicators of growth status for the children using Anthroplus softw...

Effects of Lifestyle Modification Interventions to Prevent and Manage Child and Adolescent Obesity: A Systematic Review and Meta-Analysis

“…Family based therapy where parents and children are actively involved in making healthier nutrition and physical activity choices is one of the most robust interventions for childhood obesity [58]. Complementing family based therapy with CBT where individuals are encouraged to change attitudes and behaviors that sustain a current behavior have also proven to be beneficial in this age group [59]. Thus, a comprehensive "body and mind" intervention may result in a greater impact on improving body composition [60].…”

La intervención psicológica de la obesidad: desarrollo y perspectivas

“…El tratamiento cognitivo-conductual empleado en todos los estudios analizados suele centrarse fundamentalmente en promover hábitos saludables de alimentación y actividad física. Los resultados indican que este tipo de intervención no solo reduce el peso u otras variables antropométricas, como el IMC, la masa grasa o la relación cadera-cintura (Miri et al, 2019), sino que también mejora aspectos de índole psicológica, como una mayor autoeficacia (Baños et al, 2019) o el bienestar psicológico (Roth et al, 2011), psicosociales, así como aquellos vinculados directamente con la salud, como la percepción de la calidad de vida (Weinreich et al, 2017). Algunos programas psicológicos no emplean la terapia cognitivo-conductual sino otro tipo de intervenciones, como la terapia de aceptación y compromiso, si bien suelen incluir técnicas de modificación de hábitos, propias de la intervención conductual, como las empleadas en el estudio de Tronieri et al (2019), en el que se observaron mejorías en el peso de los pacientes pero también cambios a nivel cognitivo y psicosocial.…”

Síndrome metabólico en la edad pediátrica: ¿qué sabemos hasta el momento?

“…KEYWORDS: metabolic syndrome; pediatric; primary health care; obesity; primary prevention. 1 Médica general, graduada de la Universidad de Costa Rica (UCR). Cód.…”