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

Abstract

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.

Effects of an Intensive Lifestyle Intervention to Treat Overweight/Obese Children and Adolescents

“…The prevention and the treatment of childhood obesity is complex and requires a multicomponent approach involving the family and addressing individual and social aspects [18], focusing not only on physical activity but also on nutrition and enhancing motivation toward a healthy lifestyle [19–22]. …”

Motivational Interviewing to Treat Overweight Children: 24-Month Follow-Up of a Randomized Controlled Trial

“…Despite the encouraging short-term effect, evidence of long-term efficacy is required. 16,17 In this article, we report the results of the follow-up conducted 12 months after the end of intervention.…”

Determinants of self-regulation in obesity: formation of implicit food preferences

“…The practical recommendation for individuals with obesity trying to lose weight is to develop and implement behavioral strategies to strengthen self-regulation through efficient use of cognitive resources (Ramage, Farmer, Apps, & McCargar, 2014;Altman & Wilfley, 2015). Future studies should address specific ways in which motor behavior could help in establishing automatic tendencies supporting weight loss and improvements in eating habits.…”