Integrating pediatric obesity treatment into clinical practice.

Abstract

Childhood obesity has reached epidemic proportions in the United States and other industrialized nations. Despite the significant psychosocial consequences, mental health professionals have been reluctant to provide direct treatment for these children and their parents. The author proposes a practice model for agency, clinic, and private settings, with the mental health practitioner as primary clinician. On the basis of intervention research methodology, the model presents consensus generalizations and clinical applications for evaluation and treatment. A typology of diagnostic profiles with corresponding strategies for combining diet, activity, and mental health interventions is included.

Born Fat

“…With regard to clinical applications, the present results found that the popular belief that weight is almost entirely genetic and uncontrollable is associated with poor health. Psychologists, physicians, dietitians, and other health care providers might have the opportunity to discourage the belief that weight is uncontrollable or emphasize the importance of other motivations for healthful eating and exercise (Panzer, 2006). By fighting the perception that weight is unchangeable, health care providers may be able to increase healthful behaviors among their patients.…”

“…Rising rates of obesity are one of the most important public health concerns in the United States (Flegal, Carroll, Kit, & Ogden, 2012; Panzer, 2006; Throp, Owen, Neuhaus, & Dunstan, 2011; Y. C. Wang, McPherson, Marsh, Gortmaker, & Brown, 2011; White House Task Force on Childhood Obesity Report to the President, 2010) and abroad (Karnik & Kanekar, 2012; Y.…”

Enhancing Childhood Obesity Treatment

“…Three clinical diagnoses-attention-deficit hyperactivity disorder, 5 oppositional defiant disorder, and depression 4 -have been correlated with childhood obesity, and other conditions such as anxiety and developmental disorders are observed clinically to co-occur with excess weight among youth. 6 In actuality, any childhood disorder involving poor self-regulation (ie, obsessive-compulsive disorder, pervasive developmental disorder) or emotional eating (ie, overanxious disorder, posttraumatic stress disorder, dysthymia) could lead to an energy imbalance. Nonpsychiatric constructs such as impaired self-esteem and diminished quality of life 7,8 can also accompany and complicate overweight and obesity.…”

“…A recent treatment typology proposes a matrix of 4 clinical profiles, 2 of which involve the dual diagnosis of psychosocial problems and excess weight. 6 Whether weight maintenance or reduction is indicated, both groups may require a variety of counseling formats (individual, group, family, etc), as well as psychotropic medication when indicated.…”