Treating Obesity in Childhood: Behavioral Considerations
There is strong evidence that the inclusion of behavioral interventions in childhood obesity treatment results in better outcomes than usual care, and should be a key component in treatment programs. The core behavioral interventions which have been used in treatment of childhood obesity include self-monitoring, stimulus control, reinforcement, goal setting, behavioral contracting, and preplanning. These techniques are best used in a program which includes the whole of the family, and where parents are taught behavioral change techniques and also change their own behavior. Training in behavioral techniques should be considered for all health professionals involved in obesity treatment, as should the involvement of psychologically trained health professionals. Despite these advances, many questions remain to be answered. These include which particular behavioral change techniques work best, under what conditions, with which patients, and at what stage in treatment. Additionally, the impact of patient factors (such as child and family characteristics) and treatment factors (such as service quality, health professional characteristics, timing of treatment, etc.) on treatment outcome are not well understood at this stage. A greater understanding of these remaining questions would benefit clinicians in deciding the best treatment approach for their particular patient group.
KeywordsSedentary Behavior Weight Management Stimulus Control Parenting Training Adolescent Obesity
Body mass index weight/height2 (kg/m2)
We thank Ms Gerri Minshall, Weight Management Clinical Psychologist at The Children’s Hospital at Westmead, for her very helpful comments upon drafts of the manuscript.
- Asay TP, Lambert MJ. In: Hubble MA, Duncan BL, Miller SM, editors. The heart and soul of change: what works in therapy? Washington, DC: American Psychological Association; 1999. p. 33–56.Google Scholar
- Dobson KS, Dozois DJA. In: Dobson KS, editor. Handbook of cognitive-behavioral therapies. New York: Guilford; 2001. p. 3–39.Google Scholar
- Epstein LH, Paluch RA, Gordy CC, Dorn J. Arch Pediat Adol Med. 2000b;154:220–6.Google Scholar
- Oude Luttikhuis H, Baur L, Jansen H, Shrewsbury VA, O’Malley C, Stolk RP, Summerbell CD. Cochrane Database Syst Rev. 2009; Issue 1. Art. No.: CD001872. doi:10.1002/14651858.CD001872.pub2.Google Scholar
- World Health Organization. Diet, nutrition and the prevention of chronic diseases: report of a joint WHO/FAO expert consultation. WHO technical report series: 916. Geneva: WHO; 2003.Google Scholar