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.


Sedentary Behavior Weight Management Stimulus Control Parenting Training Adolescent Obesity 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



Body mass index weight/height2 (kg/m2)


Randomized–controlled trial



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.


  1. Abraham C, Michie S. Health Psychol. 2008;27:379–87.PubMedCrossRefGoogle Scholar
  2. 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
  3. Baranowski T, Cullen KW, Nicklas T, Thompson D, Baranowski J. Obes Res. 2003;11(Suppl Oct):23S–43S.PubMedCrossRefGoogle Scholar
  4. Baumeister RF, DeWall CN, Ciarocco NJ, Twenge JM. J Personal Social Psychol. 2005;88:589–604.CrossRefGoogle Scholar
  5. Bouchard C. Am J Clin Nutr. 2009;89:1494S–501S.PubMedCrossRefGoogle Scholar
  6. Braet C, Tanghe A, Decaluwé V, Moens E, Rosseel Y. J Pediatr Psychol. 2004;29:519–29.PubMedCrossRefGoogle Scholar
  7. Cote MP, Byczkowski T, Kotagal U, Kirk S, Zeller M, Daniels S. Int J Qual Health Care. 2004;16:165–73.PubMedCrossRefGoogle Scholar
  8. Dobson KS, Dozois DJA. In: Dobson KS, editor. Handbook of cognitive-behavioral therapies. New York: Guilford; 2001. p. 3–39.Google Scholar
  9. Duffy G, Spence SH. J Child Psychol Psychiatry. 1993;34:1043–50.PubMedCrossRefGoogle Scholar
  10. Epstein LH, Wing RR, Koeske R, Valoski A. Behav Ther. 1985;16:345–56.CrossRefGoogle Scholar
  11. Epstein LH, Valoski AM, Vara LS, McCurley J, Wisniewski L, Kalarchian MA, Klein KR, Shrager LR. Health Psychol. 1995;14:109–15.PubMedCrossRefGoogle Scholar
  12. Epstein LH, Paluch RA, Gordy, CC, Saelens BE, Ernst, MM. J Consult Clin Psych. 2000a;68:717–21.CrossRefGoogle Scholar
  13. Epstein LH, Paluch RA, Gordy CC, Dorn J. Arch Pediat Adol Med. 2000b;154:220–6.Google Scholar
  14. Epstein LH, Roemmich JN, Stein, RI, Paluch, RA, Kilanowski CK. Ann Beh Med. 2005;30:201–9.CrossRefGoogle Scholar
  15. Germann JN, Kirschenbaum DS, Rich BH. J Pediatr Psychol. 2006a;32:111–21.PubMedCrossRefGoogle Scholar
  16. Germann JN, Kirschenbaum DS, Rich BH, O’Koon JC. J Adoles Health. 2006b;39:553–61.CrossRefGoogle Scholar
  17. Golan M, Fainaru M, Weizman A. Int J Obes. 1998;22:1217–24.CrossRefGoogle Scholar
  18. Golan M, Kaufman V, Shahar DR. Br J Nutr. 2006;95:1008–15.PubMedCrossRefGoogle Scholar
  19. Johnston CA, Tyler C, McFarlin BK, Poston WSC, Haddock K, Reeves R, Foreyt JP. Pediatrics 120: 2008;e1450–7.CrossRefGoogle Scholar
  20. Kahn BE, Wansink B. J Consum Res. 2004;30:519–33.CrossRefGoogle Scholar
  21. Kalavainen MP, Korppi MO, Nuutinen OM. Int J Obes. 2007;31:1500–8.CrossRefGoogle Scholar
  22. Kirschenbaum DS, Germann JN, Rich BH. Obes Res. 2005;13:1527–9.PubMedCrossRefGoogle Scholar
  23. Lobstein T, Baur L, Uauy R. Obes Rev. 2004;5(Suppl 1):4–104.PubMedCrossRefGoogle Scholar
  24. McLean N, Griffin S, Toney K, Hardeman W. Int J Obes. 2003;27:987–1005.CrossRefGoogle Scholar
  25. Moens E, Braet C. Behav Res Ther. 2007;45:1357–68.PubMedCrossRefGoogle Scholar
  26. 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
  27. Reinehr T, Widhalm K, l’Allemand D, Wiegand S, Wabitsch M, Holl RW. Obesity 2009;17:1196–9.PubMedGoogle Scholar
  28. Remick AK, Polivy J, Pliner P. Psychol Bull. 2009;135:434–51.PubMedCrossRefGoogle Scholar
  29. Rhee K. Ann Am Acad Polit Sci. 2008;615:11–37.CrossRefGoogle Scholar
  30. Saelens BE, Sallis JF, Wilfley DE, Patrick K, Cella JA, Buchta R. Obes Res. 2002;10:22–32.PubMedCrossRefGoogle Scholar
  31. Schwartz MB, O’Neal Chambliss H, Brownell KD, Blair SN, Billington C. Obes Res. 2003;11:1033–9.PubMedCrossRefGoogle Scholar
  32. Spiegelman BM, Flier JS. Cell 2001;104:531–43.PubMedCrossRefGoogle Scholar
  33. Stice E. Psychol Bull. 2002;128:825–48.PubMedCrossRefGoogle Scholar
  34. Suisman JL, Slane JD, Burt A, Klump KL. Eating Behav. 2008;9:493–6.CrossRefGoogle Scholar
  35. Wansink B, Cheney MM. JAMA 2005;293:1727–8.PubMedCrossRefGoogle Scholar
  36. 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
  37. Zeller MH, Boles RE, Reiter-Purtill J. Int J Obes. 2008;32:1474–80.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.Discipline of Paediatrics and Child HealthUniversity of SydneySydneyAustralia
  2. 2.Weight Management ServicesThe Children’s Hospital at WestmeadWestmeadAustralia

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